A lobby group of private hospitals has urged the government to immediately release outstanding dues of over ₹500 crore related to the central government health scheme (CGHS) to hospitals, and said any further delay may force them to refuse treatment to CGHS beneficiaries.
Association of Healthcare Providers of India (AHPI), in a letter to the ministry of health and family welfare, said hospitals have been made to wait for months and years to get the dues, impacting the cash flows.
Large hospital chains have started reducing their exposure to institutional business comprising CGHS and other government schemes, citing low package rates and delayed payments.
According to AHPI, the government owes more than ₹500 crore to 61 hospitals including large chains such as Max Healthcare, Apollo Hospitals, Fortis Healthcare, and Narayana Health.
CGHS dues to Max Healthcare stood the highest at ₹192 crore, followed by Fortis at ₹67 crore, Apollo at ₹62.4 crore, Narayana Health at ₹29 crore, Ruby Hall Clinic at ₹22.7 crore, and Krishna Institute of Medical Sciences at ₹12 crore, the association said in the latter.
Hospitals had signed an agreement with the government on October 1, 2014, whereby one of the provisions is to make 70% payment within five working days of submission of bills by hospitals.
“In none of the cases, payments have been made within such a stipulated time,” AHPI said. “This results in pushing hospitals to a state of unsustainability. Hospitals are forced to avoid/refuse beneficiaries for treatment.”
Max Healthcare has reduced its exposure to institutional business to 31% as on December 31, 2022, from 37% over the last three years.
The company said in the next 2-3 years, it wants to cut its exposure by half. “The continuous and perennial delay in CGHS payments seriously impacts hospitals’ cash flow,” said Girdhar Gyani, director general of AHPI.
He also pointed to low rates for reimbursement that have not been revised since 2014. “Due to these factors, CGHS is losing its sheen among hospitals as well as among beneficiaries,” Gyani said.
CGHS covers healthcare facilities extended to around four million current and retired central government employees and their families. Beneficiaries receive cashless healthcare from empanelled private hospitals, diagnostic centres, and government-run wellness centres and dispensaries, which are later reimbursed by the government.
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