Private Hospitals Look Forward to Health Ministry Revision of CGHS Crucial Package Rates

New Delhi: After revising the CGHS rates for out-patient and in-patient services and the rates for imaging investigations, the Union Health Ministry is now likely to introduce further revisions in the crucial package rates under the Central Government Health Scheme (CGHS).

The founder and patron of Association of Healthcare Providers India (AHPI), Dr Alexander Thomas informed Medical Dialogues that the Health Ministry officials mentioned about introducing the revision in three phases.

In the first two phases, rates for CGHS consultation fees, ICU charges, room rent, and 36 radiological/imaging investigations were revised. Referring to the possible changes in the CGHS crucial package rates, Dr. Thomas further pointed out how these rates have not changed since 2014.

Revision in the rates of treatment under the Central Government Health Scheme (CGHS) has been a long pending demand by doctors. 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. The rates set in 2014 were Rupees 300 as a indoor consultation and rupees 150 as a outdoor consultation.

Also Read: Health Ministry Revises CGHS Rates for 36 Radiological, Imaging Investigations, details

Not just for consultation, the rates for popular procedures were also very low. Normal delivery was paid Rs 9200 ( to NABH Hospitals) under CGHS which included all the services of the hospital as well. This was in 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 was priced at Rs 65, where the institutions claimed that even the raw material of film cost more than that.

Many of the doctors, especially super-specialists refused to provide services under CGHS due to the low rates. Further, due to delayed processing of their reimbursement claims and long-pending dues, the private hospital had already stopped cashless facilities for CGHS patients and left the program last year.

Taking cognizance of the basic cost of providing healthcare treatments, the Union health ministry had proposed to increase the treatment rates at almost 600 private hospitals that are empanelled with the Central Government Health Scheme (CGHS).

A commission was established by the Union Health Ministry to evaluate the charges imposed on the users, who are primarily active and retired central government officials and their families. Finally, the Union Health Ministry announced its decision of revising the CGHS rates.

Earlier this year, the Union Government revised the CGHS package rates of consultation fees, ICU charges and room rent. Apart from this, the Union Government also simplified the process of referral under CGHS for the benefit of its employees.

After the revision of the CGHS outpatient, in-patient, and ICU charges and room rent, the Health Ministry also revised the CGHS rates for 36 radiological/ imaging investigations. Now, private hospitals are looking forward to further changes in the crucial package rates such as appendix surgery, Tonsillectomy, Angiogram etc.

Writing to the Secretary of Union Health Ministry, Shri. Rajesh Bhushan, AHPI recently expressed its gratitude for the recent meeting and thanked the Ministry for the recent increase in rates in some areas (OP/1P/ ICU and for some of the radiology investigations) of CGHS. "This will certainly help hospitals in financial sustenance and providing quality healthcare to the beneficiaries," the association mentioned in the letter.

Referring to the possibility of further revision in the CGHS rates for crucial packages, the letter added, "As we discussed during our meeting, we are eagerly awaiting revision in; lab rates, remaining radiology investigation rates, and more importantly in the crucial package rates, which have not been revised since 2014. We believe that these revisions will be crucial in sustaining healthcare providers and would encourage more hospitals to opt for CGHS and other government insurance schemes."

Speaking to Medical Dialogues in this regard, Dr. Alexander Thomas said, "OP, IP ICU, Raiodological lots of have been revised. These rates have not changed since 2014. When we met the Health Secretary he said that the plan was to revise it in three phases. The OP/IP first, then the diagnostics and then the package rates. He said that it is likely to happen within 2-3 weeks."

"AHPI has been demanding for the revision for a long time. Finally things are happening. More hospitals will be empaneled now. We are happy with the response and waiting to see it get implemented," he further added.

Also Read: Health Ministry revises CGHS Rates, Simplifies Referral Process, Details