Gurgaon hospital to pay 1.5L as CGHS fine

Gurgaon: A city-based private hospital has been fined Rs 1.5 lakh for charging a central government health scheme (CGHS) beneficiary Rs 58 nearly two years ago.

Additional director of CGHS, Dr Praveen Kumar, has slapped the penalty on Max Hospital after it emerged that it refused free treatment to the Sushant Lok resident, a retired central government employee, despite being referred by the authority concerned.

As per norms, the empanelled hospitals are required to provide cashless facility to CGHS beneficiaries. However, Max charged him Rs 58. As per the guidelines, the hospital has to be charged with 15% of its bank guarantee (which is Rs 10 lakh) in case of refusal of free treatment to CGHS beneficiaries.

"The hospital has refused to provide credit facility even of (after) producing prior referral letter and charged a sum of Rs. 58," says the notice (a copy of which is with TOI).

The notice also mentions that the hospital didn't respond to the letters issued by CGHS in the past to provide explanation regarding the case, which is a violation of Clause 21(a) of MOA (Memorandum of Association between CGHS and empanelled hospitals).

A spokesperson for Max Healthcare said, "We treat all CGHS beneficiaries cashless. This particular case might have been a mistake by our front office. Though we are treating all CGHS beneficiaries as per norms, CGHS owe us over Rs 55 crore."

He added, "Also, CGHS is very conviniently sending us notices, but hasn't yet provided a copy of the MoU we signed with them. We are following all the norms though."

However, Saxena said complaints against hospitals by CGHS beneficiaries have increased two-fold in the past two to three years.

"We get about 200 complaints every month against various private hospitals for refusing treatment to CGHS beneficiaries. While private hospitals are paid by CGHS for providing the services, they only treat VIPs and neglect the common man. It is a very good decision to penalise a defaulting hospital. It will be a deterrent for other empanelled hospitals too," he said.

CGHS has 11 empanelled private hospitals, five eye clinics, eight dental clinics and three specialised diagnostic laboratories in the city. Over 1 lakh residents in the city are CGHS beneficiaries.

Read more at http://timesofindia.indiatimes.com/city/gurgaon/Gurgaon-hospital-to-pay-1-5L-as-CGHS-fine/articleshow/51033611.cms

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