Corporate hospitals under the scanner

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M. Sai Gopal

Hospitals charging more from CGHS patients, says Central Vigilance Commission report

HYDERABAD: Corporate hospitals in the capital are flouting rules, while submitting medical reimbursement bills of patients covered under the Central Government Health Scheme (CGHS). This comes directly from Central Vigilance Commission (CVC), which reviewed the medical bills submitted by corporate hospitals of Hyderabad to CGHC for clearance in June-July of this year.

The CVC has asked CGHS, Hyderabad to make sure that corporate hospitals, which have formed a group-A.P. Speciality Hospitals Association (ASHA), strictly adhere to the norms, framed in the Memorandum of Association (MOA). As fallout, the CGHS, Hyderabad is putting all the medical bills submitted by private hospitals since November 2008 to closer scrutiny.

Major flaw

The major flaw detected by CVC, while checking the medical bills of CGHS patients is that super speciality hospitals, when compared to CGHS, charge less to organisations like Railways, BSNL, BHEL etc, to take up similar surgery. “A private hospital noted for heart surgeries charges Rs. 40,000 to perform Angioplasty (PTCA) on Railway employees. But, when it comes to CGHS patients, the bill to conduct same surgery is Rs. 90,000,” a CGHS authority point out.

The CVC report said that all corporate hospitals are overbilling and asked CGHS, Hyderabad to take up strict scrutiny of bills. The CGHS Hyderabad is plagued by shortage of doctors to check medical bills submitted by private hospitals for clearance. Doctors from Patna and other cities were recently deputed to thoroughly check and clear the medical bills.

The Vigilance Commission also said that a majority of the private hospitals do not submit their annual reports to CGHS for scrutiny. Corporate hospitals, to be eligible to apply for MOA should provide bank guarantee. However, the bank guarantees submitted by them are undated or they are submitted late. The CVC has asked CGHS authorities not to show any favouritism and clear bills based on first in first out basis.

The CVC and CGHS has asked private hospitals to submit an undertaking that their medical reimbursement bills would be less than the bills they submit to other institutions like Railways, Midhani, NFC and even ‘Arogyasri’. Several corporate hospitals have requested CGHS for time before they respond to the request to take up an undertaking.

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