Suspension from CGHS Panel: Heart & Lung Institute, New Delhi
F. No.6-31/CGHS/Gr Cell/2014 1464
Office of the Additional Director, CGHS
Directorate General of CGHS
Shahjahan Road, New Delhi
Dated the 14th March, 2014
CGHS has empanelled private hospitals and diagnostic centres in various CGHS covered cities to provide healthcare facilities to CGHS beneficiaries. Empanelment of the private hospitals is done under a contractual agreement between the Government of India and the private hospitals and diagnostic centres on mutually agreed terms and conditions.
It was reported that your hospital has taken a unilateral decision of denying cashless/ credit facilities to eligible CGHS beneficiaries, which is tantamount to violation of terms and conditions of agreement. Provision of treatment to Pensioners and other eligible CGHS beneficiaries is one of the terms of essence, as denial of credit facility causes immense hardship to pensioner beneficiaries, who have to spend money from their meager savings.
In this connection a Show Cause notice was issued vide F.No.6-31/CGHS/Gr Cell/2014 -441 Dated 10.03.2014, giving an opportunity to your hospital to put forth your stand on the issue. The reply submitted by you in response to the show cause notice has been examined. It is observed that in your reply you have mentioned pendency of bills in general terms without specifying the amount of pendency. CGHS signed an agreement with individual hospitals and not with any association and association has no locus standi in the matter. Hence the reference to the association is not relevant. Even if any hospital has some grievance and considers not viable for it to continue on the panel, it can withdraw from the list of empanelled hospitals.
Government has taken several steps to clear the pending bills on priority basis and has cleared the pendency. As a result pendency of bills is no more an issue. It is felt that denying the treatment on cashless basis is a gross violation of the terms and conditions of the agreement signed by your hospital for empanelment with CGHS.
Since, it is open for your hospital to withdraw from the panel and denial of cashless facility to eligible beneficiaries is not acceptable from any hospital on the panel, it has been considered appropriate to suspend the CGHS empanelment of your hospital with immediate effect for a period of ‘6’ months or till further orders, whichever may be earlier. The hospital shall no longer be a part of the list of CGHS empanelled hospitals/ Diagnostic centres for any purpose under CGHS. Patients already admitted prior to the issue of this order shall however, be provided treatment at CGHS rates.
Addl. Director (HQ), CGHS Delhi
Delhi Heart & Lung Institute. 3MM II, Panchkulan Road. N.Delhi.