Complaints of overcharging by the CGHS Empanelled Private Hospitals

Complaints of overcharging by the CGHS Empanelled Private Hospitals

GOVERNMENT OF INDIA
MINISTRY OF HEALTH AND FAMILY WELFARE
LOK SABHA

UNSTARRED QUESTION NO 2402
ANSWERED ON 25.07.2014

ARBITRARY RATES FOR MEDICAL TREATMENT

2402 . Dr. VIRENDRA KUMAR

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

(a) whether certain Government hospitals/private CGHS empanelled hospitals across the country including the Institute of Liver and Biliary Sciences in Delhi are reportedly charging arbitrary rates for treatment/diagnostic tests from Central Government Employees instead of rates approved by CGHS;

(b) if so, the details thereof and thereasons therefor including action taken against the offenders;

(c) whether the Government has issuedany direction to these hospitals to charge the rates for treatment of diagnostic testsas per CGHS approved rates from CGHS beneficiaries and if so, the details thereof;

(d) the mechanism put in place tomonitor the effective implementation of the directions of the Government in the matter;and

(e) the corrective measures taken/proposed to be taken by the Government in this regard including reimbursement offull expenses incurred on medical treatment of the CGHS beneficiaries?

ANSWER
THE MINISTER OF HEALTH AND FAMILY WELFARE (DR. HARSH VARDHAN)

(a) & (b): There are certain complaints of overcharging by the CGHS empanelled private hospitals. However it does not include the Institute of Liver and Biliary Sciences in Delhi, which is an autonomous body under State Government of Delhi.

The Complaints received against some Private CGHS empanelled hospitals are as under:

Delhi

1.Kukreja Hospital
2. Indraprastha Apollo Hospital
3. JeewanHopsital& Nursing Home
4. Dr B.L.Kapoor Hospital
5. Yashoda super speciality Hospital
6. Fortis Flt Lt. RajanDhall Hospital
7. Medanta the Mediciti
8. National Heart Institute
9.Saral Advanced Diagnostics Pvt. Ltd.
10.NoidaMedicare centre
11. Max Super speciality Hospital
12. Escort’s Hospital Faridabad
13.Kailash Hospital & Heart Institute
14. Mata Chanan Devi Hospital
15. Dr Lal Path Lab

Excess amount charged has been deducted and paid to the beneficiaries.

Bengaluru:

1. Fortis Hospital , Cunningham Road
2. Fortis Hospital Bennerghatta Road
3. Shankar Eye Hospital
4. Imperial Hospital
Warning letters were issued by Addl. Director, CGHS and the excess amount charged was recovered and paid to the beneficiaries.

Patna

Show Cause Notice was issued to Ruban Memorial Hospital

Jabalpur

1. Jabalpur Hospital & Res.Centre
2. Marble city Hospital & Res. Centre
Warning letters were issued by Addl. Director, CGHS and the excess amount charged was returned to the beneficiaries.

(c): The CGHS empanelled hospitals and diagnostic centres are to charge only the approved package rates and this clause is part of Memorandum of Agreement (MOA) signed between CGHS and CGHS empanelled hospitals and diagnostic centres at the time of empanelment.

(d)& (e): Monitoring is done by the officers of CGHS, including Addl. Director of the concerned city, Joint Director(Grievances), Hospital Cell and Hospital Empanelment Cell.

As and when any instance of excess charging comes to the knowledge of CGHS, the matter is taken up with the concerned hospital / diagnostic centre and Show Cause Notice is issued seeking explanation. In case of unsatisfactory reply or no reply suitable action is taken as per terms and conditions of Memorandum of Agreement signed by the hospitals like forfeiture of performance bank guarantee , recovery of excess amount and in extreme cases removal from CGHS panel.

source : LOKSABHA