BENGALURU: Six major hospitals in Karnataka are owed approximately Rs 100 crore in terms of Central Government Health Scheme (CGHS) and Ex-servicemen Contributory Health Scheme (ECHS) reimbursement, according to Association of Healthcare Providers India (AHPI).
“The government is supposed to reimburse the hospitals from 15 days to 1 month after the scheme has been utilised by the patient. However, Rs 100 crore has been pending for major private hospitals in the state for anywhere between a few months to two years,” said Dr V C Shanmuganandan, Joint Director, AHPI, who did not name the hospitals.
A sum of Rs 2,000 crore is overdue to various private hospitals in the country by the central government for CGHS and ECHS, according to various private medical associations who held a press meet in the city on Monday.
Dr Giridhar Gyani, Director General, AHPI, said, “Government does not have the infrastructure or money for these schemes such as Ayushman Bharat.
“In fact, 60 per cent of the hospital beds are under private sector along with 85 per cent of tertiary care which is most important. The government has not done costing of medical procedures and the rates are not available. The package rates have also not been revised since 2014.”
The representatives said they will be constrained to suspend cashless services of central government schemes if the Centre does not pay dues. However, they did not give a deadline.
They also voiced their opposition against unsustainable price control by General Insurance Public Sector Association (GIPSA) insurance companies (public sector) and pending dues from them.
A senior doctor said the situation has reached a point where private hospitals are unable to sustain because of this. If the situation persists, it is feared that lakhs of hospital employees will lose their jobs.
Dr Devi Shetty, chairman and founder of Narayana Health, said, “CGHS should adopt interest rates if there is a delay in reimbursement. This aspect exists in Ayushman Bharat.”
Dr H Sudarshan Ballal, chairman of the Medical Advisory Board of Manipal Hospitals Group, said, “We need pricing to be viable as well as bills to be paid on time from the government. We have not renewed the CGHS contract.. Inflation also needs to be considered when ascertaining cost of procedures. This must be done or else quality of healthcare will fall.”
Private hospital associations oppose Insurance companies’ monopoly
Dr Ravindra, Private Hospitals and Nursing Homes Association president, said, “The GIPSA insurance companies control 70% of health insurance in the country and are using this monopoly to dictate rates, which are unviable. While the initial agreement with hospitals in Bengaluru included 53 procedures, they kept adding more. Since 2017 we have been opposing this and in 2019 they held a meeting when we said we would be forced to stop using their insurance.” However, he said that none of the demands they signed upon were adhered to. He added that of 230 hospitals in the city, 130 have not renewed their contract with insurance companies as they were negotiating absurd rates.