CGHS OPD Centres in Government Hospitals

CGHS OPD Centres in Government Hospitals

Press Information Bureau
Government of India
Ministry of Health and Family Welfare

07-August-2015 15:04 IST

CGHS OPD Centres in Government Hospitals

There is no proposal to set up separate Central Government Health Scheme (CGHS) Out-Patient Department (OPD) centres for orthopaedics and paediatrics in all the Central Government Hospitals.
However, Paediatrics Specialists are posted in Safdarjung Hospital and Dr. Ram Manohar Lohia Hospital of Delhi. Two General Duty Medical Officers with PG qualifications in orthopaedics are posted in CGHS wing of Safdarjung Hospital.

There are no sanctioned posts of Orthopaedics Specialists for CGHS wing. There is no separate CGHS wing at Lady Harding Medical College and Smt. Sucheta kriplani Hospitals.

CGHS beneficiaries can avail consultation from specialists of any Government Hospital.

The Health Minister, Shri J P Nadda stated this in a written reply in the Lok Sabha here today.

PIB

CGHS: Time limit for submission of final claims reimbursement of medical expenses

Revision of time limit for submission of final claims reimbursement of medical expenses under CS(MA) rules, 1944 – regarding.

No. S. 14025/19/2015-MS
Government of India
Ministry of Health and Family Welfare
Department of Health & Family Welfare

Nirman Bhagavan, New Delhi
Dated : 27th May, 2015.

OFFICE MEMORANDUM

Subject: Revision of time limit for submission of final claims reimbursement of medical expenses under CS(MA) rules, 1944 – regarding.

The undersigned is directed to refer to OM No. F. 29-40/68-MA dated 15.10.1968 in which it was laid down that submission of final claims for reimbursement of medical expenses of Central Government servants in respect of a particular spell of illness should ordinarily be preferred within 3 months from the date of completion of treatment.

2. A representation was received from National Council (Staff Side) to extend the time limit for submission of such medical bills from 3 months to 6 months. The matter was examined in the Ministry and it has been decided that the period of 3 month s for submission of medical claims be revised to 6 months. Henceforth, only the cases in which the bills are submitted after 6 months from the date of completion of medical treatment/discharge of the patient from the hospital are required to be taken up for condonation. The power of condonation of such delays and other terms and conditions woukld be same as enumerated in the OM No.S.14025/8/99/-MS dated 25.05.1999.

3. The issue with the approval of the competent authority.

(Sunil Kumar Gupta)

Under Secretary to the Govt. of India

Source : mohfw.nic.in

Denying cashless /credit facilities to eligible CGHS beneficiaries - Action taken against Fortis Escort Hospital

The Department of Central Government Helath Scheme has issued an order regarding suspension of empanelled hospital due to denying cashless/credit facility to eligible CGHS beneficiaries...

 

GOVERNMENT OF INDIA

Office of the Additional Director

Central Government Helath Scheme

Kendriya Sadan Parisar, Block-B, GF, Sector-10,

Vidhyadhar Nagar, Jaipur

No.CGHS/JPR/12-58/2014(Admn.) 

Dated: 14/03/2014

ORDER

 

CGHS has empanelled private hospitals and diagnostic centres in various CGHS covered cities to provide health care facilities to CGHS beneficiaries.

Empanelment of the private hospitals is done under a contractual agreement between the Government of India and the private hospitals and diagnostic centres on mutually agreed terms and conditions.

It was reported that your hospital has taken a unilateral decision of denying cashless/credit facilities to eligible CGHS beneficiaries, which is tantamount to violation of terms and conditions of MOA. Provision of treatment to pensioners and other eligible CGHS beneficiaries is one of the terms of essence, as denial of credit facility causes immense hardship to pensioners beneficiaries, who have to spend money from their meagre savings.

 

In this connection a Show Cause Notice was issued vide this office letter No.No.CGHS/JPR/12-58/2014(Admn.)/23567-68 dated 10.3.2014 giving an opportunity to your hospital to put forth your stand on the Issue.

 

The reply dated 12.3.2014 submitted by you in response to the Show Cause Notice has been examined. CGHS signed MOA with individual hospitals and not with any association and hence association has no locus stand in the matter. Hence, the reference is not relevant, Even if any hospital has some grievance and consider not viable for it to continue on the panel, it can withdraw from the list of empanelled hospitals, Government has taken several steps to clear the pending bills on priority basis and therefore, there is no major issue regarding pendency of hospital bills. It is felt that denying the treatment on cashless basis is a gross violation of terms and conditions of the MOA signed by your hospital for empanelment with CGHS.

 

Since, it is open for your hospital to withdraw from the panel and since denial of cashless facility to eligible beneficiaries is not acceptable from any hospital on the penal, it has been considered appropriate to suspend the CGHS empanelment of your hospital with immediate effect for a period of six months or till further orders, whichever may be earlier. The hospital shall no longer be a part of the list of CGHS empanelled hospitals / Diagnostic Centres for any purpose under CGHS. Patients already admitted prior to issue of this order shall however, be provided treatment at CGHS rates.

 

sd/-

(DR.D.K.GUPTA)

ADDITIONAL DIRECTOR,

C.G.H.S., JAIPUR.

 To,

The Medical Superintendent, 

Fortis Escort Hospital, 

J.LN. Marg, Malviya Nagar, Jaipur — 302017

 

Copy to The Addl.Dy.Director General.(HQ), Directorate General of CGHS, Nirman Bhawan, New Delhi.

Officer I/c, CGHS WC No.1, 2, 3, 4 5, 6, 7 and Polyclinic, Jalpur.

All the Central Govt. Office situated at Jaipur.

UTI/TSL, Bangalore.

 

View the order

 

Source: http://msotransparent.nic.in/writereaddata/cghsdata/mainlinkfile/File679.pdf

Guidelines for issue of medicines to CGHS beneficiaries from CGHS Wellness Centres for Chronic illness

Guidelines for issue of medicines to CGHS beneficiaries from CGHS Wellness Centres for Chronic illness

S 11011/2/2014-CGHS (P)
Government of India
Ministry of Health and Family Welfare
CGHS (Policy) Division

Nirman Bhawan, New Delhi
Dated; the 28th March, 2014

OFFICE MEMORANDUM

Subject: Guidelines for issue of medicines to CGHS beneficiaries from CGHS Wellness Centres - reg.

The undersigned is directed to refer to this Ministry’s O.M No.S.11011/8/99-CGHS (P) dated 13.10.1999 vide which CMO in-charge of CGHS dispensaries have been permitted to issue medicines for a maximum period of 3 (three) months at a time against a valid prescription of Government specialist to CGHS beneficiaries suffering from chronic illness like diabetes, tuberculosis, heart ailment, hypertension, I.H.D,epilepsy, etc.

2. This Ministry has been receiving representations from beneficiaries regarding the requirement of fresh consultation with Government specialist every three months for re-issue of the prescribed medicines. Requests have been received from beneficiaries to relax this condition as getting an appointment with Government specialists is difficult, especially for the old aged and physically challenged beneficiaries suffering from chronic diseases and requiring constant medication.

3. Acknowledging the difficulties being faced by the beneficiaries in obtaining prescription of Government specialist every three months, it has been decided to clarify that the CMO In-charge of CGHS Wellness Centres are competent to revalidate the prescription on the request of patient, after professionally satisfying himself / herself about the medical condition of the patient and repeat the medicines prescribed by Government specialist to beneficiaries for another three months subject to the following conditions :-

a) Medicines shall be issued against a valid original prescription from a Government specialist for advising the same.

b) CMO I/c may issue the medicines prescribed by a Government specialist fix three months at a tine during the entire treatment period indicated clearly (e.g., six months / one year) on the prescription.

c) CMO I/c may examine and advise the patient on whether to continue with the same medicines as prescribed by the Government specialist or may refer him to the Government specialist for fresh consultation, If required medically.

d) CGHS GDMOs of the Wellness Centre may prescribe routine diagnostic tests to the patients before their follow up consultation with the specialist. They should however, use discretion and not to advice specialized tests/investigations as they can only be advised by the specialists, wherever required.

e) Beneficiaries will be issued medicines for maximum three months period at a time. In such cases, where the advice of specialist is only for three months and the CMO I/c is satisfied after professional examination that the same medicines are required to be continued for treatment, the prescription may be re validated and medicines can be issued for another 3 (three) months, i.e., to a total of 6 (six) months. After six months, the beneficiaries will have to consult the Government specialist and obtain fresh prescription or get the prescription re validated from the Government specialist in cases where the treatment period is not clearly indicated on the prescription.

4. This issues with the approval of Additional Secretary and Director General, CGHS.

sd/-
(V.P.Singh)
Deputy Secretary to the Government of India

Source: www.cghs.nic.in
[http://msotransparent.nic.in/writereaddata/cghsdata/mainlinkfile/File674.pdf]

MAJORITY OF EMPANELLED HOSPITALS ARE PROVIDING CREDIT FACILITY TO ELIGIBLE CATEGORIES OF BENEFICIARIES - DIRECTORATE GENERAL OF CGHS

MAJORITY OF EMPANELLED HOSPITALS ARE PROVIDING CREDIT FACILITY TO ELIGIBLE CATEGORIES OF BENEFICIARIES - DIRECTORATE GENERAL OF CGHS

 DIRECTORATE GENERAL OF CGHS

 It is for the information of CGHS beneficiaries, particularly for pensioners, that around 95% of the empanelled hospitals are continuing with cashless facility.

Pending bills stand cleared and is no longer an issue. For revision of rates, CGHS has received bids from 1075 hospital/diagnostic centres, etc. which is a much higher number than the existing 791 empanelled hospitals/diagnostic centres etc.

  DIRECTOR
CGHS

Source: http://msotransparent.nic.in/writereaddata/cghsdata/mainlinkfile/File671.pdf

No withdrawal of CGHS Cashless Scheme - Health Ministry

No withdrawal of CGHS Cashless Scheme - Health Ministry

There have been reports in the Media that private hospitals on the panel of CGHS are denying credit facilities to the eligible CGHS beneficiaries for delay in settlement of hospitals bills. Lower package rates and inadmissible deductions etc. have also been reported to be the other reasons for withdrawal of agreed cashless /credit facilities.

In this regard, the CGHS beneficiaries are advised not to be guided by such misleading information. Delay in payments in the last quarter of the financial year due to budgetary constraints is not a new phenomenon and the hospitals are aware of it. Ministry of Health and Family Welfare has taken special steps and the pendency is likely to be cleared within a week.

CGHS has already invited bids for revision of package rates through a transparent tender process. The last date for submission of bids is 10th March, 2014. Measures have also been taken to streamline the payment related issues in the ensuing empanelment process.

The Ministry of Health and Family Welfare will ensure that the CGHS empanelled private hospitals continue to extend cashless /credit facilities to the eligible CGHS beneficiaries in compliance with the terms and conditions as laid down in the Memorandum of Agreement signed by them with CGHS. As per the information received by the Ministry, most of the private hospitals are continuing to extend the cashless facilities to the CGHS beneficiaries.

Source: PIB News