People suffer for want of CGHS empanelled hospitals

Amit Khajuria

Tribune News Service

Jammu, March 13

Beneficiaries of the Central Government Health Scheme (CGHS) are facing hardships due to absence of empanelled hospitals in the state.

Patients undergoing treatment at various hospitals in the state allegedly have to wait for more than a year to get their medical bills reimbursed.

Over 1,600 beneficiaries are enrolled under the CGHS in the state but there are no private or charitable hospitals where they can avail cashless treatment.

In the absence of empanelled hospitals in the state, beneficiaries have no other option but to visit government hospitals of the state. And in case of serious ailment or surgery the wellness centre at Jammu refers them to the empanelled hospitals outside the state.

However, bills from government or private hospitals take more than a year for reimbursement.

“My wife went under coronary surgery at Fortis Hospital in Chandigarh in 2014. I applied for reimbursement in December 2014, but I have not received the payment till date,” claimed a retired IPS officer and CGHS beneficiary.

“A pensioner cannot afford such a long wait. I had to spend Rs 2 lakh from my pocket, it is not easy for a pensioner like me,” he added.

Most of the beneficiaries in the state are pensioners who have limited approach to the CGHS head office in Chandigarh.

Their reach is restrained to the wellness centre at Jammu, which can only forward their medical bills for reimbursement to Chandigarh.

Dr Kuljeet Kour, in charge, wellness centre, Jammu, said: “The reimbursement process takes its own time depending on the formalities completed by the beneficiaries. We have now digitized the system. We have also started issuing smart cards to the beneficiaries.”

“This card will enable beneficiaries to go for cashless treatment at the empanelled hospitals across the country. Unfortunately, we do not have any hospital empanelled in the state. In case of any major disease we refer patients to the best hospitals outside the state and with these cards they will not have to spend out of their pocket,” she added.