Rs 15 lakh aid for treatments out of Ayushman cover

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HT Excerpts: In 2017-18, Rs 40 crores were used from the Rashtriya Arogya Nidhi funds at AIIMS, Delhi for providing free treatment to 926 people, approximately 4.31 lakhs per patient, according to the latest annual report from the hospital.

Poor patients in need of expensive treatment not covered by packages under the Ayushman Bharat insurance scheme will now again be able to get financial assistance of up to Rs 15 lakh under the Rashtriya Arogya Nidhi (RAN) scheme.

The beneficiaries of Ayushman Bharat scheme in need of expensive surgeries like organ and bone marrow transplants, spine surgeries, and revision surgeries for faulty joints became ineligible for assistance under RAN after the guidelines were revised in February last year.

In January, the Delhi High Court had directed AIIMS to treat a poor 11-year-old boy with aplastic anemia for free, with the Central Government reimbursing the cost of treatment, as the disease is not covered under the Central Government’s flagship Ayushman Bharat scheme. This had opened up the way for other patients to approach the court to get financial aid. However, the change in guidelines is a big relief.

I raised this issue on 25th December, 2019

PMOPG/E/2019/0725773

Name Of Complainant

Dr K K Aggarwal, 25/12/2019

Prime Minister’s Office

Discrepancies in Ayushman Bharat and Rashtriya Arogya Nidhi Schemes

Dr KK Aggarwal, President CMAAO and HCFI

I saw a report of Rema Nagarajan in TOI that a 12 years old Sameer from Bihar’s Muzaffarpur is suffering from aplastic anemia, needs Rs 12 lakh for a bone marrow transplant but in spite of being entitled under both Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) and Rashtriya Arogya Nidhi (RAN), he is getting no relief.

The hurdles are that Ayushman Bharat does not cover bone marrow transplant and an office order says that he cannot be covered under Rashtriya Arogya Nidhi (which provides up to Rs 15 lakh coverage for serious illnesses) because he is covered under Ayushman.

The job of the government is to help and not find the loopholes. Government orders cannot supersede the spirit behind the schemes. Its’ like that the rules cannot supersede the act.

I have another patient Mithilesh Kumar from Bokaro, Jharkhand. He is a contract worker. He was operated for implantation of CRTD St. Jude Device pacemaker at CMC, Vellore in 2014. At that time, he managed to arrange the amount for operation by selling his property. Now, battery of the pacemaker is to be replaced. He has Ayushman Bharat card, but it does not cover the expenses of battery replacement. He has written to PM, Narendra Modi for help.

Not covering the battery replacement does not make sense. If you have decided to cover a pacemaker it is understood that the battery would last 5-15 years depending on the type of device and second or third replacement needs to be covered.

Where should a poor man go for the clarifications? Courts are already overloaded with cases. Everyone cannot afford the courts also. Such powers should be given to District Magistrate or the CMO to handle and interpret the government orders in the right spirit.

Dr KK Aggarwal

President CMAAO, HCFI and Past National President IMA

SC seeks response from Rajasthan Govt on plea for probe into over 100 infant deaths in Kota hospital

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Reproduced from: PTI

According to government report, over 100 infants lost their lives at the Kota government hospital in December 2019.

NEW DELHI: The Supreme Court has sought response from the Rajasthan government on a plea that seeks investigation into the death of over 100 infants at a hospital in Kota recently.

A bench of Chief Justice S A Bobde and Justices B R Gavai and Surya Kant issued a notice to the state government on a plea filed by noted doctor, Dr KK Aggarwal, and social worker B Mishra, seeking probe into the death of newborns due to lack of equipment at a government hospital in Kota.

More than 100 infants had died in the Kota hospital recently.

Medical geneticist can do ultrasound

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Order

  1. The petitioner claims that it is a society established to promote awareness in the field of diagnostic ultrasound and to educate and spread awareness amongst general public against female foeticide.
  2. The learned counsel appearing for the petitioner submits that members of the petitioner are all qualified medical doctors.
  3. The petitioner is, essentially, aggrieved by the communication dated 05.10.2018 sent by the respondent, whereby the petitioner’s demand for issuance of a notification permitting MBBS doctors to practice ultrasound under the provisions of Pre-conception and Pre-natal Diagnostic Techniques

(Prohibition of Sex Selection) Act, 1994 (hereafter referred to as ‘PC&PNDT Act’) was rejected. It is the petitioner’s case that MBBS doctors who are qualified as medical geneticists, as defined under Section 2(g) of the PC&PNDT Act, are also entitled to establish ultrasound clinics.

  1. The petitioner relies on the provisions of Rule 3(3)(1) of the Preconception and Pre-Natal Diagnostic Techniques (Prohibition of Sex

Selection) Rules, 1996 (hereafter referred to as ‘PC&PNDT Rules’).

  1. At the outset, it would be relevant to refer to Section 2(g) of the PC&PNDT Act and Rule 3(3)(1) of the PC&PNDT Rules. Section 2(g) of the PC&PNDT is set out below:-

“2(g) “medical geneticist” includes a person who possesses a degree or diploma in genetic science in the fields of sex selection and pre-natal diagnostic techniques or has experience of not less than two years in any of these

fields after obtaining‒

(i) any one of the medical qualifications recognised under the Indian Medical Council Act, 1956 (102 of 1956); or (ii)a post-graduate degree in biological sciences”

  1. Rule 3(3)(1) of the PC&PNDT Rules is set out below: “(3) (1) Any person having adequate space and being or employing (c) A medical geneticist.”
  2. Indisputably, all persons who hold medical qualifications recognised under the Indian Medical Council Act, 1956 and who have the necessary experience of not less than two years in the specified field, would qualify as medical geneticists within the meaning of Section 2(g) of the PC&PNDT Act.
  3. In terms of Rule 3(3)(1)(c) of the PC&PNDT Rules, any person who employs a medical geneticist can set up a genetic clinic/ultrasound clinic/imaging centre.
  4. The petitioner’s demand from the respondent that the latter issue a notification to allow all MBBS doctors to practice ultrasound under the PC&PNDT Act and PC&PNDT Rules has not been acceded to by the respondent.
  5. Mr Mahajan, learned counsel appearing for the respondent, states that insofar as the prayer demanding the issuance of a notification is concerned, there is no provision for doing so and therefore, the decision to reject the same cannot be faulted. Insofar as the reasons for not acceding to the demand are concerned, clearly the same would have to be tested in individual cases, keeping in view their medical qualifications and experience.
  6. In view of the above, the present petition is disposed of by leaving the issue – whether a medical geneticist can operate ultrasound clinics – open to be considered in an appropriate case. The members of petitioner are not precluded from applying for registration with the concerned State Government. The issue whether they are otherwise entitled to practice diagnostic ultrasound will be considered in the given facts of individual cases. It is also clarified that the reasons given by the respondent in the impugned demand would not come in the way of the concerned individuals in making their applications to the concerned authorities, which shall consider the same in accordance with law.
  7. The petition is disposed of with the aforesaid observations. The pending application is also disposed of.

VIBHU BAKHRU, J

MAY 23, 2019/RK

IN THE HIGH COURT OF DELHI AT NEW DELHI

W.P.(C) 3004/2019 and CM APPL. 13896/2019

SONOLOGICAL SOCIETY OF INDIA ….. Petitioner

Through: Mr Khowaja Siddiqui, Mr Arup Sinha and Mr Raghav Kakar, Advocates. Versus UNION OF INDIA ….. Respondent Through: Mr Amit Mahajan, CGSC with Mr Olson Nair, Ms Nidhi Parashar, Mr Shakya Sen and Mr Sanjeev Arora, Advocates.

Dr KK Aggarwal

President CMAAO, HCFI and Past National President IMA

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