Hyderabad: The employees’ health scheme (EHS) was formulated to provide cashless treatment to state government employees and pensioners and their dependents with additional benefits such as post-operative care and chronic diseases that do not require hospitalisation. This is implemented by Aarogyasri health care trust.
Free out-patient evolution for pre-defined therapies and cashless service for post-discharge medication for up to 10 days and up to 30 days for post-discharge complications are covered under this scheme.
However, most of the private and corporate hospitals are neither honouring nor adhering to the EHS tariff that has been fixed by the government. Network hospitals are not admitting patients under the scheme stating that the state government is not clearing bills for months together.
In the bargain, government employees and pensioners are now forced to get treatment at network hospitals by paying money from their pockets and claiming reimbursement as per the approved rates. The bills and other documents are submitted to the health director for scrutiny and issue of proceedings to claim medical expenses from the treasury.
Due to undue delay that stretches beyond several months, employees, especially the retired ones, are facing a lot of hardship.
Speaking to Deccan Chronicle, retired joint director of medical and health department Dr G. Hanumanlu said that recently the government had decided to establish a separate trust with employees’ contributions to ensure cashless treatment without any hiccups, but in vain.
The Supreme Court in its recent orders in a medical reimbursement case opined that once a pensioner submits all relevant bills and documents, the amount shall be reimbursed within a month, he explained.
He urged the authorities and the directorate of health to streamline the system and expedite the reimbursement process so that the beneficiaries are not subject to any harrowing times.
