Can’t Go Cashless If Rs 1,000 Crore Dues Not Paid: Private Hospitals

BENGALURU: With the central government yet to clear huge outstanding dues, private hospitals are threatening to stop treating patients cashless under the Central Government Health Scheme (CGHS). The amount payable by the government to private healthcare establishments across India since 2018 is around Rs 1,000 crore.

The move to stop cashless treatment is being backed by private hospitals in Bengaluru too, who have given the Centre a deadline of January 2020 to clear dues. The amount payable to hospitals in Bengaluru is yet to be ascertained.

CGHS provides comprehensive medical care to central government employees and pensioners enrolled under the scheme. Currently, around 35 lakh beneficiaries are covered by the scheme in 71 cities across the country.

Delay in payments by the government is taking a heavy toll on the daily functioning of hospitals, say various managements. “Unless the dues are cleared, private hospitals wouldn’t be able to extend such medical support,” said Dr Giridhar Gyani, president, Association of Healthcare Providers of India (AHPI).

If the services are stopped, the worst affected will be those lakhs of patients who have been availing cashless medical facilities under CGHS in empanelled private hospitals.

In Bengaluru, as per the CGHS website, medical reimbursement claim is pending for several cases since January 2017. While the reason for delay is not mentioned, the status of reimbursements reads ‘booking’, ‘processing’, or ‘account section’. Private hospitals in Bengaluru alone are awaiting reimbursement from over 2,066 cases they have handled.

Ramaiah Memorial Hospital has been waiting for a reimbursement of Rs 3.5 crore since mid-2018. “The government has reimbursed in some cases. Though the entire system has been made online, there is a delay in reimbursement,” said hospital president Dr Naresh Shetty.

Hospital assn sets January 2020 deadline

The matter has been taken up by Private Hospitals and Nursing Homes Association (PHANA). “If the government does not reimburse the amount by January 2020, our members will have to take a stand on discontinuing cashless services for CGHS patients,” said Dr R Ravindra, president, PHANA.

The association has also been demanding a revision of procedure cost, specified by the Centre under CGHS. “PHANA can write to the state health department and we shall definitely refer the matter to the Centre,” said Pankaj Kumar Pandey, health commissioner, Karnataka.-Times Of India