The government has made a major change to the Central Government Health Scheme (CGHS), a health scheme for central government employees. Under this change, the old package rates have been revised. This move is expected to benefit around 4.6 million CGHS members as well as private hospitals.
The government has released new rates for 2,000 medical packages, which will come into effect from October 13. Earlier, CGHS members often complained that they could not get cashless treatment from hospitals. They had to pay large amounts out-of-pocket and wait months to get refunds.
Private hospitals said that the old package rates were outdated and did not cover current medical treatment costs. With the new rates, patients will no longer have to pay for their treatment out-of-pocket and will get cashless treatment. However, the government said that the new rates will vary depending on the hospital’s quality, the city category, the type of hospital, and the patient’s ward.
The government has made a major change to the Central Government Health Scheme (CGHS), a health scheme for central government employees. Under this change, the old package rates have been revised. This move is expected to benefit around 4.6 million CGHS members as well as private hospitals.
The government has released new rates for 2,000 medical packages, which will come into effect from October 13. Earlier, CGHS members often complained that they could not get cashless treatment from hospitals. They had to pay large amounts out-of-pocket and wait months to get refunds.
Private hospitals said that the old package rates were outdated and did not cover current medical treatment costs. With the new rates, patients will no longer have to pay for their treatment out-of-pocket and will get cashless treatment. However, the government said that the new rates will vary depending on the hospital’s quality, the city category, the type of hospital, and the patient’s ward.
Significant Changes to CGHS After 2014
The last major adjustment to the rates of the Central Government Health Scheme (CGHS) was more than 10 years ago in 2014, aside from fairly minor changes throughout that time. Earlier this month, the Central Government Employees Union (GENC) made a representation to the government.
The representation indicated that cashless treatment is creating a lot of financial difficulty for employees and pensioners for medical treatments, particularly in emergency situations. After that, the government took this important decision. The CGHS 2,000 medical package does not refer to a single package per se, but rather refers to around 2,000 types of medical treatments applicable to the Central Government Health Scheme. Private hospitals were hesitant to continue offering cashless treatment because the old rates were not consistent with medical treatments today.
How things are
The new rates for 2,000 medical packages prices vary depending on the city category (tier-I, tier-II, tier-III) and the level of quality of the hospital (NABH accredited):
- Package rates for tier-II will be 19% lower than the base rate.
- Rates for tier-III will be 20% lower than the base rate.
- Hospitals that are NABH accredited will offer services at the base rate.
- Hospitals that are not NABH accredited will receive the base rate – 15%
- Super-specialty hospitals above 200 beds will receive the base rate + 15%.
