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Mediclaim Scheme: Government Joins Hands with Third Party Administrator

The government has tied-up with a third-party administrator (TPA) in a bid to cut costs on the implementation of its universal Mediclaim scheme, Deen Dayal Swashtya Seva Yojna (DDSSY). The directorate of health services (DHS) had extended its contract with M/s United India Insurance Co Ltd, and had not appointed a new agency, despite floating a tender in March. The TPA brought on board will now handle the insurance bills raised under the scheme. However, it is unclear if the government will continue with the present arrangement or curtail it after a few months.

United India Insurance was appointed when the scheme was first launched in September 2016. In March, the health department had floated a tender to select a new agency after the scheme was modified. But some senior government doctors were of the opinion that the Mediclaim scheme should be discontinued as it benefitted empaneled private hospitals. There were also complaints of malpractices by certain hospitals. The scheme was later modified, and a tender was floated three months ago. The number of procedures or interventions also increased from 456, as against 447. But the bidders quoted two or three times more than its present outlay of ₹80 crore towards the scheme. The government expected an increased expenditure by ₹30-40 crore under the revised scheme, an official said. – TOI