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

Z 15025/105/2017/DIR/CGHS/EHS
Government of India
Ministry of Health and Family Welfare
Department of Health & Family Welfare
EHS section
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Nirman Bhawan, New Delhi
Dated the 9th November, 2017


OFFICE MEMORANDUM

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

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CGHS beneficiaries:

1. All Central Government employees paid from the Central Civil Estimates (except Railways and Delhi Administration), including their dependant family members residing in CGHS covered areas.

2. Pensioners of Central Government (except pensioners belonging to Railways and the Armed Forces) and their families.

3. Central Government Pensioners retiring with Contributory Provident Fund benefits and their families.

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     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 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.


[Sunil Kumar Gupta]
Under Secretary to Government of India
Tel- 011-2306 1986


To:
1 All Ministries / Departments, Government of India
2 Director, CGHS, Nirman Bhawan, New Delhi
3 Adl.DDG(HQ)/All Additional Directors /Joint Directors of CGHS cities outside Delhi
4 All Pay & Accounts Officers under CGHS
5 Additional Director (Hqrs) / Additional Director (SZ)/ (CZ)/(EZ)/(NZ), CGHS, New Delhi
6 JD (Gr.)/JD(R&H), CGHS Delhi
7 CGHS Desk-I/Desk-II/CGHS-I/CGHS-II, Dte.GHS, Nirman Bhawan. New Delhi
8 Estt.I/ Estt.II/ Estt.III/ Estt.IV Sections, Ministry of Health & Family Welfare
9 Admn.I / Admn.II Sections of Dte.GHS
10 Rajya Sabha / Lok Sabha Secretariat
11 Registrar, Supreme Court of India /Punjab & Haryana High Court, Chandigarh
12 U.P.S.C.
13 Finance Division
14 Deputy Secretary (Civil Service News), Department of Personnel & Training, 5th Floor, Sardar Patel Bhawan, New Delhi.
15 PPS to Secretary (H&FW)/ Secretary (AYUSH)/ Secretary(HR)/ Secretary(AIDS Control), Ministry of Health & Family Welfare
16 PPS to DGHS /SS&MD, NRHM / AS (H) /AS & DG (CGHS)
17 Swamy Publishers (P) Ltd., P. B. No. 2468, R. A. Puram, Chennai 600028.
18 Shri Umraomal Purohit, Secretary, Staff Side, 13-C, Ferozshah Road, New Delhi
19 All Staff Side Members of National Council (JCM) (as per list attached)
20 Office of the Comptroller & Auditor General of India, 10 Bahadur Shah Zafar Marg, New Delhi
21 All Offices / Sections / Desks in the Ministry
22. UTI-ITSC , 153/1, First floor, Old Madras Road, Ulsoor, Bengaluru-560008.
23 Nodal Officer, MCTC, CGHS with a request to upload a copy of OM on CGHS Web-site 24 Office Order folder

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