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Medical Interns' Protests Highlight Stipend Gaps Across India
Confirmed
In Short: In Jammu and Kashmir and Madhya Pradesh, medical interns have launched protests demanding higher stipends, highlighting the wide gap in intern salaries across different states.
Medical interns in Jammu and Kashmir and Madhya Pradesh have launched indefinite protests, demanding that their monthly stipends be increased from Rs 12,300 to Rs 30,000 and from Rs 14,337 to Rs 30,000, respectively. The protests in Madhya Pradesh culminated in a 50% hike in stipends following negotiations, while similar revisions were announced for dental and other medical streams.
The Indian Express reports that interns in Jammu and Kashmir, who were receiving Rs 12,300 a month, secured a 50% increase to Rs 18,450, while those in Madhya Pradesh, initially demanding Rs 30,000, received a 50% hike to Rs 21,668. In Madhya Pradesh, the government's decision to increase stipends was met with a water-cannon action by the police, which eventually led to a resolution.
In other states, similar protests have been ongoing. For instance, interns in Madhya Pradesh, who were receiving Rs 17,000 a month, had demanded Rs 30,000. The government agreed to increase their stipend to Rs 25,000, following which the interns called off their strike. According to reports, some interns are expected to take on additional financial burdens, but the stipend they receive is not sufficient to support a family.
The Centers for Medicare and Medicaid Services (CMS) has released guidance for states to use a "tier system" to determine which Medicaid recipients are too ill to work or volunteer at least 20 hours per week. This guidance, while somewhat encouraging, is still complicated and may not be sufficient for states to implement by the January 1 deadline. The American Medical Association has welcomed the data-driven approach, which could reduce the need for beneficiaries and physicians to submit additional documentation.
What's confirmed
- Medical interns in Jammu and Kashmir and Madhya Pradesh have launched indefinite protests, demanding that their monthly stipends be increased from Rs 12,300 to Rs 30,000 and from Rs 14,337 to Rs 30,000, respectively. The protests in Madhya Pradesh culminated in a 50% hike in stipends following negotiations, while similar revisions were announced for dental and other medical streams.
- The Indian Express reports that interns in Jammu and Kashmir, who were receiving Rs 12,300 a month, secured a 50% increase to Rs 18,450, while those in Madhya Pradesh, initially demanding Rs 30,000, received a 50% hike to Rs 21,668. In Madhya Pradesh, the government's decision to increase stipends was met with a water-cannon action by the police, which eventually led to a resolution.
- In other states, similar protests have been ongoing. For instance, interns in Madhya Pradesh, who were receiving Rs 17,000 a month, had demanded Rs 30,000. The government agreed to increase their stipend to Rs 25,000, following which the interns called off their strike. According to reports, some interns are expected to take on additional financial burdens, but the stipend they receive is not sufficient to support a family.
- The Centers for Medicare and Medicaid Services (CMS) has released guidance for states to use a "tier system" to determine which Medicaid recipients are too ill to work or volunteer at least 20 hours per week. This guidance, while somewhat encouraging, is still complicated and may not be sufficient for states to implement by the January 1 deadline. The American Medical Association has welcomed the data-driven approach, which could reduce the need for beneficiaries and physicians to submit additional documentation.
What's still developing
- The new guidance is “somewhat more encouraging,” said Benjamin Sommers, a primary care provider and professor of medicine at Harvard University, because it allows states to use existing data to automatically exempt people.
- “At the same time, it’s still a fairly complicated approach, and there’s just not much time for states to get this right,” he said.
- Under H.R. 1, passed by Congress last year, states that expanded their Medicaid program must ensure all working-age recipients are meeting the 20-hour-per-week requirement unless they are disabled, caring for young children, or have a serious health condition.
- States aren’t required to use the tier structure, but given the pressure they are under to establish an eligibility-check system by Jan. 1, more flexibility could be helpful.
- The group has been calling on CMS to clarify whether diagnostic codes alone could show medical frailty for seriously ill patients. (If not, doctors would’ve had to do more documentation, which many say is unrealistic.) Now, disease groups are lobbying for better placement in the tier structure.
- It came as a small relief to patient advocacy groups and some medical associations that had criticized “medical frailty” exemptions as confusing and potentially burdensome for patients and medical providers.
- The guidance this week means that, in addition to compiling lists of diagnostic codes that might indicate “medical frailty,” states can tier diagnoses based on how likely they are to impair someone’s ability to work.