Assam Government asks private hospitals to strictly follow IRDA's order

TREATMENT OF COVID-19 PATIENTS

STAFF REPORTER

GUWAHATI: The Assam Government on Thursday asked the private hospitals and nursing homes to strictly follow the order/circular of the Insurance Regulatory and Development Authority of India (IRDA) to alleviate the hardships that may be caused to policyholders for treatment of Covid-19.

The IRDA issued the order/circular on March 4, 2020. The State Government has issued its order after receiving reports that some private hospitals and nursing homes are not admitting patients suffering from COVID-19 even though such patients have insurance cover.

The IRDA's order/circular provides that where hospitalization is covered in a product, insurers shall ensure that the cases related to COVID-19 shall be expeditiously handled. It instructs the insurers to settle the costs of admissible expenses during treatment including the treatment during the quarantine period under the policy contract and the extant regulatory framework, and the order/circular of IRDA also instructs that all claims reported under COVID-19 shall be thoroughly reviewed by the claims review committee before repudiating the claims.

The Thursday's order issued by the Principal Secretary of Health & Family Welfare Department Anurag Goel also quoted the Gauhati High Court observation that all hospitals have to abide by the IRDA's order.

"Therefore, it is directed that all Private Hospitals and Nursing Homes registered under the Clinical Establishment Act shall strictly abide by the order/circular issued by the Insurance Regulatory and Development Authority of India while handling treatment of all COVID-19 cases reported at the hospitals through empanelled Insurance companies. Any aberration and non-compliance shall invite action as per violation/non-compliance of the enabling sections of the Clinical Establishment Act and other provisions of Law.

All Government orders, circulars, advisories including the treatment protocols issued by State & Central Governments for COVID-19 management shall be followed diligently by all hospitals. The Director of Health Services, Assam shall ensure that this order is followed in totality and take immediate action as per provisions of law and also inform State Government in Health & Family Welfare Department if some violations/aberrations are reported," the order of the Health & Family Welfare department reads.

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