13 Oct, 2012 6:21p.m.

Fortis Escorts stops accepting CGHS. Others including Medanta and Max, likely to follow

Fortis Escorts, has stopped accepting CGHS beneficiaries since October 7, citing long delays in reimbursement.  Other private hospitals, including Medanta and Max, are also likely to follow suit.

Under CGHS, entitled government employees can avail of cashless diagnostics and treatment at hospitals, which send patients' bills directly to the government for settlement. For this, the hospitals and CGHS enter into a contractual agreement for a certain period, under which the price tag for each medical procedure is put down. If a hospital wants to revise any of the rates, it has to enter into a fresh agreement with CGHS.

A notice issued by Fortis Escorts Heart Institute says, with effect from October 7, the hospital will not renew its contract with CGHS. No CGHS beneficiary will be entitled for IPD (indoor patient department) admissions and OPD (outdoor patient department) services at the hospital from this date.

A delay in payment was cited by several other private city hospitals, too. When contacted, Fortis Escorts declined to comment.

The hospitals claims that the services we provide under the scheme are at very low rates. Because of delays in payments, we have to incur interest on the amount," said Naresh Trehan, the chairman and managing director of Medanta, a multi-speciality institute located in Gurgaon. Although Medanta has not discontinued its services to CGHS beneficiaries yet, it may be compelled to do so if payment-related problems are not resolved soon.

Though Max Hospital has also not discontinued the services yet, an executive from this hospital conceded there were serious problems in CGHS payments.

Another leading hospital, on the condition of not being identified, said it had stopped providing certain expensive services under CGHS, due to payment-related issues, though it had not completely blocked the beneficiaries of the scheme.

Other hospitals also avoid the CGHS patients citing various reasons but real reason is the long delay in settling the bills. Also many queries are asked by the third party agency, which reimburses the bills on behalf of the government.

Staffcorner.com had earlier posted article on this issue.

Read : Fund shortage effects CGHS reimbursement of medical bills

The Centre's annual CGHS budget was around Rs 1,600 crore (Rs 16 billion), of which Rs 1,000 crore (Ra 10 billion) was for hospital reimbursements, including those for medicines, said an official.

While ministers do not have to go to private hospitals through the CGHS route, all bureaucrats have to opt for the scheme.  
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