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Simplification of procedure for undergoing treatment at private hospitals empanelled under CGHS

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Simplification of procedure for undergoing treatment at private hospitals empanelled under CGHS

Z 15025/105/2017/DIR/CGHS/EHS
Government of India
Ministry of Health & Family Welfare
Department of Health & Family Welfare
EHS Section

Nirman Bhawan, New Delhi
Dated the 9th November, 2017

OFFICE MEMORANDUM

Sub: Simplification of procedure for treatment at private hospitals empanelled under CGHS/CS (MA) Rules. 1944

With reference to the above mentioned subject the undersigned is directed to state that this Ministry has been receiving representations for simplification of procedure for undergoing treatment at private hospitals empanelled under CGHS. The matter has been examined and it has now been decided that CGHS beneficiaries are allowed to undergo treatment at private hospitals empanelled under CGHS of specific treatment procedures listed under CGHS rate list are advised by a Specialist in a Central Government / State Govt. Specialist hospital or a CGHS Medical Officer without any requirement of any other referral (permission) letter.

2. Private empanelled hospitals shall perform the treatment on cashless basis in respect of pensioners, ex-MPs, Freedom Fighters. Regular employees (both CGHS and CS (MA) beneficiaries) of this Ministry & other categories of CGHS beneficiaries, who are presently eligible for credit facility and shall enclose the prescription issued by Government Specialist or a CGHS Medical Officer, in original (or a self-attested photocopy) along with the hospital bill Submitted to the competent authorities.

3. Serving government employees shall enclose the prescription issued by a Government Specialist or a CGHS Medical Officer in original (or a self-attested photocopy), while submitting the medical claim to the concerned Ministry /department/office for reimbursement.

4. CGHS Medical Officer/Government Specialist shall not refer the beneficiaries to any particular empanelled hospital by name but. shall specify the treatment procedure and mention ‘referred to any CGHS empanelled centre’.

5. These orders are applicable only in respect of treatment procedures for which CGHS rates are available

6. This issue with the concurrence of IFD vide FTS No. 3130849, dated 09.11.2017.

(Sund Kumar Gupta)
Under Secretary to Government of India
Tel- 011-2306 1986

Source:Confederation

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Comments

  1. If a patient is taking treatment in empanelled hospital duly referred by CMO I/c or Medical Officer and empanelled hospital prescribed some investigations or pathological tests then endorsement from CMO or Medical officer should not be insisted because it is harassment for a patient. The tests were prescribed at 3PM and by that time CGHS dispensary is closed and endorsement is not possible. Next day is holiday then what should do in such circumstances. Secondly if a patient is taking treatment in Dwarika and his dispensary is far away say 8-9 Kms. How is it possible to get the endorsement. This points needs thorough consideration in the interest of all.

  2. Simplified delivery of routine medicines to patients who are stabilised for chronic diseases, should be sent by post after SMS message by the CGHS patients instead of going to CGHS dispensaries only to collect medicines and strained by long unnecessary waiting in queue, to all CGHS card holders.
    Patients who are bedridden should be issued medicines prescribed by their family doctor, since neither the patient can be brought to dispensaries nor CGHS specialists can do home visit . All medicines should mandatorily despatched for 3 months.
    All old cases coming to dispensaries only to collect medicines is inhuman and should be stopped forthwith and medicines including LP medicines should be posted to the residence of patients
    This will engage the medical team unnecessarily, which can be better utilised to improve the quality of medical examination of new cases, which is grossly neglected today.
    Quality of medical treatment can be improved to a great extent if each patient isafety allotted at least 15 minuted for medical examination. .

  3. CGHS Wellness centres in Hyderabad are issuing majority of the medicines manufactured by ELDER PHARMA as if they are manufactured only by the said company. Packing of these medicines are clumsy and give rise to doubts about there quality. Please look into this.