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File No.
No. Z.15025/14/2023/DIR/CGHS
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Issued From · Date
CGHS Bhawan, RK Puram Sector-13, New Delhi · 27th December, 2023
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| Government of India · Ministry of Health & Family Welfare · Directorate of CGHS | |
SUPERSEDESThis OM is in supersession of all earlier OMs on Delegation of Financial Powers for CGHS reimbursement. Para (v) of OM No. Z15025/79/2/DIR/CGHS dated 5th October 2016 is partially modified.
Office Memorandum
Subject
Delegation of Financial Powers for settlement of reimbursement claims / Permissions / ex-post facto approval in respect of Pensioner CGHS beneficiaries, etc.
✦ ✦ ✦ ✦
With reference to the above subject the undersigned is directed to draw attention to the OM No. Z 15025/79/2/DIR/CGHS dated 5th October 2016 vide which powers had been delegated for settlement of reimbursement claims / Permissions / ex-post facto approvals in respect of Pensioner CGHS beneficiaries. It has now been decided by the Competent Authority to further delegate financial powers to the Addl. Secretary & DG, CGHS and Director, CGHS in respect of approvals related to unlisted treatment procedures / investigations / implants, in partial modification of para (v) of the above referred OM as per the details given under:
Para (a) — Revised Delegation of Financial Powers
Revised Delegation for Permission / ex-post facto Approval / Settlement of Medical Reimbursement Claims in respect of Unlisted treatment procedures / investigations / Implants:
| Sl. | Authority | Revised Delegated Power | Scale |
|---|---|---|---|
| a) | Additional Director, CGHS of City / Zone | Rs. 1,00,000/- (No change) | 28% of max |
| b) | Director, CGHS | Upto Rs. 3,00,000/- | 56% of max |
| c) | Addl. Secretary & DG, CGHS | Upto Rs. 5,00,000/- | Maximum |
RATEIf there is no CGHS package rate, approval as per AIIMS rate (if any); if no CGHS/AIIMS rate, approval as per actual rate.
Para (b) — Standard Technical Committee (STC) Threshold
Unlisted treatment procedures / investigations / Implants costing more than Rs. 1,50,000/- shall continue to be placed before the Standard Technical Committee (STC) for justification before approval.
Conditions & General Provisions
| Para | Provision |
|---|---|
| 2. | Revised delegations will not include any case involving relaxation of rules, irrespective of amount. Cases exceeding limits go to Ministry of HFW with concurrence of Integrated Finance Division. |
| 3. | Delegations are in supersession of all earlier OMs on this subject. |
| 4. | Other terms in OM No. Z15025/79/2/DIR/CGHS dated 5th October 2016 remain unchanged. |
| 5. | Issues with concurrence of Integrated Finance Division, Ministry of HFW. |
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(Dr. Manoj Jain)
Director, CGHS
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To
1. Addl. DDG(HQ), CGHS / AD(HQ), CGHS / All Addl. Directors of CGHS
2. Addl. CEO, NHA
3. PPS to Secretary, Ministry of Health & Family Welfare
4. PPS to AS&DG (CGHS), Ministry of Health & Family Welfare
5. PPS to JS, Ministry of Health & Family Welfare, looking after CGHS
6. N.O., CGHS (MCTC) with the request to upload this OM on the CGHS website
7. Guard file
2. Addl. CEO, NHA
3. PPS to Secretary, Ministry of Health & Family Welfare
4. PPS to AS&DG (CGHS), Ministry of Health & Family Welfare
5. PPS to JS, Ministry of Health & Family Welfare, looking after CGHS
6. N.O., CGHS (MCTC) with the request to upload this OM on the CGHS website
7. Guard file
◆
REFOMs Referenced in this Order — Direct Links
| Date | Subject & File No. | Link |
|---|---|---|
| 07.04.1999 | No. S-12020/4/97-CGHS(P) Delegation of Powers under CGHS — referral system, permission cases & ex-post-facto approval | |
| 05.10.2016 | No. Z15025/79/2/DIR/CGHS Original Delegation of Financial Powers for Pensioner CGHS beneficiaries — partially modified by this OM | |
| 27.12.2023 | No. Z.15025/14/2023/DIR/CGHS THIS OM Revised Financial Delegation — Director CGHS upto Rs. 3L, AS&DG upto Rs. 5L. Supersedes all earlier OMs. |
OMsLater OMs that Reference this Order
NOTEThe following OMs issued after this order specifically reference this OM No. Z.15025/14/2023/DIR/CGHS for delegated financial powers.
| Date | Subject & File No. | Link |
|---|---|---|
| 13.09.2022 | OM F. No. Z15025/26/2022/DIR/CGHS Original TMH Cancer OM — referral required, MoU signed. Extended by 2026 OM. | |
| 28.06.2024 | OM File No. Z15025/19/2024/DIR/CGHS/EHS Revised Referral Guidelines — No referral for TMH & Govt hospitals. References this 2023 delegation OM. | |
| 20.02.2026 | OM F. No. Z15025/26/2022/DIR/CGHS (Revised) Revised procedure — No referral. Credit covers BMT, Proton Therapy, CAR-T. Valid upto 22.04.2028. |
SUMMARYQuick Reference
No. Z.15025/14/2023/DIR/CGHS · 27.12.2023 · Supersedes all earlier delegation OMs
| ► | Additional Director, CGHS of City/Zone — Rs. 1,00,000/- (no change) |
| ► | Director, CGHS — Upto Rs. 3,00,000/- (revised upward) |
| ► | Addl. Secretary & DG, CGHS — Upto Rs. 5,00,000/- (revised upward) |
| ► | Cases exceeding Rs. 5,00,000/- — Ministry of HFW with Integrated Finance Division concurrence |
| ► | Unlisted procedures over Rs. 1,50,000/- must first go to Standard Technical Committee (STC) |
| ► | Rate fallback: CGHS rate → AIIMS rate → Actual rate |
| ► | Referenced by OM dated 28.06.2024 (Revised Referral Guidelines) for delegated powers on unlisted procedures (Section B.iv) |
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