IRDAI & NHA propose hospital registry, empanelment process, grading

IRDAI’s joint working group and the National Health Authority (NHA) has recently made proposal of a unique common hospital registry, empanelment process, grading of hospitals and package cost harmonisation with an aim of promoting the standardisation and effective utilisation of health care infrastructure under the insurance programme. Health care schemes and private insurance at present have individual hospital empanelment process, which replicates various activities and contributes to inefficiency and duplication of processes. The Report of Network Hospital Management, prepared by the IRDAI-NHA joint working group states, “It is recommended to have common empanelment portal which can be utilised by all the schemes/insurance companies with standardised empanelment criteria will be hugely beneficial with special focus on standard safety and quality parameters.” It has been recommended by the group that a standard grading system for hospitals, based on the quality parameters should be prepared, and same grading can be used by PMJAY (Pradhan Mantri Jan Arogya Yojana) and the private insurance market. The sub-committee of the group said, “An exercise should be done to agree on these common grading parameters in discussion with National Accreditation Board of Health also.” “This list will be beneficial as a central health facility repository/registration number can be used by various schemes and insurance service providers for identification of the health facilities in geographical areas,” it added. IRDAI has asked insurers to ensure that advertisements of insurance products are clear and do not convey a fabricated sense of security to prospective customers. The IIRDAI in a circular on ‘insurance advertisements’ has prescribed dos and don’ts for insurance companies to comply with.