Explore cashless medical care under scheme, Karnataka high court tells central government | Bengaluru News

Bengaluru: Karnataka high court has directed the central govt to examine the feasibility of introducing a cashless medical treatment mechanism under the Central Govt Health Scheme (CGHS), particularly for emergency and critical care. The aim is to prevent situations where serving or retired govt employees and their dependent family members have to bear substantial medical expenses and then face prolonged reimbursement delays.Justice Suraj Govindaraj issued the directions while allowing a petition filed by Ivy Miller Chahal, a retired IAS officer. The judge also directed the authorities to fully reimburse within a period of 30 days the Rs 15.3 lakh medical costs incurred by the petitioner, along with 12% interest from Oct 30, 2023, the date of payment. Chahal, a Madhya Pradesh-cadre IAS officer living in Bengaluru, moved the high court after repeated failed attempts to seek reimbursement of the expenses incurred during the treatment of her husband, Gurmail Singh Chahal, a retired executive director of Madhya Pradesh Tourism Development Corporation. Gurmail Singh underwent emergency treatment at Narayana Institute of Cardiac Sciences in April 2023, and in Oct of the same year, he received a CRT-D (cardiac resynchronisation therapy with defibrillator) implant. The procedure and the implant cost Rs 15,30,093. He died on March 18, 2024.Justice Govindaraj noted that patients or their attendants cannot be expected to assess treatment protocols or evaluate reimbursement eligibility under the CGHS framework during life-threatening emergencies. “A welfare scheme cannot be administered in a manner that is oblivious to ground realities. The state, having assured its employees of medical security both during service and after retirement, cannot resile from it by subjecting genuine claims to rigid, post-event technical evaluation divorced from compassion, fairness, and common sense,” the judge said. The court stressed that the requirement to initially mobilise large sums of money during medical emergencies undermines the very object of a welfare health scheme. Emergency medical treatment, by its very nature, does not permit financial planning, administrative compliance, or prior approvals. In the case at hand, expecting a patient or family member to arrange funds on short notice, and then navigate procedural scrutiny for reimbursement, resulted in avoidable distress, delayed treatment, or post-treatment litigation, the judge observed, adding that such actions are especially inequitable in the case of retired employees, whose earning capacity and financial security are limited. A cashless treatment mechanism, particularly for emergency and life-saving procedures, would significantly mitigate these hardships and align the administration of CGHS with Constitutional values. Such a system would give meaningful effect to the right to health under Article 21, ensure non-arbitrary access to medical care under Article 14, and reinforce the state’s obligation as a welfare employer, Justice Govindaraj observed.