Reimbursement of additional charges paid on account of overstay in the hospitals: 48th NC JCM Meeting |

Reimbursement of additional charges paid on account of overstay in the hospitals: 48th NC JCM Meeting

Minutes of the 48th Meeting of the National Council (JCM) held on 26.06.2021 vide DoP&T OM No.3/4/2021-JCA dated 14th July, 2021

5.3. Item No. NC-47/17/19: Reimbursement of additional charges paid on account of overstay in the hospitals.

The demand in brief is that in case of extended period of stay in the hospital, the additional charges may be reimbursed. In the previous NC, it was informed by Official side that additional charges on overstay are reimbursable, if justified and the hospital issues a certificate to this effect. Chairman had then observed that in cases of deliberate overstay for reasons attributable to the hospitals, the patient be reimbursed and action against the hospital be taken, and that MoHFW may review, the matter.

Secretary (Health) stated that the additional charge on account of overstay is reimbursable, if the extended period of stay is justified. He stated that the cases are examined by a Technical Committee . He further stated that there could be instances of delay at the level of Technical Committee, which would be examined, and also that in case of overcharging by hospital, which is not justified, there is a provision for recovery from the hospitals out of their bills, and to make payment to the beneficiary who has been overcharged . He also said that suggestions to further improve the system are welcome.

Shri C. Srikumar, Staff Side, informed that this facility is available only to CGHS beneficiaries, but not to those covered under the CSMA , where beneficiaries have to spend from their own pockets and, thereafter, get reimbursement. So, the demand is especially for the CSMA beneficiaries.

Secretary (Health) stated that the benefit is available to both the CGHS and CSMA beneficiaries, and if such instances of aberration are brought to notice, it will be ensured that the amount is refunded . He also requested the Staff Side to make wide publicity of this provision.

Decision: – Chairman stated that the instances of payment of additional charges on account of over stay in the hospitals by CS (MA) beneficiaries may be brought to the notice of MoHFW for consideration by Staff Side. With this observation , the item to be treated as closed.