Difficulties of CGHS beneficiaries due to withdrawal of empanelment and nonpayment of amount due to the hospitals -NCJCM

Difficulties of CGHS beneficiaries due to withdrawal of empanelment and nonpayment of amount due to the hospitals -NCJCM

No.NC-JCM-2022/Health

February 1, 2022

The Secretary
Ministry of Health & Family Welfare
Government of India,
Nirman Bhawan,
New Delhi.

Sub: Difficulties being faced by the CGHS beneficiaries both Serving employees and Pensioners due to withdrawal of empanelment and nonpayment of amount due to the hospitals.

Dear Sir,

This office has been receiving complaints from Employees, Pensioners and their Organizations that off-late in many places including Chennai, Pune, Delhi, Hyderabad, Bengaluru, Mumbai, Kolkata etc., the CGHS has withdrawn the empanelment of many Hospitals including Multispecialty Hospitals. More over many hospitals are refusing to extend cashless treatment to the CGHS beneficiaries on the plea that a huge amount is due from the Government/CGHS to these Hospitals, mainly for the treatment given to the Pensioners. For the Ruby Hall Clinic Pune has told the Pensioners that their outstanding dues receivable from the CGHS against the claim raised by the Hospital is over Rs.23 Crore and that inspite of their repeated representations and personal approach to the CGHS authorities the matter is remaining unsettled.

Due to the above sudden development employees and Pensioners are subjected to undue hardship. In Chennai, since the Multispecialty Hospital MIOT Hospital has been withdrawn from the empanelment, the employees and Pensioners are facing lot of difficulties including to undergo dialysis treatment and Chemotherapy & Radiation etc. This is a matter of serious concern. The CGHS empanelled hospitals have now started insisting that they will not give cashless treatment and that the beneficiary has to deposit the payment for the medical treatment and subsequently to reimburse the same. Another reason the empanelled Hospitals are quoting is that the CGHS rates were last revised in the year 2014 and since it is more than 8 years they cannot afford to continue treatment to the CGHS beneficiaries. This defeat the entire purpose of CGHS scheme. Considering the seriousness of the situation, I request you to kindly intervene in the matter and to arrange for the following

1) Empanelment of more Hospitals under the CGHS in all the CGHS Governed areas including the major cities like Chennai, Pune, Delhi, Bengaluru, Mumbai, Kolkata, Hyderabad’s etc. and to re-empanel the Hospitals which are withdrawn
2) To settle all the dues to the CGHS empanelled Hospitals and to insist them to continue cashless treatment to the employees and the Pensioners.
3) To revise the CGHS rates for all Medical procedures/surgical procedures, investigations, consultations etc.

In this regard the undersigned along with few Staff Side Members would like to meet you in persons for discussing and settle the issues.

Awaiting for your favourable action please.

Thanking you,

Yours sincerely,

(Shiva Gopal Mishra)
Secretary

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