CGHS has empanelled 750 Health Care Organizations all over the country
While answering to a unstarred question No.695
in Lok Sabha on 27th Feb 2015, Minister of Health and Family Welfare Shri.Jagat
Prakash Nadda said there is no CGHS rates for implant then that implant is
reimbursed as per AIIMS/GB Pant Hospital rates. However, if a beneficiary opts
for a specific brand of implant, he/she shall have to give a written under-
taking to bear the difference between the cost of that specific brand and the
prescribed ceiling rate.
The detailed reply is reproduced and given
below for your ready reference…
The CGHS has empanelled 750 Health Care
Organizations all over the country.
As per reports received from the field, Grants
Medical Foundation Pune has restricted the cashless facilities to
serious/emergency cases only. Another hospitals in Ranchi ‘Shree Jagannath
Hospital and Research Centre’, which was empanelled recently on 17/11/2014 has
stopped this facility.
The reason for pendency of payment of hospital
bills is insufficient balance of funds available with UTI-ITSL (Bill Clearing
Agency) CGHS recoups funds to UTI-ITSL. There was delay in recoupment due to
technical reasons. However, efforts are being made to recoup the funds to
UTI-ITSL to avoid pendency.
In addition, through internal adjustment,
additional funds are being allocated to Pune & Ranchi to clear the pending
bills.
CGHS fixes rates for various treatment
procedures and investigations through tender process and rates were last
notified on 01.11.2014 for Delhi/NCR and on 17.11.2014 for CGHS cities outside
Delhi/NCR. AS per the Memorandum of Agreement signed by empanelled hospital
with CGHS at the time of their empanelment they are expected to charge as per
CGHS package rates only.
CGHS has fixed up ceiling rates for certain
implants without specifying any brand name. If there is no CGHS rates for
implant then that implant is reimbursed as per AIIMS/GB Pant Hospital rates.
However, if a beneficiary opts for a specific brand of implant, he/she shall
have to give a written under- taking to bear the difference between the cost of
that specific brand and the prescribed ceiling rate”.
Source: www.7thpaycommissionnews.in
