Problems faced by CGHS beneficiaries in private hospitals – Rajya Sabha

CGHS beneficiaries are facing problems in availing facilities at empanelled hospitals due to non-payment of pending bills of these hospitals by Government – Rajya Sabha QA

GOVERNMENT OF INDIA
MINISTRY OF HEALTH AND FAMILY WELFARE
RAJYA SABHA

UNSTARRED QUESTION NO-2494

ANSWERED ON-10.12.2019

Problems faced by CGHS beneficiaries in private hospitals

2494 . Shri Shamsher Singh Dullo

Will the Minister of HEALTH AND FAMILY WELFARE be pleased to state:

(a) whether it is a fact that CGHS patients both pensioners and working are facing problems in availing facilities at empanelled hospitals due to non-payment of pending bills of these hospitals by Government;

(b) whether it is also a fact that not only they are denied facilities but if at all entertained, they are getting substandard treatment as compared to the patients who pay cash;

(c) whether CGHS patients are also denied cashless facilities in these institutes;

(d) if so, what steps are being taken to address this issue; and

(e) the amount due to be paid to empanelled hospitals?

ANSWER

(a) to (d): Some complaints regarding difficulties in availing treatment at CGHS empanelled hospitals were received. These included non–availability of beds and refusal of credit facility. Suitable action is taken against hospitals as per terms and conditions of Memorandum of Agreement in case of violation of terms and conditions of empanelment. There are no specific complaints about sub-standard treatment. As per terms and conditions of empanelment, the empanelled hospitals are to provide cashless services to central government pensioners. Cashless service is available to serving employees in cases of emergency, otherwise they claim reimbursement from their respective offices. The bills of pensioners are settled by Ministry of Health & Family Welfare under the Pensions and Other Retirement Benefits (PORB) Budget Head. At times, payments to hospitals get delayed on account of fund availability under the said Budget Head. In such situations, immediate steps are taken to allot more funds so as to ensure expeditious clearance of hospital bills. At the central level, rigorous monitoring is done for clearance of hospital bills.

(e): Rs. 827.92 crore

Source: Rajya Sabha