Kamal Ghorui
NEW DELHI: The Centre has given private hospitals one final window to stay on the Central Government Health Scheme (CGHS) panel, extending the deadline for mandatory empanelment formalities to April 30, 2026, while making it clear that no further extension will be granted.An office memorandum issued by the Director, CGHS, Dr Satheesh Y H, on March 28 allows hospitals to sign their Memorandum of Agreement (MoA) to complete the process by the new deadline. The extension, from the earlier March 31 cut-off, comes after several hospitals flagged technical hurdles on the newly rolled out HEM 2.0 portal — the government’s digital platform meant to streamline empanelment by moving applications and approvals online.While the transition is aimed at improving transparency, it has slowed submissions. At the same time, the government has drawn a hard line: hospitals failing to comply by April 30 will be de-empanelled from May 1, making them ineligible to treat CGHS patients or raise claims, with re-entry requiring a fresh application.Empanelment is directly tied to payments—only hospitals on the CGHS panel can treat beneficiaries and raise claims, making delays or lapses in the process a direct hit on both patient access and hospital cash flows.Once empanelled, claims are processed within defined timelines, officials said, noting that settlement typically takes up to 90 days, with delays largely arising from queries or documentation gaps. The official also pointed to revised CGHS rates in October 2025 and existing provisions to penalise hospitals for denial or delay in treatment.However, this official view contrasts with feedback from the ground. Patient groups say delays and access issues persist, reflecting deeper systemic gaps. “CGHS beneficiaries today are caught in a system marked by delays, uneven access, and weak accountability,” said TK Damodaran, general secretary of the CGHS Beneficiaries Welfare Association of India, noting that complaints often remain unresolved and disparities in care continue.Hospitals, meanwhile, point to financial stress. “Delays in CGHS payments — often stretching beyond three to six months — put significant pressure on hospital cash flows, especially for smaller facilities,” said Dr Aashish Chaudhry, managing director of Aakash Healthcare. He added that while care delivery remains uninterrupted, current reimbursement rates do not fully reflect rising costs, making timely payments and realistic revisions critical for sustainability.The order acknowledges that portal-related issues contributed to missed deadlines but makes clear this is the last extension. For lakhs of CGHS beneficiaries dependent on private hospitals, any large-scale de-empanelment could directly disrupt access to cashless treatment across cities.
