07 Jan, 2014 12:31 PM

Govt to revise rates for CGHS hospitals, several new measures proposed

The Government is in the process of revising the rates of medical procedures offered by empanelled hospitals and diagnostic centres under the Central Government Health Scheme (CGHS) and giving them early payment assurance to encourage more medical institutions join the scheme.

Earlier the empanelled hospitals had threatened to stop the facilities to the employees due to the delay in payments. The hospitals claimed that the outstanding bills that have to be cleared will amount to Rs 125 crore as on date. Members of Association of Healthcare Providers India (APHI) had alleged most of the hospitals empaneled under the CGHS to treat central government employees and pensioners are not being reimbursed within reasonable time for the healthcare services offered.

The Ministry of Health and Family Welfare has floated e-tenders for empanelment of hospitals and decided that the rates of various medical procedures would be fixed by an average of rates quoted in e-tenders instead of the old system where the lowest quotation became the rate.

Rates of all medical procedure centres under CGHS will be revised by April next year.

Not just that, the Government is also revising its policy by providing empanelled hospitals assured upfront payment of 70 per cent of the total bill within five days of its presentation and balance admissible amount within a maximum period of 30 days.

The direction for a 10 per cent deduction in case of early/cash payment to hospitals under CGHS is also been removed.

Under the new policy finalised by the Ministry, the category of super specialty hospitals empanelled under the CGHS has also been done away with.

"Now, hospitals, exclusive eye hospitals/centres, exclusive dental clinics and diagnostic centres shall be empanelled for all facilities available in the health care organisation as approved by National Accreditation Board for Hospitals/National Accreditation Board for Labs and the Quality Council of India and shall not be empanelled for selected specialities/facilities," the new policy says.

The changes will help rope in more hospitals, clinics and diagnostic centres under the CGHS as many renowned and big hospitals were shying away from being empanelled under the scheme due to pending payments and low rates for medical procedures.

Sources said payments of bills amounting to around Rs 100 crore of private hospitals are pending with the government under CGHS alone, even though hospitals are crying hoarse that pending payments are to the tune of over Rs 400 crore.

Officials, however, say this huge amount is not pending under CGHS and it may include payments under ECHS, ESI and health bills of other big departments like Delhi Police and others.