Reimbursement of actual medical expenditure incurred by the employees

Reimbursement of actual medical expenditure incurred by the employees

NCJCM Standing Committee Meeting Discussion Points

S.No.21 – Reimbursement of actual medical expenditure incurred by the employees in recognized hospitals.

Ministry of Health & Family Welfare had vide their O.M. No. B- 12014/01 /2016-JCM dated 05.04.2017 informed that private hospitals empanelled with CGHS had signed Memorandum of Agreement (MoA) with Government to charge at CGHS rates. In case of any excess charging, the same is recovered from the hospital bills by CGHS and paid to the beneficiaries and the hospitals are penalised as per the provisions under the MoA. The representatives requested that specific instances may be brought to their notice so that they can take action.

Staff-Side stated that the problem has also been that the rates fixed by CGHS were so low that the hospitals were refusing to admit the CGHS beneficiaries. Another problem is about unpaid bills. They requested that the Ministry of Health & Family Welfare should revise their rates at regular intervals so that the CGHS beneficiaries do not have to suffer more on account of delay.

(Action: M/o H&FW}

Read More at : Minutes of Meeting of NCJCM Standing Committee held on 03.05.2017