Jaipur: Rajasthan Alliance of Hospital Associations (RAHA), an umbrella of hospital associations, Thursday threatened to suspend cashless facilities for RGHS beneficiaries from Aug 25 in private hospitals.
It alleged that there is no sustainable financial and operational plan for RGHS and lack of communication between political leadership (chief minister and health minister) and the bureaucracy, leading to policies that are disconnected from ground realities.
“Currently, hospitals and IPD pharmacies generate bills of approximately Rs 350 crore per month. To run the scheme smoothly, an annual budget of Rs 4,200 crore is needed, while the allocation is only Rs 3,000 crore. This shortfall of Rs 1,200 crore leads to payment delays, arbitrary deductions, rejections, and queries,” RAHA said.
RAHA demanded that govt should maintain a 45-day payment cycle for hospitals. Alternatively, return to the reimbursement model to maintain self-regulation and financial discipline.
Develop Medical Decision Protocols (MDP) for OPD and admissions, establish clear SOPs for billing and payment processes, and restart the scheme with an appropriate budget and strengthen the government health infrastructure and relieve private hospitals from unstable financial burdens.
Former chief minister Ashok Gehlot alleged that RGHS faced issues, causing inconvenience to lakhs of govt employees, pensioners and their families.
“Our Congress govt designed the RGHS scheme based on the Indian govt’s CGHS plan to provide govt employees with cashless and straightforward access to medicines and treatment. This scheme ran smoothly until Dec 2023. If any discrepancies were found at a hospital or medical store, action was taken according to the rules,” Gehlot wrote on ‘X’.
“A few days ago, private hospitals and medical stores announced suspension of treatment and medicines under RGHS due to non-payment. Govt promised to make payments, but treatment is being halted again due to lack of payment. State govt needs to demonstrate commitment and policy to keep this scheme running,” he wrote.
