Unrevised reimbursement rates are high, causing huge losses
Unrevised reimbursement rates are high, causing huge lossesDelhi Government Employees Health Scheme (DGEHS) was launched with a view to provide medical facilities to the city administration's workers and pensioners on the pattern of services provided by Central Government Health Scheme (CGHS).
While, DGEHS is fulfilling its aim to provide medical facilities to government employees, it has alienated itself from following the CGHS rates.
Earlier, the DGEHS used to follow the same rates as the CGHS. However the latter revised its rates in 2006 but Delhi government continues to stick to the old rates causing huge loss to the exchequer.
For instance, under CGHS, the rate of MRI of brain is Rs 2500 (without contrast) and Rs 3500 (with contrast), while under DGEHS the corresponding rates are Rs 5000 and Rs 8000. Meanwhile, Directorate of Health Services (DHS) says it will now give orders to follow the new rates, but will not take any responsibility for the earlier amount paid.
"The CGHS revised its rates 3 years back but we did not receive any notification at that time. The information came to us last year and we will now revise the rates", said S Bhattacharjee, Director, DHS.
"We are not bound to follow CGHS", said Bhattarcharjee on asking the reason for not following the new policy.
Even Delhi Jal Board (DJB), which is an autonomous body, has started following the revised rates. "We get the list approved first and then implement it for our employees", said an official of DJB.u00a0 DHS officials seemed wary when asked about the recovery of the amount paid earlier.u00a0 "If the case comes up in my department, we will definitely recover the amount. Otherwise, it depends on the cases and we will do the recovery accordingly," said Bhattacharjee.
Even doctors are concerned about recovery of the amount. "The amount is drawn from the Consolidated Fund of India. Now who will retrieve the huge amount that has been lost?" said a senior doctor from DHS on condition of anonymity.
| What is DGEHS? |
| Delhi Government Employees Health Scheme (DGEHS) was launched with a view to provide medical facilities to Delhi Government employees and pensioners on the pattern of Central Government Health Scheme on the basis of monthly contribution. The Directorate of Health Services provides health cards to all Delhi Government departments and offices on receiving their requirement details. The cards are issued to employees by their respective offices. In case of non-availability of medicines in the dispensary or hospital, an employee is entitled to reimbursement of the cost of the medicines.
In case of pensioners, they can avail of the benefit if they have the rates of subscription deducted from their monthly pension or make a lump sum payment which is equivalent to their subscription for five years. Pensioners who have settled outside Delhi can avail of the benefit only if treated in Delhi. |
