Hospitals threaten to stop cashless facility
PATIENTS UNDER CGHS AND ECHS ARE LIKELY TO BE AFFECTED AS BILLS WORTH AT LEAST ₹1,000 CRORE ARE YET TO BE CLEARED BY GOVT
NEWDELHI: Several associations of doctors, hospitals and nursing homes have cited low rates and delayed payments, and threatened to stop the cashless treatment of millions of beneficiaries under the central government’s medical care schemes for its employees, pensioners and their families unless timely reimbursements are made.
The warning comes as bills worth at least ₹1,000 crore under schemes like the Central Government Health Scheme (CGHS) and Ex-servicemen Contributory Health Scheme (ECHS) remain pending, according to Association of Healthcare Providers (India) or AHPI.
AHPI director-general Dr Girdhar Gyani said the group is not saying that it will stop treating patients covered under schemes like CGHS. “…all we are saying is that we will stop providing cashless treatment.”
Gyani called it a stopgap measure to deal with the delay in payments. “The beneficiaries can pay for the service at the CGHS rates and then seek reimbursements from the government,” said Gyani. Several large private hospitals like Lilavati, Hinduja, Apollo, Max, Fortis, Ganga Ram, Christian Medical College Vellore, are among at least 10,000 members of the AHPI spread across 33 states and Union Territories.
Medical associations say that special rates insurance providers have negotiated rates that are 30 - 50% lower than the regular rates, and are compounding the problem. “GIPSA [General Insurance Public Sector Association], an organisation formed by the four public insurance companies [Oriental Insurance, New India Assurance, National Insurance, and United India Insurance], has cartelised the market and negotiated arbitrarily low prices with hospitals for empanellment,” said All India Ophthalmological Society president-elect Dr Mahipal Sachdev.
DELAYED PAYMENTS
Delhi Voluntary Hospitals’ Forum secretary Dr PK Bharadwaj said that there is not a single scheme under which payments are made on time.
“For CGHS, the wait is at least six months. This creates a difficult situation for hospitals as they are then unable to pay the salaries, their vendors for medicines, consumables, etc. and the cycle keeps continuing,” said Bharadwaj.