Healthcare Providers Say Pending CGHS Payments Hitting Sustainability, Seek Clearance On Priority

A healthcare providers' body has asked the government to release pending payments of over Rs 500 crore to more than 60 private hospitals under the Central Government Health Scheme, according to a statement on Wednesday. The Association of Healthcare Providers (APHI) said that it has written a letter to the Health Ministry to draw its attention towards the huge outstanding dues under the CGHS and sought release of the pending payments "on priority", saying it has badly impacted the financial sustainability of hospitals. The APHI, which represents leading healthcare providers in the country, also highlighted various anomalies such as inordinate delay in reimbursement to hospitals and low rates for reimbursement which have not been revised since 2014, in the present system.

Due to these factors, CGHS is losing its sheen among hospitals as well as among beneficiaries, AHPI Director General Girdhar Gyani stated. Hospitals have signed an agreement effective from October 1, 2014, which has provision to make 70 per cent of the payment within five-working days of submission of bills by hospitals, the industry body said. In none of the cases, payments have been made within such a stipulated time, it added. "Hospitals have to wait for months and years to get the dues. This results in pushing hospitals to state of un-sustainability. Hospitals are forced to avoid/refuse beneficiaries for treatment. The continuous and perennial delay in CGHS payments seriously impacts the hospital’s cash flow,” Gyani noted. CGHS covers healthcare facilities extended to around 40 lakh current and retired central government employees and their families.

The scheme is one of the key initiatives by the Government of India under which healthcare facilities are extended to central government employees and pensioners, members of Parliament, sitting and former judges of the Supreme Court and high courts, former governors and lieutenant governors, freedom fighters, and certain public sector units, among others. Beneficiaries receive cashless healthcare from empanelled private hospitals, diagnostic centres, and also through government-run wellness centres/ dispensaries, who are later reimbursed by the government. 

PTI Inputs