health insurance
Representative photo. Image credit - www.financialexpress.com

The top private hospitals of the country like Max, Fortis and Medanta may discontinue cashless treatment under the Central Government Health Scheme (CGHS) and Ex-servicemen Contributory Health Scheme (ECHS) within December.

According to media reports, the central government is yet to settle dues totalling Rs 1,700 crore which may push the hospitals to discontinue cashless treatment.

As per reports, more than 37 lakh people are entitled to cashless treatment under the two schemes – CGHS and ECHS.

The health schemes are meant to ease public access to quality healthcare.

If the cashless treatment facility is withdrawn by the private hospitals, the beneficiaries of the health schemes will be charged the discounted rates outlined under CGHS and ECHS and then be reimbursed by the government.

Currently, the government reimburses the hospitals.

From Thursday, different hospital hospitals across India, including superspeciality chains such as Max, Fortis, Apollo, B.L. Kapur, Narayana Health and Medanta have started meeting to decide how long they could continue cashless treatment.

It may be mentioned that a large number of people from different parts of Northeast India are also beneficiaries of these two health schemes.

A media report quoted Dr Girdhar J. Gyani, director general of the Association of Healthcare Providers (India) as saying: “We are likely to announce total withdrawal from cashless at a press meet by the third week of December.”

The Association of Healthcare Providers (India) represents 2,500 speciality and 8,000 smaller hospitals across India.

“From today, we have started holding meetings across India to reach a final consensus,” said Gyani.

In the same vein, Dr V.K. Monga, the chairman of the Indian Medical Association Hospital Board of India (IMA HBI) said “hospitals are bleeding”.

The IMA HBI represents 50,000 facilities enrolled under the government schemes.

He also said: “We may decide on a complete exit from the scheme as many hospitals are contemplating de-empanelment.”

Several large private hospitals like Hinduja, Apollo, Max, Fortis, Lilavati, Ganga Ram, Christian Medical College Vellore, are among at least 10,000 members of the AHPI spread across 33 states and Union Territories.

The medical associations are of the view that special rates insurance providers have negotiated rates that are 30 – 50% lower than the regular rates, and are compounding the problem.

Out of Rs 1,700 crore, according to AHPI data, the central government had checked the authenticity of claims to the tune of Rs 1,000 crore and approved payment.

But the money is yet to reach hospitals, reports said.

A media report quoted a senior official saying that the health ministry had “sent a request to the finance ministry for allotment of funds to the tune of Rs 1,000 crore to clear dues under CGHS”.

The official said: “We are awaiting a response (from the health ministry).”

Union minister of state for defence Sripad Naik told Parliament last month that an additional Rs 3,500 crore was sought under the ECHS.

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