Question : UNIFORM FACILITIES TO CGHS INSURANCE BENEFICIARIES

(a) whether Central Government Health Scheme (CGHS) beneficiaries are liable to get the health care facilities in empanelled hospitals at par with those in Public Sector Undertakings (PSUs) and also health insurance beneficiaries;

(b) if so, the details thereof and if not, the reasons therefor;

(c) whether the Government has received complaints regarding harassment of patients admitted under the CGHS schemes and discrimination against them;

(d) if so, the details thereof; and

(e) the corrective steps taken/proposed by the Government in this regard?

MINISTER OF HEALTH AND FAMILY WELFARE (SHRI GHULAM NABI AZAD)

(a) & (b): CGHS beneficiaries are provided quality health care facilities through its large network of dispensaries in various systems of medicine. In addition, inpatient facilities are provided through the Government hospitals and a large number of empanelled private hospitals. The hospitals are under the contractual obligation to follow the terms and conditions of empanelment which include following the CGHS guidelines and the approved package rates for providing medical treatment to CGHS beneficiaries. The scope and coverage of CGHS is quite exhaustive and many public sector organisations are broadly following the CGHS guidelines in providing healthcare facilities to their employees.

(c) & (d): CGHS has received various complaints against private hospitals empanelled under CGHS regarding overcharging, denial of credit facilities, dishonoring the permission letter and pressurizing for shifting the patients before complete treatment etc.

(e): Appropriate actions are taken as per the terms and conditions of empanelment against the erring hospitals which include forfeiture of performance bank guarantee, suspension of empanelment, depanelment and even blacklisting of hospital for future empanelment under CGHS. Surprise inspections of empanelled private hospitals are also done on regular basis by the senior officers of CGHS to ensure that the CGHS beneficiaries get quality healthcare services as per the CGHS guidelines and the terms and conditions of empanelment.