DMA alleges ESIC conniving with big hospitals for CGHS facility

The Delhi Medical Association (DMA) has written to Labour Minister Santosh Kumar Gangwar protesting against new selection norms of ESIC for empanelment of hospitals for CGHS facility. The Association also alleged that these norms have been floated to help only big hospitals and eliminate the smaller ones.

The new norms also bundle diagnostic services and offers them to pay at Central Government Health Scheme (CGHS) rates which are currently sourced at a discount of 10-25 per cent over existing CGHS rates, according to some entities who have written to Employees' State Insurance Corporation (ESIC) Director General Raj Kumar in protest. "We are quite surprised to note from the above referred tender notice dated July 8, 2019 that the eligibility criteria for participating in the said tender process is per se arbitrary, discriminatory and appears to have been tailor made to suit large hospitals/ established chains and to eliminate small medical establishments," the DMA said in a letter dated July 29 to the Labour minister.

The DMA has objected to the requirement of National Accreditation Board for Testing and Calibration Laboratories (NABL)/National Accreditation Board for Hospitals and Healthcare Providers (NABH) accreditation for healthcare organisation as the recommended bodies are private bodies and have no connection with the ESIC of government of India. "It is not understood as to how a government body like ESIC can mandatorily require a certification from a private body as a precondition for empanelment," the DMA letter said.

The DMA has protested against a minimum requirement of 100 beds for multi-speciality hospitals and 50 beds for single speciality or super speciality healthcare organisations under new selection process. "By incorporating a minimum 100 beds, ESIC has eliminated small, yet efficient hospitals/nursing homes which are providing state of the art medical care to their patients. This condition is not only discriminatory and without any specific basis but has also limited the number of eligible hospitals to a fraction, thereby denying better option to the patients," the letter said.

The new selection norms offers to pay empanelled HCO (health care organisation) at CGHS rates while currently diagnostic and pathology services are sourced by ESIC at a discount in the range of 10-25 per cent. "The empanelled HCO would be paid at Central Government Health Scheme (CGHS) rates, terms and conditions as adopted by ESIC Headquarters Office from time to time," according to the new norms.

The finance wing of ESIC is also learnt to have raised question on bundling of diagnostic service with in the new HCO selection process as they are procured at discounted rates. When contacted, ESIC said that as approved by apex decision making body of the Corporation in June 2008, the services which are not available in-house and of super specialty nature are being provided at CGHS rates by empanelment of private hospitals and diagnostic centers.

"In this background the guidelines for empanelment of private hospitals and diagnostic services on CGHS rates have been framed and revised to provide quality medical care to IPs (insured persons) and their beneficiaries," ESIC said in a statement. It further said that the provisions are aimed to not only provide medical care services to the beneficiaries but also to maintain a common standard of such empanelled private hospitals and diagnostics and facilities available there.

(This story has not been edited by Devdiscourse staff and is auto-generated from a syndicated feed.)