Rajasthan High Court: In a civil writ petition filed by Medipulse Hospital, the petitioner, challenging an office memorandum issued by the Additional Director of the Central Government Health Scheme (CGHS), which de-empanelled the hospital from the CGHS network for five years, a single-judge bench of Dinesh Mehta, J., quashed the de-empanelment order and directed the respondent to allow the petitioner hospital to resume its services under CGHS immediately.
In the instant matter, the petitioner, Medipulse Hospital was empanelled under CGHS through an agreement executed on 07-09-2019. The CGHS provides that Central Government employees can receive treatment at their own cost and seek reimbursement, while retired employees can either use a CGHS card for cashless treatment or bear the cost and later claim reimbursement.
On 26.02.2024, a retired Central Government employee, was admitted to the hospital. A dispute arose regarding the treatment costs, leading to a complaint on 04-03-2024 alleging inadequate care and pressurisation for cash payments. The Additional Director of CGHS issued a show-cause notice to the petitioner hospital on 06-03-2024, seeking reply within three days. The petitioner claimed that they had not received the notice and instead received the de-empanelment order directly on 05-04-2024. Aggrieved by the impugned de-empanelment from the CGHS network for five years, the petitioner hospital filed the present petition challenging the office memorandum dated 05-04-2024 issued by Additional Director of CGHS.
The petitioner argued that the de-empanelment order violated the principles of natural justice as the petition hospital did not receive the show-cause notice and was not given a fair opportunity to respond before the decision was made. The petitioner contended that there is no provision in CGHS guidelines or the agreement that permits de-empanelment for five years, making the order illegal and arbitrary. However, the respondents argued that the petitioner was given a chance for a post-decision hearing, as directed by the court, and that the ongoing review will address the issues raised. The respondents asserted that the petitioner should await the final decision of the competent authority without undue interference.
The Court found that the de-empanelment order dated 05-04-2024 was issued in contravention of natural justice principles due to the lack of proper notice and opportunity for the petitioner to respond. The Court also noted that there is no statutory provision or agreement clause supporting the de-empanelment for five years, thereby deeming the order illegal.
The Court quashed the de-empanelment order and directed the respondent to allow the petitioner hospital to resume its services under CGHS immediately. The Court further directed that any future proceedings against the petitioner hospital be conducted in accordance with the law, ensuring the petitioner hospital is given a personal hearing and a reasoned order is issued.
[Medipulse Hospital v. Union of India, 2024 SCC OnLine Raj 2464, Decided on 06-08-2024]
Advocates who appeared in this case :
Mr. RN Mathur, Sr. Advocate assisted by Mr. Falgun Buch and Mr. Vikas Balia, Sr. Advocate assisted by Mr. Gopal Krishna Chhangani, Counsel for the Petitioner
Mr. Mukesh Rajpurohit, Dy. SG assisted by Mr. Uttam Singh Rajpurohit, Counsel for the Respondents
