Private hospitals threatened to stop cashless service under Central Government Health Scheme (CGHS) and Ex-Servicemen Contributory Health Scheme (ECHS)
The association of private hospitals has called stopping CGHS and ECHS cashless services as their bills worth over Rs 1,600 crore are pending with the the Ministry of Finance.
A letter, flagging pendency of bills, was sent to the Ministry of Finance in July this year but not much has moved since then – prompting the hospitals to press panic button which may affect close to one crore beneficiaries of the CGHS and ECHS.
Association claims that the pendency has worsened since the launch of Ayushman Bharat, or the Pradhan Mantri Jan Arogya Yojana (PMJAY) healthcare scheme by the Modi government.
The Association of Healthcare Providers of India (AHPI), in a recent meeting, decided to stop cashless service to the CGHS and ECHS beneficiaries if the pending bills are not cleared by the Centre.
“The pending bills have been accumulating over the past three years as the number of hospitals covered under these schemes has gone up while the periodic budget to clear bills continues to be the same,” Dr Girdhar Gyani, Director General of AHPI, said.
“The situation has worsened since the launch of Ayushman Bharat and the pending bills are now close to Rs 1,600 crore,” Dr Girdhar Gyani said, adding, “We are going to soon write to the ministry and intimate the officials that we will be forced to stop cashless service as an emergency measure to cap our growing losses,” Dr Girdhar Gyani said.
MEMORANDUM TO MINISTRY OF FINANCE
The decision of private hospitals come after their memorandum to the Ministry of Finance in July this year which yielded no result.
AHPI, in its letter to the ministry, had said that due to a long pendency of dues the scheme is losing its sheen, both among the healthcare providers as well as the beneficiaries.
Reimbursement to hospitals is the major concern. Hospitals have signed agreement based on the terms and conditions defined by the CGHS, effective from 1st October 2014, which has provision to make 70 per cent payment within five working days of submission of bills by hospitals.
In none of the cases payments have been made within such stipulated time.
Hospitals have to wait for months and years to get the dues. This results in pushing hospitals to state of unsustainability and hospitals are forced to avoid/refuse beneficiaries for treatment.
AHPI warned its its letter that unless the ministry releases bulk amount, the outstanding will continue to remain in same bracket.
“We would be grateful if you could look into this long pending issue, which is making hospitals unsustainable, this has also impact on flagship scheme PMJAY under Ayushman Bharat as hospitals are vary of joining government schemes for same fear of not getting timely reimbursements,” AHPI said.
Pending bills of top hospitals like Max Healthcare have accumulated beyond Rs 150 crore while that of Fortis Group was close to 58 crores in July.
“In response to the issue of pending bills flagged by us, the Ministry of Finance has responded with a memo seeking suggestions from stakeholders for improving and revamping the CGHS services,” an AHPI functionary said, adding, “But no word on addressing concerns raised by us so far from the ministry,” he added.
The decision of private hospitals once implemented will impact close to 37 lakh central government employees, their dependents and pensioners under the CGHS and over 52 lakh ex-servicemen dependents covered under the ECHS in over 1,000 hospitals and nursing homes providing healthcare services.
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