The Modified Guidelines on Standardization in Health Insurance Business issued by the Insurance Regulatory and Development Authority of India (IRDAI) on November 26, this year, is likely to block the growth of the Ayush industry and institutions in India, according to manufacturers and practitioners.
The regulatory authority has issued the new guidelines to all insurance companies and third party agencies (TPAs) in India.
As per the modified guidelines, the insured patients can claim for reimbursement of their treatment expenses only if they take treatments from institutions certified by National Accreditation Board for Hospitals and Healthcare Providers (NABH) or institutions obtained State Level Certificate under National Quality Assurance Standards (NQAS) issued by National Health Systems Resource Centre (NHRC). All the institutions must comply with the requirements within 12 months of notification of the modified guidelines, says the circular issued by IRDAI.
According to sources from Ayush sector, the insurance companies will settle the reimbursement claims only to those patients who were admitted and treated either in NABH accredited hospitals or state level accredited institutions.
Unlike allopathic health institutions, there are very few number of Ayush hospitals which have obtained NABH accreditation. In certain states, respective governments have launched state level accreditation programs. Institutions which have obtained higher level certificates of such agencies are also eligible to admit patients under the insurance claim scheme. But less than ten hospitals have obtained this accreditation in any state in India.
Talking to Pharmabiz on the implications of the new guidelines of the IRDAI, Dr. MM Sanal Kumar, president of Kerala Ayurveda Cooperative Society in Kozhikodu, said Kerala government has formed Kerala Accreditation Standards for Hospitals (KASH) to ensure delivery of an optimum level of services. About 12 Ayush hospitals in the state have these credits. But more than 600 hospitals and same number of Ayush Day Care Centres are working all over Kerala. If IRDAI’s modified guidelines are to be complied, all the institutions, except the accredited centres, will have to be closed down as no patient will come to the hospitals for treatment, he says.
He wanted the government of Kerala to give KASH certifications to maximum number of Ayurveda hospitals to withstand the crisis due to the IRDAI guidelines and considering their services to the society all these years.
Further, Dr. Sanal Kumar said these guidelines will adversely impact on the manufacturing sector. If medicines are not sold or the patients do not want to purchase, all the MSME industrial units of Ayurveda will vanish from the sector before long. In a letter to the state health minister, on behalf of the Ayurveda Cooperative Society, a society of Ayush drug manufacturers in northern Kerala, he said immediate attention of the state government is required in this matter.
Click here to read all the modified guidelines: