F. No. S. 11011/51/2015 - CGHS (HEC)
Directorate General of CGHS
Ministry of Health & Family Welfare
(Hospital Empanelment Cell)
Nirman Bhawan, New Delhi
Dated 4th August, 2015
Subject: - Suspension of empanelment of Dr. S.S. Doda’s Ultrasound Centre, Pusa Road, New Delhi.
Whereas as a complaint was received from Mrs. Vijaya Srivastava against ill-treatment meted out to her parents at Dr. S.S. Doda’s Ultrasound centre situated at Pusa Road, New Delhi.
Whereas it was mentioned in the complaint that the beneficiary had obtained prior appointment for MRI and registration no. 01 1507290262 and 011207290263 were given at the centre. However, even after waiting for more than two hours, no clear idea was given to them regarding when the MRI would be done. The CGHS beneficiary was discriminated vis-a-vis general patients. The beneficiaries had to leave the centre without getting the MRI done. It was alleged that centre employs two different set of rules, one for CGHS and other for patients making their own payments and attitude of the centre was callous and negligent towards old and indigent patients.
Such a behavior from CGHS beneficiary violate clause 3 (A) 8:. 18 (9) of MOA, which are reproduced below:-
“3. CONDITIONS FOR PROVIDING TREATMENT/SERVICES
A. General Conditions the hospitals, Exclusive Eye hospitals/ centres, Exclusive Dental Clinics and Diagnostic centres shall be empanelled for all facilities/ services available in the health care organization as approved by NABH/NABL/QCI and shall not be empanelled for selected specialties/ facilities. The Hospitals, Exclusive Eye Hospitals/ centres, Exclusive Dental clinics, Diagnostic Laboratories/ Imaging Centres shall investigate / treat the CGHS beneficiaries only for the condition for which they are referred with due authorization letter. In case of unforeseen emergencies of these patients during admission for approved procedure, provisions of emergency treatment" shall be applicable. It is agreed that CGHS beneficiaries shall be attended to on priority. CGHS has the right to monitor the treatment provided in the Private Hospitals, exclusive eye hospitals/ centres, exclusive dental clinics, Diagnostic Laboratories/ Imaging centres”.
18. “FOREEITURE OF PERFORMANCE BANK GUARANTEE AND REMOVAL FROM LIST OF EMPANELLED ORGANIZATIONS
In case of any violation of the provisions of the MOA by the health care Organizations empanelled under CGHS such as: 1. refusal of service, 2. undertaking unnecessary procedures, 3. prescribing unnecessary drugs/ tests 4. Over billing, 5. Reduction in staff/ infrastructure/ equipment etc. after the hospital/ has been empanelled. 6. Non submission of the report, habitual late submission or submission incorrect data in the report 7. Refitsal of credit to eligible beneficiaries and direct charging from them. 8. If not recommended by NABH/NABL/ QCI at any stage 9. Discrimination against CGHS beneficiaries vis-a-vis general patients.
The amount of Performance Bank Guarantee will be forfeited and the CGHS shall have the right to de-recognize the health Care Organization as the case may be. Such action could be initiated on the basis of a complaint, medical audit or inspections carried out by CGHS teams at random- The decision of the CGHS will be final.
The issues raised in the complaint were viewed very seriously and the action of your institute in discrimination against CGHS beneficiaries vis-a-vis general patients is in violation of Clause 3 (A) 85 18 (9.) of the MOA, which is highly unjustified and objectionable.
Therefore, it has been decided to suspend the empanelment of Dr. S.S. Doda’s Ultrasound Centre, Pusa Road, New Delhi from CGHS with immediate effect till further orders. In addition the centre may submit its explanation to above issues with in a period of three weeks failing which its empnelment from CGHS would be cancelled.
[Dr. D.C. Joshi]
Nirman Bhawan, New Delhi