Master list of 2,179 medical procedures drafted
To check misuse of health insurance schemes, the Government has drafted a list of over 2,179 medical treatment procedures — including those under general surgery, gynaecology and obstetrics, orthopaedics, physiotherapy, endoscopic and heart-related diseases for which one can avail the insurance benefits.
It will be used as a master list of procedures under various Government and private insurance schemes, said a senior Union Health Ministry official.
This, he said, "has been done after it was found that the hospitals as well as many insurance companies were at their whims and fancies exploiting the insurance schemes with unnecessary procedures".
It was also leading to confusion and complications about whether some procedures were included or not, he added.
The master list has been drafted in consultation with the private and public agencies like CGHS, RSBY, Rajiv Arogyasree, Indian Medical Association, Health Institutions, FICCI, private insurance schemes etc.
Once the list is finalised, for which comments and suggestions are being sought from the public and stakeholders, the medical treatment procedures covered under any insurance scheme should be from it only.
As per the official, over 300 procedures under general surgery, more than 120 ENT surgery procedures, around 150 procedures under gynaecology and obstetrics, 200 under orthopaedics, several procedures under physiotherapy, surgical gastroenterology, endoscopic procedures have been enlisted.
Also, cardiothoracic surgery, paediatric surgery, neurosurgery, ophthalmology, surgical oncology, medical oncology, radiation oncology, plastic surgery, cochlear implant surgery (CIS), prosthesis, dental surgery, critical care, general medicine, infectious diseases, paediatrics, cardiology, pulmonology and dermatology are among in the list.
The official noted that even minor procedures like dressing of wounds, removal of stitches, sterl puncture etc, injection for haemorrhoids , injection for varicose veins, catheterisation and many other medical treatments have been included in the list.
Fast look
This has been done after it was found that the hospitals as well as many insurance companies were at their whims and fancies exploiting the insurance schemes with unnecessary procedures
Over 300 procedures under general surgery, more than 120 ENT surgery procedures, around 150 procedures under gynaecology and obstetrics, 200 under orthopaedics, several procedures under physiotherapy, surgical gastroenterology, endoscopic procedures have been enlisted