CGHS - Issue of OPD Medicines for CGHS beneficiaries going abroad

CGHS

Issue of OPD Medicines for CGHS beneficiaries going abroad

No.1-40/2019-CGHS/C&P/DIR/CGHS
Government of India
Ministry of Health and Family Welfare
Department of Health & Family Welfare
Directorate General of CGHS

Nirman Bhawan, New Delhi 110 011
Dated the 19th August , 2019

OFFICE ORDER

Subject: - Issue of OPD Medicines for CGHS beneficiaries going abroad

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With reference to the above subject the undersigned is directed to draw attention to Circular No 4-20/2003 - C&P Section dated the 28th April , 2005 vide which guidelines were issued for supply of OPD Medicines for upto '6' months to CGHS beneficiaries , who are going to stay abroad and to state that the matter has been reviewed by this Ministry and it is now decided in modification of the earlier guidelines that hereinafter, Chief Medical Officer I/C of concerned CGHS Wellness Centre is empowered for issue of OPD medicines for upto six months to the CGHS beneficiaries visiting abroad, subject to submission of the following documents:

(a) Copy of valid CGHS Card.
(b) Valid prescription for six months.
(c) Documentary Proof of going abroad like ticket , visa etc.

(Dr. Atul Prakash)
Director, CGHS

Source: CGHS

CGHS - Enhancement of Financial Powers of HoD from Rs. 2 Lakhs to Rs. 5 Lakhs

CGHS - Enhancement of Financial Powers of HoD from Rs. 2 Lakhs to Rs. 5 Lakhs

No.S.11011/20/2014-CGHS (P)/EHSS
Government of India
Ministry of Health & Family Welfare
Department of Health & Family Welfare
EHS Section

Nirman Bhawan, New Delhi
Dated: the 23 November, 2016

OFFICE MEMORANDUM

Subject: Delegation of powers to Heads of Departments in various Ministries/Departments for settling permission cases and post facto approval relating to referral system and medical reimbursement under CGHS - Enhancement of ceiling rate from Rs. 2 Lakhs to Rs. 5 Lakhs without consultation of IFD of concerned Ministry - Reg.

The undersigned is directed to refer to this Ministry’s OM No. S.12020/4/97-CGHS (P), dated 27.12.2006 and its clarification issued vide this Ministry's OM No. S.11011/20/2014-CGHS (P), dated 20.06.2014, wherein financial powers were delegated to the Heads of Departments/Ministries to settle all such cases where there is no relaxation of rules involved and admissibility of claim was worked out with reference to the CGHS approved rate list and guidelines.

2. This Ministry has been receiving requests from different Ministries/Departments for enhancement of delegation of financial powers to Head of Departments to settle medical claims/medical advance cases involving financial implications upto Rs. 5 Lakhs without referring the case to Internal Finance Division (IFD).

3. The matter regarding enhancement of delegation of financial powers to the Heads of Departments/Ministries has been examined in this Ministry and it has been decided with the approval of the competent authority to enhance the existing limit of Rs. 2 Lakhs to Rs. 5 Lakhs to settle all cases where there is no relaxation of rules and the entitlement was worked out with reference to the rate list prescribed.

In respect of cases involving payment exceeding Rs. 5,00,000/- (Rupees 5 Lakhs only) but as per the prescribed rate list, the concerned Departments/Ministries may settle such cases in consultation with their respective Internal Finance Division. Only in those cases where the settled scheme/rules are required to be relaxed, should the case be referred to the Ministry of Health and Family Welfare.
4. This issue with concurrence of Internal Finance Division vide FTS No. 91725, dated 01.11.2016.

(Sunil Kumar Gupta)
Under Secretary to the Govt. of India
(Tel 2306 1986)

Source: www.cghs.gov.in

Promotion of prescription of generic drugs by medical practitioners: CGHS Order

CGHS Order: Promotion of prescription of generic drugs by medical practitioners - reg

Government of India
Ministry of Health & Family Welfare
Department of Health & Family Welfare,
Nirman Bhawan, Maulana Azad Road,
New Delhi 110 001

No. S-11011/16/2012-CGHS(P)

Dated the 8th April 2015

    Sub: Promotion of prescription of generic drugs by medical practitioners - reg
Reference is invited to MoHFW OJVI. No. H-11013/4/2010-DFQC dated 19th May 2011 followed by a Circular No. H-11013/7/2012-CGHS (P) dated 8th February 2013 and No.S-11011/16/2012-CGHS(P) dated 3rd May 2013 emphasizing the need of prescribing generic drugs. in this regard, it is reiterated that all Specialists/Doctors working in CGHS are hereby directed to ensure that generic drugs are prescribed to the maximum extent possible with a view to make medical treatment cost effective and affordable.

sd/-
(Bindu Tewari)
Director (CGHS-P)

Source: http://msotransparent.nic.in/writereaddata/cghsdata/mainlinkfile/File983.pdf

CGHS withdraws the OM dated 25-08-2014 regarding issue of Medicine/ reimbursement of expenditure on investigations / treatment procedures / implants and other medical devices

CGHS withdraws the Office Memorandum dated 25-08-2014 regarding issue of Medicine / reimbursement of expenditure on investigations / treatment procedures / implants and other medical devices

No. 2-2/2014/CGHS(HQ)/PPTY/CGHS(P)
Government of India
Ministry of Health & Family Welfare
Department of Health & Family Welfare

Nirman Bhawan, New Delhi
Dated: the 13th March, 2015

OFFICE MEMORANDUM

Subject: Clarification regarding issue of Medicine under CGHS

With reference to the above mentioned subject the under signed is directed to state that the situation arising out of issue of office memorandum NO 2-2/2014/CGHS(HQ)/PPTY/CGHS(P) dated the 25th August, 2014 has been engaging the attention of government for quite some time. Although the guidelines were modified subsequently vide Office Memorandum of even number date 01.10.2014 and 23.12.2014, this Ministry is in receipt of representations seeking clarifications. The matter has been reviewed and it has now been decided to withdraw the OM of even no. dated 25.08.2014.

(Sunil Kumar)
Under Secretary to the Govt. of India

Source: http://msotransparent.nic.in/writereaddata/cghsdata/mainlinkfile/File953.pdf

MoD seeks clarification on the dependency of family members in CGHS & CS(MA) Rules

Revision of Income limit for dependency for the purpose of providing CGHS coverage to family members of the CGHS covered employees subsequent to implementation of recommendations of the VI CPC-Clarification regarding

No. 9(6)/2014/D(Civ-II)

Government of India

Ministry of Defence

Sena Bhavan, New Delhi

Dated, 30th December, 2014

 

OFFICE MEMORANDUM

Subject: Revision of Income limit for dependency for the purpose of providing CGHS coverage to family members of the CGHS covered employees subsequent to implementation of recommendations of the VI CPC-Clarification regarding.

The undersigned is directed to refer to the above mentioned subject and to state as follow:

As per MoH&FW ()M No. S-11012/1/98-(‘GHS‘(P) dated 10.12.2008 issued with the commence of Deptt of Expenditure vide ID No. 566/EV/2008 dated 4.11.2008- “It has been decided, in consultation with the Department of Expenditure, to revise the income limit for the purpose of providing CGHS coverage to the family members of the CGHS covered Central  Government employees to “Rs. 3500/- glus the amount of dearness relief on basic pension of Rs. 3500/- as on the date of consideration.

 

The income limit for dependency of Rs. 3500/- plus amount of the deamess relief on the basic pension of Rs. 3500/- as on the date of consideration Shall also be applicable for the cases covered under CS(MA) Rules, 1944 for the purpose of examining divisibility of family members of the Central Government emplqvee for medical facilities under the Rules.

 

2. However, the Note 1 below sub-section 1(1) of Section 4 of Swamy’s Compilation of the Medical Attendance Rules as amended vide Deptt of Expenditure ID No. 566/E.V/2008 dated 4.11.2008 states that “A member of the family is treated as dependent only if his/her incomes from all sources including pension/family pension is less than Rs. 3500/- (excluding dearness relief on the basis pension of Rs. 3500/)".

 

3. Since, the Note 1 below sub-section 1(1) of Section 4 of Swamy’s Compilation of the MA Rules is contradictory to the MoH&FW’ OM dated 10.12.2008, it is requested that the necessary clarification on the dependency of family members may be furnished to this Ministry immediately.

 

(Gurdgep Singh)

Under Secretary to e Govt. of India

 

To

Ministry of Health & Family Welfare,

[CGHS(P) Section],

Nirman Bhavan New Delhi.

 

Ministry of Health & Family Welfare,

(MS Section),Nirman Bhavan,
New Delhi.

Copy to: Shri Mukesh Singh, Secretary, Bharatiya Pratiraksha Mazdoor Sangh (BPMS), 2-A Naveen Market, Kanpur -20001

Clarification of CGHS rates on 2014 which have been placed on CGHS website for information and acceptance only

Clarification of CGHS rates on 2014 which have been placed on CGHS website for information and acceptance only

F. No. S. 11011/20/2014-CGHS (HEC)
Directorate General of Central Govt. Health Scheme
Ministry of Health & Family Welfare

Nirman Bhavan, New Delhi
Dated, 16th July, 2014

CLARIFICATION

It has been brought to the notice of the undersigned that some of the CGHS empanelled Health Care Organizations have started charging new CGHS rates 2014 which have been placed on CGHS website for information and acceptance only. Since these rates have not yet been notified by Ministry of Health and Family Welfare, the empanelled HCOs cannot charge these new rates and CGHS 2010 rates would prevail. Charging these new rates 2014 from CGHS beneficiaries by empanelled health care organizations would amount to overcharging and suitable action including recovery of overcharged amount and forfeiture of performance bank guarantee would be initiated against those HCOs by CGHS.

Dr. (Mrs.) Sharda Verma
Director (CGHS)

Source: http://msotransparent.nic.in/writereaddata/cghsdata/mainlinkfile/File712.pdf

CGHS: Cashless facility to CGHS Benficiaries

CGHS: Cashless facility to CGHS Benficiaries

GOVERNMENT OF INDIA
MINISTRY OF HEALTH AND FAMILY WELFARE
LOK SABHA

UNSTARRED QUESTION NO 2812

ANSWERED ON 07.02.2014

CASHLESS FACILITY TO CGHS BENEFICIARIES

2812 . Shri RUDRAMADHAB RAY

M. K. RAGHAVAN

Will the Minister of HEALTH AND FAMILY WELFARE be pleased to state:-

(a) the medical assistance and other facilities provided by the Government to retired Central Government pensioners under the Central Government Health Scheme (CGHS) through empanelled hospitals;

(b) whether the empanelled hospitals under CGHS provide cashless facility to the pensioners only for the diseases for which they are empanelled even during the emergencies and if so, the details thereof along with the regulations in this regard;

(c) whether the Government plans to instruct all empanelled hospitals to provide cashless facilities to pensioners and other CGHS beneficiaries irrespective of diseases for which they are empanelled during emergencies and shift the patients to other authorised hospitals after first aid;

(d) if so, the details thereof and if not,the reasons therefor; and

(e) the steps taken/proposed to check exploitation of patients in emergencies by empanelled hospitals?

ANSWER

THE MINISTER OF HEALTH AND FAMILY WELFARE (SHRI GHULAM NABI AZAD)

(a) to (e): Central Government Health Scheme (CGHS) empanels private hospitals for providing inpatient medical treatment to its beneficiaries. They may avail the requisite treatment with prior permission for procedures advised by CGHS and other government specialists / CMO–in-charge. CGHS pensioner beneficiaries are entitled for cashless medical treatment in the CGHS empanelled private hospitals. The empanelled private hospitals under CGHS provide treatment to the pensioners on credit /cashless basis for the procedures for which they are empanelled.

However, in case of emergency conditions empanelled hospitals are expected to provide treatment to pensioners on credit basis, even for conditions for which they are not empanelled and they are expected to shift the patient to another empanelled hospital after stabilization as per the Memorandum of Agreement (MoA) signed with government.

In case of violation of the terms of the Memorandum of Agreement, suitable action, including depanelment can be initiated against errant hospitals.

Source: Loksabha Q&A
via: karnmk.blogspot.in

Deletion of the name of ineligible Dependent & Opting out of the CGHS Scheme

Deletion of the name of ineligible Dependent & Opting out of the CGHS Scheme

Text of DGHS No. D.12011/2/78-DESK –II, dt. 7.4.1978 

Govt. Servant responsible for Deletion of the name of an ineligible Dependent

The undersigned is directed to state that in accordance with the definition of ‘family’ mentioned in Ministry of Health Memo. No. F.6(1) 1-54-H, dated the Ist May, 1954 the family of a beneficiary for the purpose of CGHS scheme includes husband/wife of the CGHS card-holder, as the case may be, wholly dependent children or step-children and parents, who are mainly dependent on and residing with the Government Servant. While it is incumbent upon the card issuing. Authorities, i.e. various departments and offices participating in the scheme, to ensure that the names of only genuine and eligible persons are included in the CGHS token cards, it is the responsibility of the employees concerned to apply for a deletion of the name of the dependent from the CGHS card, when the ward is no more entitled to the benefit eligible under the scheme. The failure on the part of a cardholder to get the name of a child deleted from the CGHS token-card when he is no more dependent on him is a good and sufficient reason for initiating disciplinary proceedings against him in terms of the CCS (CCA) Rules, 1965.

All Ministers/Departments of the Government of India are requested kindly to ensure that the above said provisions are complied with fully. These instructions may also be brought to the notice of all employees concerned.

Opting out of the C.G.H. Scheme

Spouse employed outside Central Government and availing Medical Facilities provided by his/her Employer

Central Government Servants covered under Central Govt. Health Scheme and whose spouse is employed in Defence or Railway Services, State Government or Corporations or Bodies financed partly or wholly by the Central or State Government, Local Bodies and private organizations which provide medical facilities to the employees and their family members, can opt out of the CGH Scheme and avail medical facilities so provided by the above mentioned organizations.

It is to be ensured that neither of the two nor their family members avail medical facilities from both the sources at the same time and for this purpose, the concerned Central Government employee shall give an undertaking to the authority issuing the CGHS Card.

Re-admission under CGHS after ‘opting out’

Such Government Servants, who have opted out of CGHS, may apply for readmission and avail the benefit of CGHS in case their spouse dies or resigns or is dismissed from the office/organization, which provided medical facilities.

Availability of ‘Opting Out’ Facility

The facility of opting out of CGHS can only be availed twice during the whole service career of the employee. Administrative Ministry/Department shall record the same by making an entry in the employee’s Service Book.

Source: http://cghsmumbai.gov.in/http://cghsmumbai.gov.in/htmldocs/circulars.htm