Team  SoOLEGAL

SC: No restriction can be imposed regarding treatment of patients covered under CGHS

Team SoOLEGAL 14 Apr 2018 11:50am

SC: No restriction can be imposed regarding treatment of patients covered under CGHS

New Delhi : In a decision which will have wide implication for entire health sector of the country as well as 44 lakh government employees covered under Central Government Health Services(CGHS),the  SC has ruled that a person covered under CGHS can get treatment in any Hospital where he/she thinks can get the best treatment. It is not necessary that a person has to go only to empanelled Hospitals. Further the limit on cost of treatment is not valid, the patient has to be reimbursed in toto.

The ruling came in a PIL filed by former Indian Revenue Service officer and advocate Shiva Kant Jha who was treated for a heart ailment at Fortis Escorts Hospital in Delhi and Jaslok Hospital in Mumbai in 2003. He incurred an expense of Rs 13.8 lakh on treatment. Initially he was refused reimbursement on the grounds that first the hospital was not on empanelled list, second there was no requirement for implanting CRT-D device.

After regular follow ups, an amount of Rs 5.84 lakh was reimbursed as per rates fixed under CGHS. Not satisfied, he approached SC for release of rest of the money.

In SC, govt argued that reimbursement must be done on the rate fixed by it for treatment, as private hospitals charge abnormally high treatment cost. This argument was not only rejected by the SC but it also strongly criticised  the govt for taking an "inhuman approach". The court ordered the government to release rest of the treatment cost within a month. 

This decision can also affect other PSU's which get similar benefits through their respective organisations but are bound by similar restrictive rules as in CGHS.

Tagged: SC   CGHS   PIL  
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