Amidst CGHS Package Rate Hike, Pricing Of Diagnostics, Surgical Packages Unchanged
The Union Health Ministry has decided to revise the Central Government Health Scheme (CGHS) package rates for all beneficiaries and has also simplified the referral process under it for the benefit of the employees, according to an official statement.
For the approximately 42 lakh Central government employees, pensioners, and other beneficiary categories registered in the programme, as well as their dependents, CGHS serves as the nodal healthcare provider.
The CGHS provides a comprehensive range of medical services, including preventive, promotive, curative, and diagnostic services. It also includes hospitalization, specialist consultations, and medicines.
OPD rates increased from Rs. 150 to Rs. 350, while the IPD consultation price increased by Rs. 50 to Rs. 350. ICU services, which include accommodation for all ward entitlements, have been set at Rs 5,400.
The cost of hospital rooms was also changed. A semi-private ward's charge has climbed from Rs 2,000 to Rs 3,000, while a private room's rate has gone from Rs 3,000 to Rs 4,500. The rent for a general room has been set at Rs 1500 from Rs 1,000 previously.
The decision will result in an increase in spending for the government from Rs 240 crore to Rs 300 crore.
“We welcome the announcement by the government regarding the revision of CGHS rates for hospitals. CGHS rates were last fixed in 2014 and if we look at inflation, it is difficult for hospitals and labs to provide healthcare services at rates that were fixed almost 10 years back. One of the major elements of the CGHS rate revision - the pricing of package services - remains unchanged, rendering the revision too little, too late. Additionally, the revision does not include any changes to the pricing of diagnostic or surgical packages rates,” said Dr. Ashutosh Raghuvanshi, President, NATHEALTH.
According to the statement, the ministry has proposed to initially revise the CGHS package rates of consultation fees, ICU charges and room rent following an examination of demands from stakeholders and taking into consideration the increase in costs of various components of healthcare.
Commenting on the lacking provisions under the revised CGHS, Dr Raghuvanshi, stated, “We feel that the revisions have not been able to address other real challenges faced by healthcare providers especially around commitment on payment timelines apart from sustainable package rates. We urge the government to continue working towards establishing a sustainable pricing model for healthcare providers. We would also request the government to consider linking CGHS rates/prices to WPI/CPI or a comparable index for automatic corrections to keep them as current as possible.”
The referral process under CGHS has also been simplified. Earlier the CGHS beneficiary had to visit the CGHS Wellness Centre in person to be referred to a hospital. Now, a CGHS beneficiary can send a representative with the documents to the wellness centre to get referred to a hospital.
A medical officer can refer the beneficiary to a hospital after checking the documents. A CGHS beneficiary can also get a referral through a video call.
The scheme was introduced in 1954 and is currently administered by the Ministry of Health and Family Welfare. The scheme caters to central government employees and pensioners, including Members of Parliament, judges of the Supreme Court and High Courts, and employees of certain autonomous bodies, universities, and statutory organizations.
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