It is learnt that the cabinet secretary has been holding rounds of discussions with stakeholder ministries and departments over the last few weeks to address various problems currently ailing the CGHS – from flagging partnership with major private hospitals amid pending dues to taxing referral system and shortage of doctors and healthcare staff to the simmering concern on linkage of CGHS cards with the digitalised Ayushman Bharat Health Account (ABHA) cards.
A committee of secretaries is learnt to be looking into the issues.
The key focus is on cutting the red tape and backlog with a simpler process that distinguishes high value transactions from petty/lower value ones, ET has learnt. The government plans to bring a minimal scrutiny regime for low value transactions below Rs 10,000 while ensuring proper verification process for higher value transactions of above Rs 10,000.
The CGHS caters to over 4.5 million people, ensuring cashless healthcare services to serving and retired central government employees, their dependents, and other beneficiaries across governmental and private hospitals/health facilities empanelled with the government.
CGHS has empanelled 1,735 private hospitals and 209 laboratories across the country for carrying out investigations and indoor treatment facilities, as per submissions made to a parliamentary panel in February this year.However, with the rates of procedures/diagnosis not revised since 2014, several private hospitals are seen as reluctant partners in the scheme. The stagnant government rates, clubbed with heavily delayed settlement of dues, have dragged down the scheme’s efficacy and treatment capability considerably.Assessments in the government point to the burgeoning bills for settlement pending within, most of which are low-value transactions.
“In all, the low-value transactions are clogging the settlement chain considerably even though they may be just about 10% of the total billing value,” an official in the know told ET.
