U Sudhakar Reddy/Hyderabad
Vigilance and Enforcement has unearthed health
fraud by private referral hospitals across the State where the
hospitals are charging excess than the CGHS rates for government
employees, pensioners, MLAs and ex-MLAs causing huge loss to the
exchequer which would run into crores of rupees.
In the investigation done by Vigilance department it was also found
that most of the hospitals are avoiding free treatment to BPL families
of 5 per cent of total inpatients and 10 per cent of outpatients and
not giving free health care to the students of social welfare hostels.
In a major irregularity and manipulation some of the hospitals have
created records to show that they provided free treatment to white
card holders. However they have claimed the same bills under
Aarogyasree scheme and other insurance.
Out of 827 hospitals in the State, 69 were checked at random, and all
of them were found to be erring. In Hyderabad, all top hospitals are
under violators list and Vigilance department has asked State Medical
and Family Welfare department to recover excess charges and levy
penalty.
When contacted Vigilance and Enforcement Director Mr. RP Thakur
confirmed the report on irregularities by the private referral
hospitals and said it has been submitted to the State government.
Checks were conducted in Hyderabad, Vishakapatnam, Vijayawada and all
other cities and towns of the State.
Out of 39 patients checked as random sampling in all city hospitals
loss suffered by the government is Rs 81.53 lakh. The report said
“..very drastic and adverse excess bill amounts have been charged by
the referral hospital as against the package rate or CGHS rate….The
very purpose of MOU entered between government and hospital to
streamline the performance of referral hospitals has failed..Spirit of
government to extend welfare measures to BPL families and students
failed,”
Vigilance asked health department to warn the hospital for no
compliance. Several hospitals are not even maintaining the date.
ASHA(AP Super specialty Hospitals Association) president Dr B Bhaskar
Rao said ,”there are discrepancies as pointed by the Vigilance.
Government need to relook into this to save the health industry.
Government has been putting all kind of taxes including luxury tax,
service tax, power charges under commercial category branding
hospitals as commercial establishments. There are no incentives like
land or power given to hospitals. Health sector in the State has
created thousands of jobs. We have taken huge bank loans and to
sustain we need to run the hospitals very carefully. All the white
card holders in the State are covered under Aarogyasree scheme so
there are no patients left over to cover them under this 162 GO.
Ironically star hotels are no providing free rooms to BPL families we
the health sector is facing all these issues. Government should
rethink and come out with clarity including on packages,”
Vigilance also observed that the hospitals are not conducting free
health camps in the villages adopted by them. The enquiry report also
rapped Director of Medical Education for not conducting audits and
checks at the hospitals and for non implementation of GO 162 issues in
2005 which makes free treatment up to certain per cent of patients is
mandatory. Though the rules permit DME to hire a chartered accountant
to conduct audit he failed to do so.
DME Dr G Santa Rao said ,”After I took over four months ago I started
activating the system and served notices to several hospitals asking
them to submit information on free treatment and free cams conducted
by them. The core issue is whether they are complying with Memorandum
of Understanding. If they are not complying their recognition can be
withdrawn. We are also conducting surprise checks,”
The vigilance report also blamed the principal and wardens of SC ST BC
social welfare hostels for failing to refer the sick students to the
private referral hospitals. Interestingly the superintendents of
government hospitals are not aware of the GO regarding free treatment
to 5 per cent of BPL families.
Vigilance and Enforcement has unearthed health
fraud by private referral hospitals across the State where the
hospitals are charging excess than the CGHS rates for government
employees, pensioners, MLAs and ex-MLAs causing huge loss to the
exchequer which would run into crores of rupees.
In the investigation done by Vigilance department it was also found
that most of the hospitals are avoiding free treatment to BPL families
of 5 per cent of total inpatients and 10 per cent of outpatients and
not giving free health care to the students of social welfare hostels.
In a major irregularity and manipulation some of the hospitals have
created records to show that they provided free treatment to white
card holders. However they have claimed the same bills under
Aarogyasree scheme and other insurance.
Out of 827 hospitals in the State, 69 were checked at random, and all
of them were found to be erring. In Hyderabad, all top hospitals are
under violators list and Vigilance department has asked State Medical
and Family Welfare department to recover excess charges and levy
penalty.
When contacted Vigilance and Enforcement Director Mr. RP Thakur
confirmed the report on irregularities by the private referral
hospitals and said it has been submitted to the State government.
Checks were conducted in Hyderabad, Vishakapatnam, Vijayawada and all
other cities and towns of the State.
Out of 39 patients checked as random sampling in all city hospitals
loss suffered by the government is Rs 81.53 lakh. The report said
“..very drastic and adverse excess bill amounts have been charged by
the referral hospital as against the package rate or CGHS rate….The
very purpose of MOU entered between government and hospital to
streamline the performance of referral hospitals has failed..Spirit of
government to extend welfare measures to BPL families and students
failed,”
Vigilance asked health department to warn the hospital for no
compliance. Several hospitals are not even maintaining the date.
ASHA(AP Super specialty Hospitals Association) president Dr B Bhaskar
Rao said ,”there are discrepancies as pointed by the Vigilance.
Government need to relook into this to save the health industry.
Government has been putting all kind of taxes including luxury tax,
service tax, power charges under commercial category branding
hospitals as commercial establishments. There are no incentives like
land or power given to hospitals. Health sector in the State has
created thousands of jobs. We have taken huge bank loans and to
sustain we need to run the hospitals very carefully. All the white
card holders in the State are covered under Aarogyasree scheme so
there are no patients left over to cover them under this 162 GO.
Ironically star hotels are no providing free rooms to BPL families we
the health sector is facing all these issues. Government should
rethink and come out with clarity including on packages,”
Vigilance also observed that the hospitals are not conducting free
health camps in the villages adopted by them. The enquiry report also
rapped Director of Medical Education for not conducting audits and
checks at the hospitals and for non implementation of GO 162 issues in
2005 which makes free treatment up to certain per cent of patients is
mandatory. Though the rules permit DME to hire a chartered accountant
to conduct audit he failed to do so.
DME Dr G Santa Rao said ,”After I took over four months ago I started
activating the system and served notices to several hospitals asking
them to submit information on free treatment and free cams conducted
by them. The core issue is whether they are complying with Memorandum
of Understanding. If they are not complying their recognition can be
withdrawn. We are also conducting surprise checks,”
The vigilance report also blamed the principal and wardens of SC ST BC
social welfare hostels for failing to refer the sick students to the
private referral hospitals. Interestingly the superintendents of
government hospitals are not aware of the GO regarding free treatment
to 5 per cent of BPL families.
