Govt Data Shows CGHS Spending on Private Hospitals Rose From 24% to 60% in 4 Years

According to earlier parliamentary responses and information from the CGHS website, the number of CGHS beneficiaries has grown from 34.2 lakh in 2019-20 to 47.6 lakh in 2023-24, marking a 39% increase.

Reimbursements to impaneled private hospitals under the Central Government Health Scheme (CGHS) have increased significantly, from 24% of total expenditure in 2019-20 to nearly 60% in 2023-24.

The health ministry revealed the data in response to a parliamentary question.

According to earlier parliamentary responses and information from the CGHS website, the number of CGHS beneficiaries has grown from 34.2 lakh in 2019-20 to 47.6 lakh in 2023-24, marking a 39% increase.

This increase in beneficiaries has sparked concerns over fraudulent billing, overcharging, and lack of oversight by impaneled hospitals.

The latest data shows that reimbursements to private hospitals for treatment have surged by almost 300%, from INR 935 Cr to INR 3,646 Cr during this period.

Further, between 2019-20 and 2023-24, total government expenditure on CGHS increased by 54%. The rising financial burden and allegations of malpractice have led to growing calls for stricter oversight and regulatory reforms.

Moreover, the data highlights a significant rise in reimbursements to private hospitals, raising questions about the scheme's cost-effectiveness and regulatory oversight.

During a parliamentary discussion on March 21, health minister JP Nadda cited an advisory issued by CGHS headquarters in December 2023, warning impaneled hospitals against fraudulent practices.

The advisory acknowledged beneficiaries' complaints regarding overcharging, treatment denial, and other grievances.

Recently, CGHS suspended the empanelment of 19 hospitals and healthcare organizations under CGHS Delhi/NCR due to fraudulent billing practices.

Some of these institutions were found to have repeatedly admitted beneficiaries alongside their family members and raised fake bills.

Unlike the Ayushman Bharat scheme, which imposes an INR 5 lakh spending cap per patient, CGHS has no limit, further fueling concerns about unchecked medical expenses.

In 2024, the Ministry of Health and the Quality Council of India (QCI) announced a five-year collaboration to improve Central Government Health Scheme (CGHS) healthcare services.

The partnership aimed to provide high-quality healthcare services to an estimated 42 Lakh CGHS beneficiaries, ensuring that the scheme becomes the role model for efficient healthcare in India.

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