Question : CHARGES BY CGHS EMPANELLED HOSPITALS

(a) the details of the Central Government Health Services (CGHS) standing technical committee of RK Puram area which examines each case on its merit;

(b) the terms and conditions on which private hospitals have been empanelled for the benefit of CGHS beneficiaries;

(c) whether those terms and conditions are beneficial to the beneficiaries or is there any proposal to review them;

(d) if so, whether certain doctors of Centre for Sight generally operates eyes only on their charges which range from Rs. 40000/- and above;

(e) if so, the extent to which these charges are justifiable; and

(f) the steps taken by the Government to take up the matter with the centre for sight and fix reasonable/affordable charges for such centres for CGHS beneficiaries?

MINISTER OF THE STATE IN THE MINISTRY OF HEALTH AND FAMILY WELFARE (SHRI GHULAM NABI AZAD)

(a): There is no such Standing Technical Committee at R.K. Puram area. However, the Ministry has constituted a Standing Technical Committee to examine, assess and make suitable recommendations on acceptability/ admissibility of medical reimbursement claims wherever required, as per the CGHS guidelines.

(b): The basic terms and conditions for empanelment of private hospitals are as under:

# they will charge CGHS approved rates for different procedures;

# they will provide cashless treatment to pensioner beneficiaries;

# they will comply with CGHS rules and guidelines issued from time to time; and

# they will strictly follow the terms and conditions of the Memorandum of Agreement (MOA) signed with CGHS. A cop of the draft MOA is available at the CGHS website: http://msotransparent.nic.in/cghsnew/index.asp

(c): The terms and condition are sat up keeping in view of the benefits/convenience of the CGHS beneficiaries and to provide comprehensive and Quality medical care to them. The terms and conditions are reviewed at the time of initiating fresh empanelment.

(d) & (e): Center for Sight a CGHS Empanelled hospital and is supposed to charge CGHS beneficiaries as per the approved rates only.

(f): As an empanelled hospital, Centre for Sight is under a legal obligation to charge the approved CGHS rates for different clinical procedures. In case of any violation of the terms and conditions of Memorandum of Agreement signed by them, suitable penalties can be imposed including depanelment of hospital.