The West Bengal Health Scheme has expanded cancer-treatment access for eligible state government employees, pensioners and their dependants by adding five AIIMS centres and fixing reimbursement rates for specialised surgical oncology at empanelled private hospitals, according to a state notification reported by the Times of India.
The newly recognised AIIMS facilities are located in Patna, Guwahati, Kalyani, Bhubaneswar and Deoghar. Beneficiaries covered under the scheme can now seek treatment at these centres without obtaining prior permission. AIIMS New Delhi was already recognised under the scheme.
The decision increases the number of public tertiary-care institutions available to WBHS beneficiaries for treatment outside West Bengal and within the state. The notification does not provide a separate list of procedures or rates in the available report, but says the new schedule is intended to address gaps in the existing WBHS rates, which did not adequately cover several advanced surgical oncology procedures.
Alongside the AIIMS expansion, the state has fixed rates for specialised surgical oncology procedures carried out at private healthcare organisations empanelled under the West Bengal Health Scheme. The revised rates will apply only to facilities that are empanelled under the scheme and hold valid NABH accreditation for surgical oncology.
The admissible cost of treatment will be calculated under multiple heads. Consultation fees will continue to be reimbursed at the existing rates. However, reimbursement will remain subject to the scheme’s existing provisions and will be restricted to the actual amount charged by the healthcare institution or the admissible amount under WBHS, whichever is lower.
The revised oncology rates will not apply to Tata Medical Centre, Chittaranjan National Cancer Institute or the Woodburn ward at IPGMER-SSKM. These institutions have therefore been excluded from the notified rate framework described in the report.
For beneficiaries, the changes address two separate administrative barriers in accessing specialised cancer care: the limited coverage of advanced surgical procedures under the earlier rate structure and the requirement for prior permission when seeking treatment at certain institutions. The notification expands the recognised institutional network while keeping reimbursement subject to the scheme’s existing ceilings and rules.
The addition of AIIMS Kalyani is particularly relevant to beneficiaries seeking treatment within West Bengal, while the inclusion of the centres in Patna, Guwahati, Bhubaneswar and Deoghar extends the scheme’s recognised options across eastern and adjoining regions. The notification also retains AIIMS New Delhi among the recognised facilities.
The state government’s order does not alter the stated exclusion of the three named institutions from the new specialised oncology rates. It also does not remove the condition that private empanelled hospitals must maintain valid NABH accreditation for surgical oncology. Further claims under the revised framework will continue to be assessed against the amount charged and the admissible amount under WBHS, with the lower figure determining reimbursement.
