Government urged to ensure effective implementation of Employees Health Scheme

The Hindu

09-05-2025

Leaders of Andhra Pradesh Joint Action Committee (JAC) Amaravati have urged the government to ensure effective implementation of the Employees Health Scheme (EHS) — launched a decade ago to cater to the medical needs of the government employees, teachers and pensioners in the State.
A delegation of the JAC met Chief Secretary K. Vijayanand on Thursday and said the health cards given under the scheme were being honoured only for select illnesses in select hospitals, while the promised 'cashless treatment' was not being implemented. Despite monthly contributions which ran into crores of rupees, employees were forced to spend money from their pockets for major illnesses, they said. To meet their medical expenses, employees were forced to opt for private loans running into lakhs of rupees and falling into huge debt traps, they added.
JAC chairman Bopparaju Srinivasulu and secretary general P. Damodara Rao said the empaneled hospitals offered treatment only for the procedures that were financially beneficial to them and even after submitting the reimbursement claims, the employees were paid only a fraction of the claimed amounts.
The JAC leaders said issues like the network hospitals denying treatment to the employees due to accumulation of huge pending bills, absence of proper tariff-based billing system for recognised treatments and surgeries, lack of annual price escalation in line with consumer price index and outdated and unreviewed treatment packages needed to be addressed immediately.
The network hospitals association continues to issue warnings on its intention to stop the services on account of non-payment of the bills, leaving the employees in the lurch and defeating the purpose of cashless medical treatment under EHS, they said and pointed out that a steering committee meeting chaired by the Chief Secretary in August, 2023, and a management committee meeting held by the Medical Services Trust in March, 2024 had failed to yield any desired result. There is no transparency or information on whether the agreed resolution was implemented, they said, pointing out that hospitals had started refusing EHS cards, forcing a major chunk of the employees, especially pensioners, to borrow money at high interest rates for treatment.
They demanded immediate steps to ensure that all the network hospitals provide all types of free medical services under the EHS scheme, provision of annual health check-ups for employees, pensioners and their families, out-patient services for chronic diseases, free supply of generic medicines, streamlining of the medical reimbursement process, issue of smart health cards, revision of the health package rates and increase in the reimbursement ceiling for all medial procedures.