Withdrawal of cashless facilities to the CGHS beneficiaries by the empanelled private hospitals due to non-revision of rates since 2014.

Withdrawal of cashless facilities to the CGHS beneficiaries by the empanelled private hospitals due to non-revision of rates since 2014.

BHARAT PENSIONERS’ SAMAJ
(All India Federation of Pensioners’ Associations)

No BPS/SG/CGHS/021/6

Dated :17.10.2021

The SECRETARY,
GOI MINISTERY OF HEALTH AND FAMILY WELFARE
SRI RAJESH BHUSHAN, IAS

SUBJECT: Withdrawal of cashless facilities to the CGHS beneficiaries by the empanelled private hospitals due to non-revision of rates since 2014.

Ref.: Letter No.CCCGPA/CGHS/2021 dated at the 14″ October, 2021 from Co-ordination Committee of Central Government Pensioners’ Associations, Karnataka, Bengaluru

Sir,

Bharat Pensioners Samaj , the Federation of Pensioners with a reach to over 10 lac pensioners, one of the identified Pensioners Welfare organization of DOPPW & an associate NGO of International Federation on Ageing (IFA)- Canada strongly supports Co-ordination Committee of Central Government Pensioners’ Associations, Karnataka, Bengaluru’s representation addressed to you vide their No CCCGPA/ CGHS/2021 dated 14 October, 2021. The text of which is appended hereunder. The issue raised therein may be treated as an all India issue.

Thanking you

Yours faithfully,

SC Maheshwari
Secy. Genl. Bharat Pensioners Samaj

Text of CCCGPA letter under_reference

No.CCCGPA/CGHS/2021

Dated : 14 October, 2021

Respected Sir,

SUBJECT: WITHDRAWAL OF CASHLESS FACILITIES TO THE CGHS BENEFICIARIES BY THE EMPANELLED PRIVATE HOSPITALS DUE TO NON-REVISION OF RATES SINCE 2014.

Greetings from the Co-ordination Committee of Central Government Pensioners’ Associations, Karnataka, Bengaluru, to which more than 30 Central Government Pensioners’ Associations and Pensioners’ Associations of Autonomous/Statutory Bodies of Central Government are affiliated.

The Coordination Committee of Central Government Pensioners’ Associations, Karnataka, formed as long back as in the year 1998, is having more than 30 Central Government Pensioners’ Associations and Pensioners’ Associations of Autonomous/Statutory Bodies of Central Government as its affiliates. The Coordination Committee regularly takes up initiative to act as a bridge between the pensioners/family pensioners and concerned departments in the Central Government in order to convey and help in resolving their genuine grievances, if any, and also looks after the welfare of members of its affiliates.

2. At the outset, on behalf of all our affiliates, we wish to commend the Government for the way in which the pandemic has been efficiently tackled during the various phases of lockdown and unlock. We are also thankful to your kind self and your department for having issued guidelines from time to time, especially to the senior citizens considering their vulnerability to Corona Virus, in the matter regarding the necessity of their staying at home to keep themselves safe and to restrict their movement outside unless it is absolutely essential. Special orders permitting reimbursement of the cost of OPD medicines purchased locally to CGHs/CS(MA) beneficiaries in view of pandemic Covid 19, orders issued to the private hospitals empanelled under CGHS to admit the CGHS beneficiaries, without any hassles, listing a series of precautionary measures to be taken during this Covid-19 pandemic, revision of time limit for submission of final claims for reimbursement of medical expenses under CGHS from 3 months to 6 months, etc. are among many other beneficiary friendly /welfare measures taken by your ministry in the recent past with a great concern for the health of senior citizens.

3. Considering the spread and severity of the Corona virus, the quality healthcare and prompt medical treatment had become need of the hour. Though the Government had reiterated many a time that all the CGHS empanelled hospitals should not deny treatment facilities/admission to CGHS beneficiaries and shall charge as per CGHS norm and rates, some of the empanelled hospitals are not adhering to these instructions. They had refused admissions on the pretext of non-availability of beds even during pandemic-Covid-19 emergency. As a result of this, many of CGHS beneficiaries had been put to not only financial hardship, but also to mental stress. Some of them unfortunately, passed away for not getting the proper medical treatment at right time. When we approached some of the empanelled hospitals on the complaints received from our beneficiaries, grievances expressed by them, orally, were:

They are not being reimbursed within reasonable time the charges for the healthcare services offered by them.
The tariff for procedures arrived under the CGHS is very low, which was notified about 8 years back and that no revision has taken place since then.
Inspite of the request made by them to the Government, individually and also through their Association for revision of rates, the Government has not addressed these issues or resolved till now.
The hospitals have incurred huge loss while funding the Government Schemes
The services to the CGHS beneficiaries are not financially viable for private and charitable hospitals.

4. While many of the empanelled hospitals have expressed orally that, if the rates fixed by the Government in the year 2014 were not revised immediately, they may have to withdraw the facilities extended to the CGHS beneficiaries. It has been brought to our notice that some of the empanelled hospitals under CGHS at Bangalore, as listed below, have notified that they have withdrawn themselves as empanelled hospitals from CGHS and that they are no longer empanelled under CGHS. Asa result of which they have withdrawn the facilities extended to the CGHS beneficiaries.

5. As your good self is aware, the Central Government Health Scheme, for the last six decades, is providing comprehensive medical care to the Central Government employees and pensioners enrolled under the Scheme by empanelling many of the private hospitals in more than 70 cities across the country. It is also the endeavour of the Government to include more cities to improve the accessibility of the services to the Central Government employees and pensioners. Recently, the Government has also decided to open Wellness Centres in 16 more cities for which we are grateful to you. If the Government does not consider revision of CGHS rates early, which were fixed in the year 2014, there may be chances of many more empanelled hospitals withdrawing themselves from the Central Government Health Scheme and it is our apprehension that, in the near future, there may not be many empanelled hospitals, Diagnostic Centres and Dental Clinics to cater to the needs of CG employees and pensioners. If this happens, the objectives for which this Scheme was drawn about 60 years back, ie. to cater comprehensive medical care to the CG pensioners, who have served the Government for more than 3 decades, and whose service conditions provided for suitable health care facilities even after their retirement, cannot be achieved, and also the CGHS beneficiaries will be put to financial hardship as they have to spent from out of their own savings when they are hospitalised. We also wish to bring to your kind attention that it is the a vowed policy of the Government of India to provide suitable health care facilities especially to the retired employees.

6. Under the above circumstances, we appeal to your good self to consider revision of CGHS rates, at the earliest, thereby motivating the private hospitals to support CGHS, which is in existence for more than six decades, and facilitate the CGHS beneficiaries, many of whom are in the evenings of their life, to get medical care at CGHS rates on cashless basis, without any hassles. Private Empanelled Hospitals, Diagnostic Centres & Dental Clinic removed from the list of empanelled HCOs recently in Bengaluru were