Under the Pradhan Mantri Jan Arogya Yojana (PMJAY), which offers low-income households health insurance coverage, the Gujarat government unveiled new Standard Operating Procedures (SOPs) for hospitals on Monday. Following a scam at Khyati Multi-Speciality Hospital, where needless medical procedures, including angioplasties, were performed in order to get false insurance benefits under the PMJAY plan, these instructions were issued. The state government took action when it was claimed that the scam was a factor in the deaths of at least two patients in November.
The new initiatives, which are aimed at raising standards in a number of medical specialties, including as cardiology, cancer, and neonatal care, were introduced by Health Minister Rushikesh Patel. Preventing malpractice and maintaining the integrity of medical operations are the goals. Patel underlined that every facet of patient care has been taken into account in order to prevent any possible illicit activity in the medical field.
The requirement for video-recorded permission for important medical procedures including cancer surgeries, organ transplants, angioplasty, and angiography is a significant reform. This Clinical Establishment Act-2024 provision aims to ensure that patients and their families are fully informed about the treatment they are going to receive by bringing accountability and transparency to the consent process.
Hospitals must now hire full-time cardiologists and cardiothoracic surgeons to provide cardiology services and make critical care choices. This guarantees that in urgent circumstances, trained specialists—rather than general practitioners—are in charge of patient treatment. Similar to this, the recommendations for oncology require that medical, surgical, and radiation oncologists form tumor boards in order to jointly decide on cancer treatment strategies. In order to ensure high-quality care rather than depending on outside suppliers, hospitals that offer specialized cancer treatments like brachytherapy must have their own facilities.
There is also more stringent regulation of neonatal care services. While maintaining patient privacy, hospitals are required to install CCTV cameras in neonatal intensive care units (NICUs). Pediatricians are now required to work full-time, and the number of nursing staff members must match the number of patient beds. To guarantee compliance, taluka health authorities would conduct routine monitoring.
The rules also require hospitals to closely adhere to government infection control procedures and give patients diagnostic reports and discharge summaries. A State Anti-Fraud Unit (SAFU) has been established by the state to supervise the application of these laws.
More than 72.79 lakh claims totaling ₹15,562 crore have been processed since PMJAY was introduced. Nevertheless, a number of claims have been denied or modified to account for fraud. With 99% of responders expressing pleasure, patient feedback has been extraordinarily favorable despite these difficulties.
These new rules are a part of continuous efforts to make sure PMJAY fulfils its mission of eradicating fraudulent activities and offering vulnerable communities high-quality, reasonably priced healthcare.
SOURCE :
HINDUSTAN TIMES
