De-empanelment of Shalby Hospital Jabalpur due to breach of MOA- Refusal for admission and not Providing cashless facilities to CGHS pensioner beneficiaries
GOVERNMENT OF INDIA
MINISTRY OF HEALTH & FAMILY WELFARE
OFFICE OF THE ADDITIONAL DIRECTOR
CENTRAL GOVERNMENT HEALTH SCHEME
1544/A-NAPIER TOWN JABALPUR (M.P.)-482001
No. 5-26/2020 ESTT/CGHS/JBP/ DI6/2700-2706
Dated the 16th October 2020
Sub: De-empanelment of Shalby Hospital Jabalpur due to breach of MOA- Refusal for admission and not Providing cashless facilities to CGHS pensioner beneficiaries.
A Memorandum of Agreement (MOA) was signed between Addl. Director CGHS Jabalpur and Shalby hospital in association with SMJ trust (Shalby Ltd) vijay Nagar Jabalpur(NABH accredited) in first and second part on 01-06-2017 with a view to provide treatment facilities and diagnostic facilities to the beneficiaries in the private empanelled hospitals.
Undersigned vide this office letter No. 5-26/2020/2458 dated 21-09-2020 read with Min of Health & FW OM No. S-11011/29/20/91 dt 13/09/2019 instructed all hospitals that under emergency condition no CGHS beneficiary be denied for admission or insist on referral memo from CGHS WCs. Despite instructions, complaints were received for refusal for admission and asking cash for admission.
This office vide letter no. 5-26/2020 dt. 25.09.2020 issued to show cause reply within 3 days from receipt of the letter emailed on 25.09.2020, hard copy got received in hospital on 26.09.2020 and also emailed to corporate on 28.09.2020, warned shalby hospital on complaints regarding not admitting CGHS beneficiary in hospital and asking cash. The hospital was also advised to refrain from such practices in future otherwise in case of default full PBG will be forfeited with removal of hospital from the empanelment under CGHS Jabalpur.
The hospital did not reply within the time frame and CGHS vide this office letter dt. 06.10.2020 and undersigned resorted to impose penalty 15% of total amount PBG ie. 1.5 lakh with instruction to the banker to deduct the amount and deposit it with government account NTRP “Bharat Kosh.”
Hospital replied on 08.10.2020 showing inability of the hospital to provide cashless facility to Covid-19 patients of CGHS as the cost of medicines/consumable is quite high
Another complaint of Shri Pushpendra Singh addressed to Additional Secretary, Joint Secretary Ministry of Health & FW, Director CGHS, Additional DDG HQ New Delhi was received to this office to take necessary action for providing cashless facilities to CGHS beneficiary. His mother was admitted in the hospital with covid positive patients with dialysis was refused to provide cashless facility.
During the corona endemic, CGHS beneficiaries mostly senior citizens are not being admitted and instructions of undersigned being overlooked and adamant not to adhere to the terms and conditions of agreement.
After issue of this office letter dated 6/10/2020 deduction 150,000/-, The Shalby hospital reiterated that unprecedented it is extremely difficult to offer credit facilities in Covid-19 treatment as the cost of medicines/consumable quite high.
Shalby hospital is not adhering to clause no 4 treatment in emergency (Refusal for admission) and clause 18 (7) Forfeiture of PBG and removal from list of empanelled organization – Refusal of credit to eligible beneficiaries and direct charging from them is breach of MOA.
In view of the above it has been decided to de-empanel the Shalby hospital in association with SMJ Trust, (Shalby Limited) Jabalpur. from the empanelled list of hospital with immediate effect with forfeiture of full bank guarantee of 10,00,000/-( Rupees Ten Lakh only) inclusive of 150,000/- ordered earlier vide letter dt 06-10-2020. The CGHS beneficiaries already being treated in the centre prior to the issue of this order shall however be continued to be provided treatment at CGHS rates till completion of their treatment and their bills would be submitted to UTIITSL/concerned department with justification, for consideration on merits.
1. The Medical Supdt., Shaby Hospital in association with SMJ Trust,(Shalby Limited) Viyay Nagar Jabalpur.
2. Director (CGHS) , Dte General of CGHS, Nirman Bhawan New Delhi.
3. Additional DDG (HQ) Dte. General of CGHS Nirman Bhawan New Delhi.
4. Pay & Account Office, Lady Harding Medical Collage New Delhi.
5. UTITSL Bhopal.
6. Branch Manager, HDFC Bank Ltd,2™ Floor, Above Emrald Honda, Opp. Gandhi Gram Railway station, Off. Ashram Road, Ahmedabad.
7. Account Section CGHS office, Jabalpur.
8. Incharges of all WCs under CGHS Jabalpur.