Hospital group seeks regulator as insurance disputes mount

Association of Healthcare Providers, India (AHPI) has warned insurers over health insurance practices, issuing notices to Bajaj General, Care Health and Star Health threatening to suspend cashless services across member hospitals, a move targeted more towards bringing insurers to the negotiating table.

- Deepti Bhaskaran

AHPI accuses insurers of resisting tariff revisions, suspending cashless facilities and rejecting claims. However, insurers deny the charges, and the General Insurance Council has criticised AHPI’s stance. In an interview with Mint, director general, AHPI, Girdhar J. Gyani talks about issues that strain hospital-insurer relations. Excerpts:

AHPI’s warning to Star Health Insurance is the third such public warning. Why?

Insurerstry to cartelize with the sole aim of reducing rates at our member hospitals. We tell them that to compensate for medical inflation, hospitals would also like to revise tariffs every 2-3 years. It can’t be that the 2017 or 2019 rates continue. To put pressure,their tactics include suspending cashless facilities or refusing to empanel bonafide new hospitals, thus forcing member hospitals to accept lower rates. Private insurers target hospitals collectively, raising frivolous issues to abruptly stop cashless services. Ultimately, patients vent their frustration at hospitals.

Isn't AHPI following the same playbook: threatening to revoke cashless services to bring insurers on the negotiating table?