Private hospitals treating government employees under the Central Government Health Scheme (CGHS) have started denying them the cashless facility after unpaid payments accrued to more than Rs. 1,000 crore.
According to the Association of Healthcare Providers India (AHPI), the Central government didn't clear payment even after the health ministry assured hospitals that it would do so at a meeting on May 12, 2022.
CGHS covers over 40 million beneficiaries, both serving civil service officials and retired. It provides treatment at nominal monthly charges, through CGHS wellness centres and empaneled private hospitals and diagnostic centres.
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According to AHPI, over Rs. 1,000 crore in CGHS dues are pending; three hospitals; Max, Fortis and Medanta, alone have outstanding dues of Rs. 400 crore.
“More than 50% of CGHS beneficiaries are in Delhi-NCR including all IAS officers. Surprisingly, CGHS-DG, being in the rank of Additional Secretary, is unable to solve simple issues of outstanding dues. They threaten hospitals to take action when they talk of stopping cashless treatment, but not taking responsibility for payments on time,” said Dr Girdhar Gyani, Director General of AHPI.
Gyani said hospitals were being forced to discontinue cashless transactions because their financial sustainability is at stake, adding that they were still treating civil servants at CGHS rates but after receiving cash.
Hospitals have been refusing to admit patients with CGHS cards on the pretext that they had no space.
"The hospitals are now refusing cashless payment. What should a retired employee do if a hospital which has been treating him for long refuses its beneficiaries the cashless treatment?” a retired central government employee said on condition of anonymity.
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“The hospitals tend to turn a blind eye when we bring up the issue of CGHS cards for treatment. They do help if there is a cash payment, otherwise it is an uphill task to get treatment. The government should do something in this regard," he added.
Because of technical issues, payments of CGHS beneficiaries on the National Health Authority's information technology platform are not getting processed, increasing the outstanding dues, people aware of the development said.
At the May 12 meeting with the Union health minister, the health ministry and NHA officials blamed technical glitches for the delay in payments, promising that the issue will be resolved soon.
Gyani wrote a letter to the health minister on June 15, saying payment delays were a demotivating factor in tertiary care hospitals joining the Pradhan Mantri Jan Arogya Yojana.
“We received a response from the office of the minister that he was personally following this case and that all the outstanding amount should be cleared in a month,” he said.
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