Tuesday, August 26, 2014

CGHS: Issue of medicines / reimbursement of expenditure on investigations / treatment procedures / implants and other medical devices under CGHS- regarding

CGHS orders on issue of medicines, reimbursement of expenditure on investigations, treatment procedures, implants and other medical devices under CGHS

No. 2-2/2014/CGl-IS. HQ/PPT/CGHS(P)
Government of India
Ministry of Health & Family Welfare
Department of Health & Family Welfare
Nirman Bhawan, New Delhi
Dated: the 25th August , 2014
OFFICE MEMORANDUM

Sub- Issue of medicines / reimbursement of expenditure on investigations / treatment procedures / implants and other medical devices under CGHS- regarding

With reference to the above mentioned subject the undersigned is directed to state that this Ministry has examined the matter in detail and with a View to streamlines the procedures regarding issue of medicines, reimbursement of expenditure on investigations, treatment procedures, implants and medical devices and with a View to plug the loopholes in the system, it has now been decided that:

a) CGHS shall supply / indent only those medicines, which are included in the CGHS formulary, except for para (b) below. However, for medicines prescribed outside formulary, medicines with identical formulations and /or similar therapeutic effect may be supplied from CGHS formulary against such medicines. CGHS formulary containing 1447 generic and 622 branded medicines is available on CGHS Website at http://msotransparentnic.in/cghsnew/index.asp

b) Anti Cancer and other similar medicines are however supplied on a case to case basis. Only the medicines approved by DCGI for use in India shall be supplied. In case an Indian version is available, which is cheaper than the imported medicine, only the Indian medicine shall be supplied even if, an imported medicine has been prescribed.

c) Medicines shall be supplied for a maximum period of one month.

d)In case of CGHS beneficiaries going abroad, issue of medicines shall be restricted for a maximum period of three months.

e) CGHS shall hereinafter allow only the listed investigations / treatment procedures for which there are prescribed CGHS rates, to be under taken in CGHS empanelled diagnostic centres and hospitals.

f) Similarly, only listed implants / medical devices with a CGHS prescribed ceiling rate shall be permitted for treatment / reimbursement under CGHS.

g) In those cases where any unlisted investigation / treatment procedure is undertaken the reimbursement shall be limited to the rate of nearest similar investigation / treatment procedure under CGHS. Addl. Director of the city /zone shall take a decision based on justification in such cases, in consultation with experts in the field, if necessary.

h) In those cases where any unlisted implant / device is installed reimbursement shall be limited to the CGHS rate of nearest similar implant / device. Addl. Director of the city / zone shall take a decision based on justification in such cases in consultation with experts in the field, if necessary.

i) Registration of Mobile number with CGHS has been made compulsory as a guard against misuse of CGHS Card.

j) In order to provide a mechanism to update the investigations / treatment procedures / implants , etc., as an ongoing process , a Technical Committee is being constituted to consider inclusion / exclusion of investigations /treatment procedures / implants , etc., under CGHS.
sd/-
(RAVI KANT)
Under Secretary to Government of India
011-2306 1441
Source: http://msotransparent.nic.in/writereaddata/cghsdata/mainlinkfile/File738.pdf

0 comments:

Post a Comment

Now Trending

34% DA Order for Central Govt Employees wef 01.01.2022 - Latest CG Employees DA Order Jan 2022

 DA Order for Central Government Employees from Jan 2022 - Finmin Order 2022 Latest CG Employees DA Order Jan 2022 Dearness Allowance payabl...

Disclaimer:

All efforts have been made to ensure accuracy of the content on this blog, the same should not be construed as a statement of law or used for any legal purposes. Our blog "Central Government Staff news" accepts no responsibility in relation to the accuracy, completeness, usefulness or otherwise, of the contents. Users are advised to verify/check any information with the relevant department(s) and/or other source(s), and to obtain any appropriate professional advice before acting on the information provided in the blog.

Links to other websites that have been included on this blog are provided for public convenience only.

The blog "Central Government Staff news" is not responsible for the contents or reliability of linked websites and does not necessarily endorse the view expressed within them. We cannot guarantee the availability of such linked pages at all times.

Any suggestions write to us
centralgovernmentnews@gmail.com