Treatment by CGHS empanelled hospitals in emergency cases: Rajya Sabha Q&A

GOVERNMENT OF INDIA

MINISTRY OF  HEALTH AND FAMILY WELFARE

RAJYA SABHA

ANSWERED ON  25.11.2014

(a) whether Government is aware that empanelled hospitals provide cashless services to pensioners only for the diseases for which they are empanelled, even during the emergencies;

(b) if so, the extant Rules and Regulations in this regard;

(c) whether Government plans to instruct all empanelled hospitals to provide

cashless facilities to pensioners and other CGHS beneficiaries, irrespective of diseases for which they are empanelled during emergencies and shift the patients to other authorized hospital after first aid;

(d) if not, the reasons therefor; and

(e) the steps proposed to check exploitation/looting of patients in emergencies by empanelled hospitals?

   

ANSWER

THE MINISTER OF HEALTH AND FAMILY WELFARE (SHRI JAGAT PRAKASH NADDA)

(a) to (d): Recently, the Government has amended the terms and conditions for empanelment of private hospital under the Central Government Health Scheme (CGHS). Now, the hospitals are empanelled as a whole, meaning that all facilities available in the hospital would be provided to CGHS beneficiaries. Disease – specific empanelment has now been stopped.

(e): To ensure that the terms and conditions of the Memorandum of Agreement are followed scrupulously by the empanelled hospitals, a monitoring cell under the aegis of a senior officer of CGHS has been established to check irregularities including exploitation of patients. There are provisions in the MoA including issue of Show Cause Notice, issue of warning, recovery of amount charged illegally from the beneficiaries, also confiscation of part or whole of PBG (Performance Bank Guarantee), and ultimately removal from the CGHS list, that can be resorted to in appropriate cases.