Health
& Family Welfare Minister Shri. Ghulam Nabi Azad replied in Lok Sabha on
17.8.2012 to the question of 'what action taken by the Government, whether
complaints have been received about the dissatisfaction of a large number of
Central Government Employees with the services provided by the Government under
the Central Government Health Scheme'.
PERFORMANCE OF
CGHS
While CGHS endeavors to provide best possible health care facilities to the
large number of beneficiaries consulting / visiting CGHS Wellness Centres
(approx. 1.2 Crore during the last one year), some complaints are received
about unsatisfactory services.
The dissatisfaction relates to shortage of doctors and other manpower resulting
in waiting period before consulting doctors, issue of medicines, delay in
settlement of medical claims of pensioners, issue of medicines of specific
brand, reimbursement at CGHS rates for the treatment taken from unrecognized
hospitals, overcharging by empanelled hospitals, opening of new dispensaries,
etc.
Government has been receiving increased budgetary support over the last few
years to take care of CGHS beneficiaries.
Government has undertaken several steps to improve the functioning of CGHS.
These include:
·
Computerization to improve better inventory
management and availability of medicines at CGHS Wellness Centres. Based on
computer data, 272 commonly indented medicines are procured from manufacturers
at discounted rates and make them available at Wellness Centres.
·
Portability of CGHS cards at any dispensary all over
the country.
·
Issue of medicines for three months in cases of
chronic illnesses.
·
Appointment of Medical officers on contract basis as
an interim measure to tide over shortage of doctors.
·
Receipt of medical claims of pensioners at
Dispensary level and proper verification of documents by CMO i/c to ensure that
all required documents are submitted.
·
Enhancement of financial powers of Addl. Directors
upto Rs.5 Lakhs for speedy settlement of medical claims of pensioners.
·
Regular meetings undertaken by Addl. Directors with
CMOs i/c to ensure smooth functioning of Wellness Centres for better delivery
of services.
·
Reimbursement from two sources – i.e., from CGHS as
well as medical insurance in respect of beneficiaries holding mediclaim
policies.
·
Formation of Standing Technical Committees for
examination of requests for full reimbursement.
·
Settlement of hospital bills of empanelled hospitals
and diagnostic centres through UTI-ITSL for early settlement of claims to
ensure that the empanelled hospitals provide credit facility to pensioners ,
etc.,
Pensioner CGHS beneficiaries
residing in non-CGHS areas are permitted to avail IPD and follow up treatment
from CS (MA)/ ECHS empanelled hospitals with prior permission from CGHS.
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