Lok Sabha Question No. 639 (UNSTARRED), answered on 2022-02-04
Subject: Cashless Facilities to CGHS Beneficiaries
Ministry: HEALTH AND FAMILY WELFARE
Asked by: K. Shanmuga Sundaram, P. Velusamy

## GOVERNMENT OF INDIA MINISTRY OF HEALTH AND FAMILY WELFARE DEPARTMENT OF HEALTH AND FAMILY WELFARE

## LOK SABHA UNSTARRED QUESTION NO: 639 TO BE ANSWERED ON 04 TH  FEBRUARY, 2022

## 'CASHLESS FACILITIES TO CGHS BENEFICIARIES'

## 639 SHRI SHANMUGA SUNDARAM K.: SHRI VELUSAMY P.:

Will the Minister of HEALTH AND FAMILY WELFARE be pleased to state:-

- (a) whether  the  Government  is  aware  of  the  fact  that  several  private  hospitals  empanelled  under  the Central Government Health Scheme  (CGHS)  decided to suspend cashless services to the beneficiaries of the healthcareprogramme;
- (b) if  so,  the  details  thereof  and  the  pending  amount  to  be  paid  to  the  hospitals  both  private  and Governmentcategory;
- (c) whether the cashless services to Ex-Servicemen Contributory Health Scheme is also suspended  by thehospitals in private  sector; and
- (d) the    steps    taken    by    the    Government    to    ensureun-interrupted  cashless  services    to  the beneficiaries?

## ANSWER

## THE MINISTER OF STATE IN THE MINISTRY OF HEALTH AND FAMILY WELFARE (DR. BHARATI PRAVIN PAWAR)

(a)  to  (d):Under  the  Central  Government  Health  Scheme(CGHS),  empaneled  Health  Care  Organizations (HCOs) are required to provide cashless facilities to the eligible CGHS beneficiaries. However, there have been reports that some hospitals are not providing cashless facilities. Suitable action is taken against them whenever  such  cases  come  to  notice.  AMRI  Hospital,  Bhubneshwar,  M/s  Charnock  Hospitals  Pvt.  Ltd., Kolkata,  Rabindranth  Tagore  International  Institute  of  Cardiac  Sciences,  Kolkata  and  Utkal  Hospital, Bhubaneshwar,  Fortis  Healthcare  Limited,  Shalimar  Bagh,  New  Delhi  and  Amar  Eye  Centre,  Naveen Shahdara Delhi have submitted notice to opt out of CGHS.

Under CGHS, during the current Financial Year, HCOs' bills worth Rs. 1200 crore (approx.) have been paid and bills amounting to Rs. 1100 crore (approx.) are received for payment.

Regarding  Ex-Servicemen  Contributory  Health  Scheme  (ECHS),  as  per  the  information  provided  by  the Ministry of Defence, 174 Health Care Organizations (HCOs) have stopped giving cashless services to ECHS beneficiaries.

Under CGHS, following steps have been taken to ensure uninterrupted cashless services to the beneficiaries:(i) Adequate funds are provided to CGHS under the relevant Head of Account for clearance of hospital bills. (ii)  Hospital  Bills  are  regularly  processed  for  settlement  and  an  amount  of  Rs.  1200  crore  (approx.)  has already been paid to private hospitals during current Financial Year 2021-22. (iii) Additional manpower has been mobilised to expedite settlement of hospital claims. (iv) In June 2021, CGHS has shifted to settlement of bills in paperless mode on the IT Platform of National Health Authority which is an attached Office of Ministry of Health & Family Welfare. As informed by Ministry  of Defence,  following  steps  have  been  taken  for  timely  payment  of  bills  to  the hospitals empanelled under ECHS: (i) Provision of adequate budgetary support has been made. (ii) Usages of IT solution for continuous monitoring for efficient processing of bills and timely payment. (iii) Empanelment of additional HCOs as an alternative to those who have refused services.

*******