CASHLESS FACILITY TO CGHS BENEFICIARIES

Certain CGHS empanelled hospitals have stopped providing cashless facility to the CGHS beneficiaries due to their huge amount of bills pending for payment. 23 hospitals in Delhi, Hyderabad, Bangalore and Jaipur had stopped providing credit facility alleging pendency of payment of hospital bills. Show-cause notices were issued and after review, 2 hospitals in Delhi, 2 hospitals in Bengaluru and one hospital in Jaipur were removed from CGHS panel.         There was shortfall in the budget in the last quarter of financial year 2013-14. Additional Budget under PORB was received and direct payment to hospitals (instead of payment through UTI-ITSL) up to Rs. 75 crores was made and the pendency was largely cleared by 31st March 2014.           Package rates and ceiling rates of implants are revised as per recommendations of experts from time to time. Last revision of Ceiling rates for Drug eluting stents was done on 29/04/2014.         Empanelled hospitals cannot charge more than the approved package rates and ceiling rates for implants. If any of CGHS beneficiaries wants to have any implant by a specific brand name which is having more sale price than the CGHS rates, the difference between the sale price of that particular brand and the ceiling rate under CGHS is to be borne by him.        CGHS invited e-tenders for fixation of rates (revision) and empanelment of hospitals under CGHS in different cities. Technical evaluation of the bids has been completed.       The Health Minister stated this in a written reply in the Lok Sabha here today.  *****

MEDICAL FACILITIES TO GOVERNMENT EMPLOYEES

Central Government Health Scheme provides medical care to its beneficiaries which include serving as well as retired Central Government employees. The CGHS provides its services through a network of CGHS Wellness Centers which are in operation presently in 25 major cities of the country. Expenditure on medical reimbursement in respect of pensioners is borne by CGHS and in respect of serving employees it is borne by concerned Ministry/ department/office. The pensioner beneficiaries are eligible for credit facility for treatment in CGHS empanelled hospitals.  Central Services (Medical Attendance) Rules, 1944 are applicable to serving Central Government employees only who are residing in non-CGHS covered areas. Medical attendance is provided by the Authorized Medical Attendant appointed by concerned department. The CS(MA) Rules 1944 are not applicable to pensioners. As per these Rules, there is no provision for issue of medicines and medical reimbursement claims are to be settled by the concerned department/ Ministry.  The Health Minister stated this in a written reply in the LokSabha here today.  *****