With dues to the tune of ₹1,200 crore pending for treatment of patients under the Central Government Health Scheme (CGHS) and Ex-servicemen Contributory Health Scheme (ECHS), private hospitals across the country have threatened to stop cashless facility under the scheme from February 1.
If implemented, it will impact nearly 36 lakh Central government employees, including their dependants, and pensioners under CGHS and over 52 lakh ex-servicemen and dependants covered under ECHS in over 1,000 empanelled hospitals and nursing homes in 71 cities. Of these, over 1.23 lakh beneficiaries are from Bengaluru.
“We have given the Centre a deadline of two weeks and are hoping for a response. Our dues have accumulated since 2014 and if not cleared at the earliest, we will be constrained to suspend cashless services to beneficiaries,” Alexander Thomas, president of Association of Healthcare Providers of India (AHPI), told The Hindu.
A letter flagging pendency of bills was sent to the Union Ministry of Finance in July 2019 but not much has moved since then, prompting the hospitals to take a call on stopping cashless services.
A majority of the empanelled hospitals are in Delhi, Pune, Bengaluru, and Hyderabad. Hospital representatives claimed that the pendency has worsened ever since the launch of Ayushman Bharat or Pradhan Mantri Jan Arogya Yojana healthcare scheme.
Giridhar Gyani, APHI Chief Executive Officer, said the healthcare industry is on the brink of financial unsustainability due to pendency of dues. “Agreements that hospitals have signed with these agencies are not being honoured. This has pushed many hospitals to the brink of unsustainability. Some are unable to pay even salary to their staff and there are cases where staff are being laid off,” he said.
The problem is compounded owing to the fact that even CGHS reimbursement rates for procedures have not been revised since 2014, whereas hospital have to pay nominal increment to staff and match inflation-related expenses, he said.
Payment of interest
“We have demanded the government not only clear dues in bulk at the earliest but also henceforth pay an interest of 1% per month on the amount pending if it is not reimbursed within a stipulated period after submission of bills. Such a condition exists in the agreements signed for Ayushman Bharat,” said Dr. Thomas.-The Hindu