Rajasthan med association protests shift to insurance-based RGHS

JAIPUR: The Indian Medical Association (IMA) has voiced opposition to the state govt’s proposal to transition the Rajasthan Govt Health Scheme (RGHS) to an insurance-based model. The IMA argues that this move could adversely impact essential services such as outpatient care (OPD) and pharmacy, which are crucial components of the RGHS.

Health minister Gajendra Singh Khimsar announced the intention to shift the scheme to an insurance framework, citing the need to curb fraud and enhance operational efficiency.

IMA vice-president Dr Sunil Chugh, however, criticised the proposal, stating that the insurance model is only suitable for indoor patient department (IPD) services and is ill-equipped to handle the nuances of outpatient care, medication distribution and diagnostics that are vital to the RGHS.

The RGHS has been under considerable strain, primarily due to allegations of fraud and significant unpaid dues owed to private hospitals, amounting to crores. As a result, many private hospitals have begun denying treatment to RGHS beneficiaries, as payments remain unresolved.

Harji Lal Atal, CEO of the Rajasthan State Health Assurance Agency, confirmed Thursday that the state is indeed contemplating the shift to an insurance model.

The move has, however, faced pushback from the private hospital sector, which argues for the reinstatement of the earlier reimbursement system. Under the former arrangement, patients paid hospitals directly for treatment and medications, obtained receipts and subsequently sought reimbursement from the govt.

Dr Vijay Kapoor, president of the Private Hospitals and Nursing Homes Association, emphasised that the reimbursement approach would be more effective than the proposed insurance system, providing a better solution for both patients and healthcare providers.

The ongoing crisis has already led to disruptions in services. Since March 24, private hospitals affiliated with the Rajasthan Alliance of Hospital Associations have halted cashless medicine services in OPD pharmacies under the RGHS, citing non-payment issues. They have now also suspended IPD services in protest against the arrest of a doctor in a case linked to alleged RGHS fraud.

As both OPD and IPD services continue to be affected, RGHS beneficiaries are increasingly facing challenges in accessing necessary medical treatment at private hospitals.Get real-time updates and result insights on the CBSE 12 Result 2026.