Suspension of cashless services to CGHS, ECHS beneficiaries if dues not paid in 30 days

Private hospitals empanelled under the CGHS and ECHS have decided to suspend cashless services to the beneficiaries if their outstanding dues not paid by the Centre

Private hospitals may be forced to suspend cashless services under CGHS and ECHS as their reimbursements under these government schemes, running into crores, are pending for several months, the Indian Medical Association (IMA) said on Thursday.

The healthcare industry is passing through a crisis and crores of rupees to be paid to private hospitals under the Central Government Health Scheme (CGHS) and Ex Servicemen Contributory Health Scheme (ECHS) is pending for the past several months, the IMA claimed at a media briefing.

“Non-payment of legitimate dues by the government is taking a toll on the day-to-day functioning of the hospitals and is unable to pay salaries to the employees. Many hospitals have begun to cut down on operations by closing certain wards and beds, and are forced to lay off employees.

“If the situation is allowed to persist, it is feared that lakhs of hospital employees may lose jobs. Despite repeated attempts made by hospitals and associations, the situation has improved,” IMA Secretary General Dr R V Asokan said.

The IMA claimed that financial crunch coupled with reduced number of staff are going to adversely affect patient safety, which in turn would lead to increased morbidity and mortality, without getting noticed.

While non-payment of dues has pushed hospitals to the brink of collapse, rates for various medical procedures under CGHS have not been revised since 2014, whereas hospital expenses continue to grow, Asokan said.

Rates and agreements between CGHS and hospitals were supposed to be revised every two years. However, the CGHS have been postponing it unilaterally without furnishing any reason, he said.

Studies carried out by various institutes show that rates of many procedures under CGHS do not cover even the operating cost incurred by hospitals, the IMA secretary general said.

India currently has less than half the number of beds compared to WHO norms. Accessibility is even worse as most tertiary care hospitals are confined within metro, tier one and tier two cities.

“The prime minister while launching the Ayushman Bharat scheme had rightly stressed on the need for opening of 2,500-3,000 new hospitals in tier one and tier two cities to cater to the demand of PMJAY.

“The current scenario however is not going to encourage any new investment and will adversely affect effectiveness of flagship scheme PMJAY/ Ayushman Bharat,” the IMA said in a statement.

“Considering that 70 per cent of OPD and 60 per cent of IPD patients are being taken care of by private healthcare providers, the likely disruption of health services due to financial crunch is going to impact the national healthcare scenario more so in tertiary care where private sector provides more than 85 per cent of such services,” Dr Alexander Thomas, the president of Association of Healthcare Providers (AHPI) said.

It is therefore time that government takes urgent stock of ground realities and engages with the private sector to assess their genuine concerns and save the health industry from a collapse or slowdown, he said.

“Besides having social obligations, the healthcare industry has the potential to be the largest employer and it is therefore of utmost importance that the government and private sector engage in a dialogue and to pave the way for universal health coverage through Ayushman Bharat,” Thomas said.

Source: business-standard