15.01.2018 simplification_referral_cghs.pdf
File No.Z15025/117/2017/DIR/CGHS
Z 15025/117/2017/DIR/CGHS/ EHŞ Government of India
Ministry of Health & Family Welfare Department of Health & Family Welfare EHS Section
Nirman Bhawan, New Delhi. Dated the 15 January, 2018
OFFICE MEMORANDUM
Sub: Simplification of referral system under CGHS
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 CGHS beneficiaries to undertake treatment at private hospitals empanelled under CGHS. The guidelines issued earlier on referral/ permission under Office Memoranda No S 11011/6/96-CGHS (P) dt. 11/6/97 and 02/09/99, S-12020/4/97 -CGHS (P) dt. 07/04/1999. S.11011/1/200-CGHS (P) dt. dated. 11/06/2010, and 10/04/2001 RA/Cons/Hyd/09-10/CGHS-IV, Z.15025/105/2017/DIR/CGHS dt. 09/11/2017 has been reviewed and it has now been decided to revise the guidelines for consultation and treatment at CGHS empanelled private hospitals as per the details given under:
i)
and
All CGHS beneficiaries (in all CGHS Cities) shall be permitted for seeking OPD consultation from Specialists at Private hospitals empanelled under CGHS after being referred by any Medical Officer/CMO of CGHS Wellness Centre. The referral may be mentioned on the computer generated Prescription slip. After consultation at empanelled hospitals beneficiary shall report back to concerned wellness centre, where MO/CMO would endorse listed investigation and issue medicines as per guidelines mentioned below. For unlisted investigation/treatment procedure CMO Incharge shall submit the prescription to competent authority for consideration in case of pensioner beneficiaries. Serving employees shall seek permission for unlisted investigation/treatment procedure from their department as per prevailing guidelines.
The medicines prescribed by specialists shall be supplied by CGHS as per the available generic name at the CGHS Wellness Centre.
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