Cardiologists from private hospitals in Kolkata have sought a revision of reimbursement rates under Ayushman Bharat PM-JAY for pacemaker implantation, saying the existing package does not adequately cover the cost of newer devices and procedures.
An appeal signed by around 50 cardiologists has been submitted to the state health department and the Union Health Ministry. The doctors have sought changes to the rates to make pacemaker procedures financially viable for hospitals while ensuring that patients covered by the government health scheme continue to receive appropriate treatment.
Under the current Ayushman Bharat package, the cost of a pacemaker is capped at Rs 75,000, while Rs 33,000 is allowed for the implantation procedure. Cardiologists have argued that the device component has remained unchanged since the scheme was introduced in 2018.
Doctors and hospital representatives have pointed to the rising cost of imported pacemakers and changes in currency values as factors affecting procurement. They have also raised concerns about the availability of different types of devices within the existing package.
Pacemakers are implanted in patients with certain heart rhythm disorders and can be life-saving in cases where the heart is unable to maintain an adequate rhythm on its own. The choice of device depends on the patient’s medical condition and clinical requirements.
The cardiologists have therefore sought a review of the package rather than a reduction in the quality or range of devices available to eligible patients.
The issue also highlights the challenge of keeping government health-insurance reimbursement packages aligned with changes in medical technology and treatment costs.
The request is now before the state and central health authorities for consideration. Any revision of the package rates will depend on decisions by the relevant authorities.
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