Questions Raised Over Large CGHS Bill Cuts, Letter Sent to Centre for Transparency

Kanpur: The issue of large deductions from bills of hospitals empanelled under the Central Government Health Scheme (CGHS) has now been taken up with the Central Government. Pension Forum General Secretary Anand Awasthi has written to the Additional Secretary and Director General, Ministry of Health and Family Welfare, New Delhi, seeking transparency and accountability in the process.

The letter says that large amounts are being deducted from the bills of CGHS panel hospitals in Kanpur under the name of "unjustified items". The forum has raised concern that hospitals are not being given an item-wise details showing how much money was deducted, under which item it was deducted and the reason for the deduction.

Awasthi referred to Office Memorandum No. Z/1/2022-DIR(CGHS), dated November 10, 2022. He said CGHS has the authority to check bills and deduct amounts for unjustified items, but the process should be clear, specific and based on proper reasons. He said that when the reason for a deduction is not given, hospitals do not get an opportunity to explain their position or match the deductions with their bills.

The issue was also raised during a meeting between the Pension Forum and the Additional Director, CGHS Kanpur. According to the forum, it did not receive a satisfactory response. The forum said that when a deduction directly affects the payment received by a service provider, it should not be treated only as an internal accounts matter.

The letter lists six main demands. These include a review of the bill checking process across the country, details of the item, quantity, amount and rule for every deduction, providing the deduction details to hospitals before the bills are settled, and setting up an appeal system where hospitals can seek an explanation or raise a dispute over a deduction.

The forum has also demanded a review of delays in hospital bill payments after the implementation of CGHS-2.

Awasthi said that if hospitals do not receive their full payments on time, it could directly affect the health services provided to CGHS beneficiaries.