Reimbursements to empanelled private hospitals under the Central Government Health Scheme (CGHS) have risen sharply, from 24% of total CGHS expenditure in 2019-20 to nearly 60% in 2023-24.
This data, revealed by the health ministry in response to a parliamentary question, highlights a significant shift in healthcare spending.
The number of CGHS beneficiaries grew by 39% in this period, from 34.2 lakh in 2019-20 to 47.6 lakh in 2023-24.
However, reimbursement to private hospitals surged by nearly 300%, from ₹935 crore to ₹3,646 crore.
On March 21, the minister cited a December advisory warning empanelled hospitals against fraudulent billing, overcharging, and denial of treatment.
Complaints from beneficiaries had raised concerns about unethical practices.
Unlike Ayushman Bharat, which has a ₹5 lakh ceiling per patient, CGHS imposes no such limit.
Experts argue that this lack of oversight encourages unnecessary procedures, leading to excessive billing without accountability.
Total CGHS spending increased by 54% between 2019-20 and 2023-24.
Experts warn that growing reliance on private hospitals is undermining CGHS’s original mission of providing preventive and primary care.
Instead, CGHS is now functioning as a referral system for private hospitals, with minimal cost evaluation.
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