Question : REIMBURSEMENT OF CGHS BENEFICIARIES

(a) whether the Government are aware that in private hospitals recognised for CGHS beneficiaries charge Rs. 1650/- for dialysis whereas Rs. 400/- are given as reimbursement for the same;

(b) if so, the reasons for which full reimbursement is not given for the amount CGHS beneficiaries pay in such hospitals; and

(c) the steps, the Government propose to take to remedy the situation and make full payment of the expenses incurred by CGHS beneficiaries in private hospitals recognised for them?

Answer given by the minister

THE MINISTER OF STATE IN THE MINISTRY OF HEALTH AND FAMILY WELFARE (SHRI A. RAJA)

(a) The various private hospitals recognised under CGHS charge different rates for dialysis. The approved rates for dialysis under CGHS is as follows :-

1. Rs.400/- as procedural charges.	2. Actual cost of medicines.	3. Actual cost of artificial Kidney.	4. Actual cost of disposable surgical sundries.

Therefore, as per the above calculation, the admissibility for reimbursement of dialysis charges to CGHS beneficiaries varies from case to case.

(b) The reimbursement of the treatment taken by CGHS beneficiaries in private hospitals recognised under CGHS is restricted to the package deal rates/ceiling rates approved by the Govt.

(c) The Government would henceforth be entering into a Memorandum of Undertaking (MOU) with the private hospitals which get recognised under CGHS and this would restrict such private hospitals to charge CGHS beneficiaries as per the approved rates fixed by the Govt.

Question : REIMBURSEMENT OF CGHS BENEFICIARIES

Answer given by the minister

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