Private hospitals have threatened to stop cashless service under the Central Government Health Scheme (CGHS), and Ex-Servicemen Contributory Health Scheme (ECHS) as over ₹1,600 crore worth their bills are pending with the Ministry of Finance.
The decision comes after the hospitals wrote to the Ministry of Finance informing them about the pending bills in July this year. But the letter hasn’t received any response yet.
The unresponsiveness of the government prompted the hospitals to stop the cashless services, which may affect nearly one crore CGHS and ECHS beneficiaries reported India Today.
The Association of Healthcare Providers of India (AHPI), has claimed that the pendency has worsened since the launch of Ayushman Bharat, or the Pradhan Mantri Jan Arogya Yojana (PMJAY).
“The pending bills have been accumulating over the past three years as the number of hospitals covered under these schemes has gone up while the periodic budget to clear bills continues to be the same,” Dr Girdhar Gyani, Director General of AHPI, said. “The situation has worsened since the launch of Ayushman Bharat, and the pending bills are now close to Rs 1,600 crore,” Dr Girdhar Gyani added.
AHPI, in its letter to the ministry, had said that because of long pendency of dues, the scheme is losing its importance, both among the healthcare providers as well as the beneficiaries.
“We are going to soon write to the ministry and intimate the officials that we will be forced to stop cashless service as an emergency measure to cap our growing losses,” Dr Gyani added.
Payments, A Major Concern
Reimbursement to hospitals has been a matter of serious concern. Hospitals have signed an agreement based on the terms and conditions given by the CGHS, effective from October 1, 2014, which allows 70 per cent payment to be made within five working days of submission of bills by the hospitals.
In none of the cases, payments have been made within the designated time limit. Hospitals have to wait for months and years to get their dues, forcing the hospitals to refuse beneficiaries for treatment.
AHPI, in its letter, warned that unless the ministry releases bulk amount, the outstanding will continue to remain in the same bracket.
“We would be grateful if you could look into this long-pending issue, which is making hospitals unsustainable, this has also impact on flagship scheme PMJAY under Ayushman Bharat as hospitals are varied of joining government schemes for same fear of not getting timely reimbursements,” AHPI said.
Pending bills of several private hospitals like Max Healthcare have accumulated to the tune of Rs 150 crore while that of Fortis Group was nearly 58 crores in July.
“In response to the issue of pending bills flagged by us, the Ministry of Finance has responded with a memo seeking suggestions from stakeholders for improving and revamping the CGHS services,” an AHPI functionary said. “But no word on addressing concerns raised by us so far from the ministry,” he added.
The decision of private hospitals once implemented will affect nearly 37 lakh, central government employees, their dependents and pensioners under the CGHS and over 52 lakh ex-servicemen dependents covered under the ECHS in over 1,000 hospitals providing healthcare services.
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