Private hospitals demand CGHS Rs 500 crore dues owed to them

Recently, writing to the Union Ministry of Health and Family Welfare, the Association of Healthcare Providers of India (AHPI), a body having huge representations in the medical fraternity, has requested to clear the dues on priority basis.

Apart from this, AHPI has also highlighted in the letter that there are Inordinate delays in making reimbursement to the hospitals and the low rates for reimbursement have not been revised since 2014.

"CGHS covers healthcare facilities extended to around 40 lakh current and retired central government employees and their families. CGHS is one of the key initiatives by the Government of India under which healthcare facilities are extended to central government employees and pensioners, members of Parliament, sitting and former judges of the Supreme Court and high courts, former governors and lieutenant governors, freedom fighters, and certain public sector units, among others. Beneficiaries receive cashless healthcare from empanelled private hospitals, diagnostic centers, and also through government-run wellness centers/ dispensaries, who are later reimbursed by the government," the association mentioned in its release.

Referring to the scheme, Dr. Girdhar J Gyani, Director-General of AHPI opined, "Over the years, the scheme is losing its sheen, both among the healthcare providers as well as the beneficiaries."

Also Read: Demand for revision of CGHS rates exclate: Doctors meet Health Minister

Hospitals have signed agreement effective from 1st October 2014, which has provision to make 70% payment within 5-working days of submission of bills by hospitals.

However, in none of the cases payments have been made within such a stipulated time, pointed out the association. Hospitals have to wait for months and years to get the dues.

It results in pushing hospitals to state of un-sustainability and ultimately, the hospitals are forced to avoid/refuse beneficiaries for treatment.

"We have collected sample data of outstanding from 61-hospitals which have outstanding amount of more than Rs. 500 crores," informed AHPI in its release.

"The continuous and perennial delay in CGHS payments seriously impacts the hospital's cash flow," added Dr. Gyani.

"The hospitals had made several unsuccessful attempts to recover their dues from the ministry of health and family welfare—the nodal ministry for implementing schemes such as the ex-servicemen contributory health scheme (ECHS) and central government health scheme (CGHS)," added the release.

Referring to the matter, the president of AHPI, Dr Alexander Thomas informed media that the association has requested the Ministry of Health and Family Welfare to release the outstanding on priority basis as it badly impacts the financial sustainability of hospitals.

Apart from the pending bills, the letter has also pointed out that the CGHS rates have not been revised since 2014.

Medical Dialogues has repeatedly written about the abysmal rates under the CGHS scheme, the un-viability of which has forced many doctors and hospitals to withdraw from the scheme itself. These rates had been set in 2014 and back then it was Rs 300 as a indoor consultation and Rs 150 as a outdoor consultation. Not just for consultation, the rates for popular procedures are also very low. Normal delivery is paid Rs 9200 (to NABH Hospitals) under CGHS which includes all the services of the hospital as well.

This is n sharp contrast to Rs 50,000 plus being charged currently in Tier 1 cities from private patients. Similarly, one of the basic tests, X-ray chest is priced at Rs 65, where the Institutions claim that even the raw material of film costs more than that.

Last year, the Union Health Minister had assured the representatives on the revision of CGHS rates and a swift action had also been promised by the Ministry in this regard.