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HindustanTimes Wed,23 Apr 2014

Govt’s unpaid bills may cost 34 million health cover

HT Correspondent, Hindustan Times  New Delhi, December 19, 2013
First Published: 20:26 IST(19/12/2013) | Last Updated: 14:40 IST(20/12/2013)

Some of the country's largest private hospitals on Thursday threatened to withdraw cashless facility to Central Government Health Scheme (CGHS) beneficiaries from next month unless the government cleared pending bills to the tune of up to Rs. 125 crore.

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There are nearly 34 million CGHS beneficiaries - government employees, pensioners, etc and their families. Of them, 400,000 are in Delhi and the NCR.

Members of Association of Healthcare Providers India (AHPI) said most of the hospitals empanelled under the CGHS to treat central government employees and pensioners were not being reimbursed within reasonable time for the healthcare services offered.

The AHPI has also asked for a revision of rates for various procedures offered under the scheme.

The AHPI comprises the biggest private hospitals in India including the Apollo Group of Hospitals, Medanta, Fortis Healthcare, Max Healthcare, Sir Ganga Ram, PD Hinduja, Lilavati and Narayana Health.

"If these issues are not resolved immediately, these hospitals will be constrained to withdraw the cashless facility to CGHS beneficiaries with effect from January 15 in Delhi, Andhra Pradesh and Karnataka followed by other states in the country," APHI director general Girdhar J Gyani told reporters here.

According to APHI, the total pending bill is in the range of Rs. 100 crore to Rs. 125 crore.

However, CGHS beneficiaries can continue to avail of treatment against payment at CGHS tariffs, he added.

"The hospitals believe that this move will spur the system to correct the prevailing anomalies and establish better working arrangement benefiting all stakeholders," Gyani added.

With steep increase in foreign exchange rate and funds crunch due to non-payment from CGHS, the hospitals are getting into huge debts, incurring heavy interests from banks while funding the government schemes, he added.

The association, which claims to represent around 10,000 private and charitable hospitals across the country, also asked the government to look into revision of rates for various procedures, anomalies in payment structure and refund of unauthorised deductions from running bills.

"The tariff for procedures arrived by CGHS is very low. As a result, the services to CGHS beneficiaries are not financially viable for private and charitable hospitals," Gyani said.

Commenting on the issue, eminent cardiac surgeon and philanthropist Devi Shetty said, "...It is important that remuneration and timely payment for CGHS schemes are standardised. This will help charitable and private hospitals to extend their services to all the government-sponsored health schemes."

He added it was important for the CGHS to work with the network hospitals and address their grievances.

(With inputs from Agencies)

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