To
The Hon’ble President of India,
Rastrapati Bhawan, New Delhi.
Subject: Representation regarding alleged corruption in CGHS functioning and need for urgent policy reforms:
Respected Madam,
I, Lokanath Mishra, Chief Adviser, All India Pensioners Association of CBIC, most respectfully submit this representation for your kind consideration.
It has come to notice through recent developments and complaints that serious allegations have emerged regarding irregularities in the functioning of the Central Government Health Scheme (CGHS). As per reports, a complaint by Dr. Ravindra Dagar of Santosh Hospital has indicated that illegal gratification was allegedly being demanded for the release of hospital bills under CGHS.
It has further been alleged that payments were linked to a percentage of hospital bills, reportedly ranging between two to five percent. Reports also suggest that officials were taken into custody in connection with these allegations, and that intermediaries were being used for collection of such payments.
Such practices, if true, undermine transparency, discourage ethical healthcare providers, and adversely affect pensioners and beneficiaries who depend upon CGHS for their medical needs.
In light of the above, the following reforms are humbly submitted for consideration:
- Mandatory and Transparent Empanelment of Private Hospitals
All eligible private hospitals fulfilling prescribed criteria should be brought under CGHS through a transparent and uniform empanelment system. Selective inclusion should be eliminated to prevent discretion and possible malpractice. - Time-bound Digital Bill Processing System
A fully digitized system with defined timelines should be implemented for submission, processing, and settlement of hospital bills, with real-time tracking. - Interest on Delayed Payments to Hospitals
Any delay in settlement of dues to hospitals beyond the prescribed period should attract interest @12% per annum. - Interest for CGHS Beneficiaries
CGHS beneficiaries should also be granted interest @12% per annum on reimbursement claims if their bills are pending for more than one month. - Timely Supply of Indented Medicines
Medicines prescribed should be supplied within the next day of prescription without delay. - No Change in Prescribed Brand by Specialists
The brand name of medicines prescribed by specialists should not be altered or substituted arbitrarily. - Improved Behaviour and Accountability at Wellness Centres
Medical Officers and staff of CGHS Wellness Centres should be sensitized to treat pensioners and beneficiaries with dignity, courtesy, and respect. Mechanisms for accountability should be strengthened. - Independent Vigilance and Grievance Redressal Mechanism
A robust system for vigilance, third-party audit, and time-bound grievance redressal should be established to ensure transparency and accountability. - Encouraging Wider Participation of Hospitals
Ensuring fairness, transparency, and timely payments will encourage more private hospitals to join CGHS, thereby enhancing healthcare access for beneficiaries.
This representation is submitted in the larger public interest to ensure transparency, accountability, and dignity in healthcare services provided under CGHS.
I request your good offices to kindly intervene and initiate necessary reforms in the system.
Thanking you,
Yours faithfully,
Lokanath Mishra
Chief Adviser
All India Pensioners Association of CBIC
Copy to:
Ministry of Health and Family Welfare (Cabinet Minister)
Minister of State, Health & Family Welfare
Secretary, Health & Family Welfare
Director, Central Government Health Scheme (CGHS):
Additional Director, CGHS.