EHS draws strong response as cashless treatment expands to 919 hospitals

HYDERABAD

The New Employees Health Scheme (NEHS), introduced for Telangana government employees, pensioners and their eligible family members, has received a strong response, with 919 hospitals now providing cashless treatment.

According to government claims, since its launch on July 17, the scheme has received pre-authorisation for 15,395 treatments involving ₹104.63 crore. The empanelled hospitals include 778 private and 141 government hospitals. The police department was brought under the scheme from September 1.

The scheme is supported by a dedicated monthly fund of ₹88 crore, with employees and pensioners contributing 1.5% of their basic pay or basic pension and the government matching the contribution. While the employees and pensioners contribute about ₹44 crore a month, the government contributes an equal amount. Funds for three months have already been transferred to the trust. The annual budget for the scheme is estimated at ₹1,056 crore.

The scheme covers not only inpatient treatment but also outpatient services. Consultations, diagnostic tests and medicines are being provided cashless at wellness centres. At present, 12 wellness centres are functioning in 12 districts. Proposals have been prepared to establish another 25 centres — 21 in different districts and four in Hyderabad and Medchal-Malkajgiri — taking the total number of centres to 37.

For inpatient treatment, 1,816 CGHS treatment packages are being implemented. The packages cover treatment, medicines, diagnostic tests, consumables, implants and follow-up medical services.

In emergencies, beneficiaries can get admitted to the nearest empanelled hospital without a prior referral, though the required details have to be communicated to the trust within the stipulated time, officials said.

Officials have clarified that eligible beneficiaries should not be denied treatment merely because a health card has not been issued. Employees and pensioners can avail themselves of treatment using their identification numbers.

As of September 28, health cards had been generated for 12,56,962 beneficiaries, of whom 7,56,210 had downloaded their cards.

Of the 15,395 pre-authorised cases, 3,192 cases relating to employees involved ₹18.75 crore, while 5,669 cases relating to their family members involved ₹39.52 crore. For pensioners, 4,042 cases involving ₹29.27 crore were approved, while 2,492 cases involving their family members accounted for ₹17.08 crore.

The government has also released ₹70 crore towards pending bills under the old EHS after the new scheme came into force. Another ₹100.52 crore remains to be paid, including ₹23.85 crore to private hospitals and ₹76.67 crore to government hospitals. Cheques worth ₹19.23 crore have already been prepared for payment to private hospitals.