Extension of CGHS Dispensaries/Hospitals

Ministry of Health and Family Welfare

Extension of CGHS Dispensaries/Hospitals

The   norms   for   establishment   of   new   Wellness   Centre   under   CGHS   are   as   under:-

I. In an existing CGHS City:-

For opening of a new CGHS Wellness Centre in an existing CGHS  City,  there  has  to  be  a  minimum  of  2000  Card  holders  (serving  employees  of Central Government and Central Civil Pensioners).

Also check: NPS covered pensioners allowed to use CGHS facilities without any bar of minimum qualification service

II. Extension of CGHS to a new City:-

For extension of CGHS to a new City, there has to be a minimum of 6000 Card holders.

At present, there is no such proposal. Opening of new CGHS Wellness Centre is considered as per the extant norms in this regard, subject to availability of resources.

The Minister of State (Health and Family Welfare), Sh Ashwini Kumar Choubey stated this in a written reply in the Lok Sabha here today.

Source: PIB

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Poor Condition of CGHS Dispensaries - Lok Sabha Q&A

Poor Condition of CGHS Dispensaries - Lok Sabha Q&A

GOVERNMENT OF INDIA
MINISTRY OF HEALTH AND FAMILY WELFARE
LOK SABHA

UNSTARRED QUESTION NO: 1236
ANSWERED ON:09.02.2018

Poor Condition of CGHS Dispensaries

Tejpratap Singh,Yadav
Will the Minister of HEALTH AND FAMILY WELFARE be pleased to state:

(a) whether the Government is aware of poor functioning of CGHS dispensaries due to malfunctioning of server, depleted strength and absence of doctors/staff, discontinuation of visit of Medical specialist, lack of infrastructure and nonavailability of medicines daily, long queue of patients, working of dispensaries in rented building etc. and if so, the details thereof;

(b) whether the Government has received a number of such complaints regarding poor functioning of CGHS in the country including Delhi;

(c) if so, the details thereof, dispensary-wise along with the action taken by the Government on such complaints so far during the last three years;

(d) whether the Government has ever conducted any enquiry/ audit/ study on the functioning of CGHS facility in the country and if so, the details and outcome thereof and if not, the reasons therefor; and

(e) the other steps taken by the Government to improve the functioning of CGHS in the country?
Will the Minister of HEALTH AND FAMILY WELFARE be pleased to state:-

ANSWER
THE MINISTER OF STATE IN THE MINISTRY OF HEALTH AND FAMILY WELFARE

(SHRI ASHWINI KUMAR CHOUBEY)

(a): Yes; problems of breakdown of internet connectivity, shortage of manpower including Doctors/Staff, some CGHS Dispensaries working in rented buildings etc. have been brought to the notice of CGHS.

(b) & (c): Information is being collected and will be laid on the Table of the House.

(d) No, Regular inspection of CGHS Wellness Centres is undertaken by all the Additional Directors of concerned CGHS cities, therefore, the need of separate study was not felt.

(e) Following steps have been taken to improve the functioning of CGHS in the country:-

(i) Govt. has recently permitted CGHS beneficiaries to avail OPD consultation from Specialists at CGHS empanelled Hospitals.

(ii) The requirement of separate permission letter for taking treatment at empanelled hospitals has been done away with once a specific treatment procedure has been advised by a Govt. Specialist/CGHS Doctor.

(iii) Provision for self-printing of CGHS cards by CGHS beneficiaries after it has been verified by Additional Director of concerned CGHS city has been made.

(iv) CGHS beneficiaries also have the option to avail online appointment system for consulting a CGHS Doctor and they can reach the Wellness Centre a little before the scheduled appointment and avoid standing in a queue.

(v) Orders have been issued for special facilities for CGHS beneficiaries aged 80 and above. They need not stand in a queue and their medical claims shall be processed on priority.

(vi) Provision for online transfer of CGHS cards of serving employees has been made in case of transfer to other CGHS covered cities without surrendering the card.

(vii) CGHS beneficiaries have the option to avail facilities from any CGHS Wellness Centre in the Country.

(viii) CGHS beneficiaries have the option to obtain medicines upto 3 months in case of chronic illness.

(ix) Data cards for internet access have been provided to CMO I/c of CGHS Wellness Centres to manage during breakdown of net connectivity.

Source : Lok Sabha

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CGHS Dispensaries/Wellness Centres

CGHS Dispensaries/Wellness Centres

Details of the CGHS Wellness Centres opened by the Government across the country during the last 3 years and the current year, State/UT – wise are given below:

Details of the CGHS Dispensaries/Wellness Centres. Opened in the last 3 years and the current year

Sl.No	Year of opening	State	Name of the Dispensary / Wellness Centre
1.	2013	Delhi/ NCR	Sahibabad
2.	2015	Gujarat	Gandhinagar
3.	2016	Himachal Pradesh	Shimla
		Madhya Pradesh	Indore

There are some states which did not have CGHS Dispensaries / Wellness Centres. Therefore, orders have been issued on 17.11.2014 for opening of at least one CGHS wellness centre in the capital city of all States at the following locations:

Raipur, Shimla, Itanagar, Panaji, Agartala, Imphal, Aizwal, Kohima, Gangtok, Gandhi Nagar, Puducherry.
The Minister of State (Health and Family Welfare), Sh Faggan Singh Kulaste stated this in a written reply in the Lok Sabha here today.

PIB

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Emergency Facilities in CGHS Dispensaries

Emergency Facilities in CGHS Dispensaries

The CGHS dispensaries have all the medicines required in emergency. As per the CGHS guidelines, a provision is there to keep medicines available to counter any medical emergency that might arise within the Wellness Centre. There is an Emergency Tray available with the nursing staff which contains most of the medicines required under emergency situation. The availability of the medicines with their valid date of expiry in this Emergency Tray is checked on a regular basis and also during surprise checks.

A complaint was received on 07.09.2013 from Sh. R. C. Khuntia, the then Member of Parliament in respect of pensioner beneficiary, Sh. B. K. Joshi regarding non-supply of life saving drugs on time by CGHS Bhubaneswar. The delay in supply was due to non availability of cancer medicine with the authorized stockiest.

In case the medicines are not available at the Wellness Centre, they are procured through local purchase. If any medicine is prescribed by the treating doctor that is required to be used immediately and if that medicine is not available in the Wellness Centre, authority slip is issued to the patient to collect the medicine from the authorized local chemist free of cost.

The Minister for Health and Family Welfare, Shri J P Nadda stated this in a written reply in the Rajya Sabha here today.

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Fresh empanelment of private Health Care Organizations (HCOs) and revision of package rates applicable under CGHS Delhi & NCR

Fresh empanelment of private Health Care Organizations (HCOs) and revision of package rates applicable under CGHS Delhi & NCR

No.S.11045/36/2012-CGHS (HEC)
Ministry of Health & Family Welfare
Government of India
Directorate General of Central Govt. Health Scheme

Maulana Azad Road, Nirman Bhawan,
New Delhi 110 108 dated the 1st October, 2014

OFFICE MEMORANDUM

Subject: Fresh empanelment of private Health Care Organizations (HCOs) and revision of package rates applicable under CGHS Delhi & NCR.

The undersigned is directed to state that CGHS had initiated action for fresh empanelment of private HCOs under CGHS Delhi and NCR and also for the revision of package rates to be paid to HCOs, by floating tender for the same. On the basis of the arrived at and have been uploaded on the website of CGHS. www.mohfw.nic.in/cghsnew/index.asp and can be downloaded from there. Similarly, a copy the agreement containing the terms and conditions of empanelment has also been uploaded on the above quoted website of CGHS.

2. The approved list of the hospitals for empanelment under CGHS Delhi and NCR as per the terms and conditions empanelment and MOA signed between CGHS and HCOs is enclosed her with.

3. The revised rates and terms and conditions as mentioned above will come into effect from 1st October, 2014. The empanelment shall be for a period of two years from date of issuance of this order. The HCOs already on the panel of CGHS which do not find their name sin annexed list of empanelled HCOs are allowed to continue on CGHS panel till 15th October, 2014 at old CGHS rates to facilitate the patients who are already admitted / permitted, to continue with thier treatment course.

4. This issues with the concurrence of Internal Finance Division in the Ministry of Health and Family Welfare vide FTS. No.AS & FA/62678/2014 dated the 19th August, 2014.

5. A copy of this Office Memorandum along with a list of empanelled HCOs, rate list and agreement are placed on the internet at http://mohfw.nic.in/cghsnew/index.asp.

sd/-
[Dr.(Mrs.) Sharda Verma]
Director (CGHS)

Source : http://msotransparent.nic.in/writereaddata/cghsdata/mainlinkfile/File800.pdf

#CGHS Hospitals, #CGHS Package Rates, #CGHS Dental Clinics in New Delhi,# CGHS Diagnostic Centres, #CGHS Dispensaries, #CGHS Hospitals, #CGHS Package Rates

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

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

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Criteria fixed for setting up a Central Government Health Scheme (CGHS) dispensary

Criteria fixed for setting up a Central Government Health Scheme (CGHS) dispensary

 

The below information is tabled to a question in Lok Sabha on 11th July 2014 by the Minister of Helath and Family Welfare Shri Harsh Vardhan as follows…

 

The criteria fixed for setting up a Central Government Health Scheme (CGHS) dispensary in a particular area are as under:-

(i) In an existing CGHS city:- For opening of a new Allopathic CGHS dispensary in an existing CGHS city, there has to be a minimum of 2000 Card holders (serving employees of Central Government and Central Civil pensioners).

(ii) Extension of CGHS to a new City:- For extension of CGHS to a new city, there has to be a minimum of 6,000 Card holders. However, due to financial and other resource constraints it is not always possible to adhere to the above criteria.

(b): The details about number of CGHS allopathic/AYUSH dispensaries and Hospitals in the country, State/UT-wise are at Annexure.

 

Keeping in view the financial and other resource constraints, a decision has been taken not to expand CGHS to cover new cities/ areas. There are some States and UTs which do not have the presence of CGHS as yet. Accordingly, the Ministry has mooted a proposal to open at least one CGHS dispensary in the capital city of such States/UT’s namely, Himachal Pradesh, Chhattisgarh, Goa, Arunachal Pradesh, Tripura, Manipur, Mizoram, Sikkim, Nagaland, Gujarat and Pudduchery.

 

In addition, there is also a proposal to open one CGHS dispensary in Indore in compliance of the High Court’s directions.

 

ANNEXURE

STATEMENT SHOWING DETAILS OF CGHS HOSPITALS/WELLNESS CENTRES

S.No.	City	ALLOPATHY	POLYCLINIC	AYUSH	CGHS HOSPITALS
1	AHMEDABAD	8	1	2	0
2	ALLAHABAD	7	1	2	0
3	BANGALORE	10	1	4	0
4	BHOPAL	2	0	0	0
5	BHUNESHWAR	3	0	1	0
6	CHANAI	14	2	4	0
7	CHANDIGARH	1	0	0	0
8	DEHRADOON	2	0	0	0
9	GUWAHATI	5	0	1	0
10	HYDERABAD	13	2	6	0
11	JAMMU	2	0	0	0
12	JAIPUR	7	1	2	0
13	JABALPUR	4	0	0	0
14	KANPUR	9	0	3	0
15	KOLKATA	18	1	4	0
16	LUCKNOW	9	1	3	0
17	MEERUT	6	0	2	0
18	MUMBAI	26	2	5	0
19	NAGPUR	11	1	3	0
20	PATNA	5	1	3	0
21	PUNE	9	1	3	0
22	RANCHI	3	0	0	0
23	SHILLONG	2	0	0	0
24	TRIVENDRUM	3	0	2	0
25	DELHI	94	4	36	4
	TOTAL	273	19	85	4

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Dental Clinics in CGHS Dispensaries

Dental Clinics in CGHS Dispensaries

The dental services in CGHS Delhi have been outsourced in 13 Wellness Centres (5 under Central Zone and 8 under South Zone) for 22 dental procedures. The location wise details are at Annexure-A.

The details of payment made to the service provider in respect of these clinics from the starting of the services till July, 2013 are at Annexure-B.

No specific complaint has been reported about such irregularities committed by the dental clinics in connivance of some officers. However deficiency in services has been reported from the beneficiaries. An Inspection Committee has been constituted for regular inspection of the dental units to ensure proper delivery of services as per the terms and conditions of the agreement.

ANNEXURE –A

Details of CGHS Wellness Centers where the Dental Care Services have been outsourced

Central Zone : New Delhi

 

S. No.	Wellness Centres Name	Address
1.	Dr. Z.H. Road (D44)	CGHS Dispensary Building, Dr. Z.H. Road, New Delhi.
2.	Chitra Gupta Road (D51)	CGHS Dispensary Building, Near Aram Bagh, New Delhi.
3.	Aliganj, Lodhi Road -I (D9)	CGHS Dispensary Building, Near Lodhi Road, New Delhi.
4.	Kali Bari (D 76)	CGHS Dispensary Building, Kali Bari Marg, DIZ Area, New Delhi.
5.	CGHS Dispensary Chanakyapuri	CGHS Dispensary Chanakyapuri, New Delhi.

South Zone: New Delhi

 

S. No.	Wellness Centres Name	Address
1.	Sadiq Nagar (D63)	CGHS Dispensary Building , Behind Siri Fort Road, Near G.K.-I, New Delhi.
2.	SriniwasPuri	CGHS Dispensary Building, Sriniwaspuri, New Delhi
3.	PushpVihar (D78)	A-B/125, 126, 127 – Sector –IV, PushpVihar, New Delhi.
4.	R.K. Puram-V (57)	CGHS Dispensary Building, Sector-XII, R.K. Puram.
5.	Moti Bagh (D 16)	CGHS Dispensary Building near Begum Zaidi Market, Moti Bagh, New Delhi.
6.	Kidwai Nagar (D 12)	CGHS Dispensary Building, 61-63, Kidwai Nagar.
7.	Kalkaji. I (D42)	CGHS Maternity Centre & Dispensary, Kalkaji.
8.	Faridabad (D70)	CGHS Dispensary Building, NH-4, Faridabad.

ANNEXURE –B

Details of Expenditure of Outsourced Dental Units in CGHS Delhi

(Figures in Rs)

 

S. No.	Month	Central Zone	South Zone	Total
1.	Oct-11	448956	-	448956
2.	Nov-11	497881	-	497881
3.	Dec-11	4043711	-	-
4.	Jan-12	-	-	-
5.	Feb-12	-	-	-
6.	Mar-12	176163	-	176163
7.	Apr-12	1179142	2586424	3765566
8.	May-12	13006909	-	13006909
9.	Jun-12	1303705	5290870	6594575
10.	Jul-12	484770	1928530	2413300
11.	Aug-12	3552947	7443269	10996216
12.	Sep-12	2663951	941197	3605148
13.	Oct-12	2425373	-	2425373
14.	Nov-12	3272900	-	3272900
15.	Dec-12	2359883	-	2359883
16.	Jan-13	1740479	2075111	3815590
17.	Feb-13	298461	2490650	2789111
18.	Mar-13	6519138	14361771	20880909
19.	Apr-13	2582860	2586424	5169284
20.	May-13	5579933	3251084	8831017
21.	Jun-13	2628854	12823634	15452488
22.	Jul-13	4296128	7420154	11716282

This information was given by the Union Minister of Health & Family Welfare Shri Ghulam Nabi Azad in written reply to a question in the Rajya Sabha yesterday.

BN/BK/HB
(Release ID :98825)
Source: PIB via centralgovernmentnews.com

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Dental Clinics in CGHS Dispensaries

Dental Clinics in CGHS Dispensaries

The dental services in CGHS Delhi have been outsourced in 13 Wellness centres (5 under Central Zone and 8 under South Zone) for 22 dental procedures. The location wise details are at Annexure-A.

The details of payments made to the service provider in respect of these clinics from the starting of the services till July, 2013 are at Annexure-B.

No specific complaint has been reported about irregularities committed by the dental clinics in connivance of CGHS officials. However, deficiency in services has been reported from the beneficiaries. An Inspection Committee has been constituted for regular inspection of the dental units to ensure proper delivery of services as per the terms and conditions of the agreement.

This information was given by the Union Minister of Health & Family Welfare ShriGhulamNabi Azadin written reply to a question in the LokSabha yesterday.
ANNEXURE -A
Details of  CGHS Wellness Centers where the Dental Care Services have been  outsourced

Central Zone: New Delhi

S.No.	Wellness Centers Name	Address
1	Dr. Z.H. Road (D44)	CGHS Building , Dr. Z.H. Road, New Delhi.
2	Chitra Gupta Road (D51)	CGHS Building, Near Aram Bagh. New Delhi.
3	Aliganj, Lodi Road 1(D9)	CGHS Building , Near Lodhi Road, New Delhi.
4	Kali Bari (D76)	CGHS Building, Kali Bari Marg, DIZ Area, New Delhi.
5	CGHS Dispensary Chanakyapuri	CGHS Dispensary Chanakyapuri. New Delhi.

South Zone : New Delhi

S.No.	Wellness Centers Name	Address
1	Sadiq Nagar (D63)	CGHS Dispy., Behind Siri Fort Road, Near G.K.-I, New Delhi.
2	SriniwasPuri	CGHS own Building, Sriniwaspuri, New Delhi.
3	PushpVihar (D78)	A-B/125, 126, 127 – Sector-IV, PushpVihar, New Delhi.
4	R.K. Puram-V (57)	CGHS Dispensary Building, Sector-XII, R.K. Puram.
5	MotiBagh (D16)	CGHS own Building near Begum Zaidi Market, MotiBagh, New Delhi.
6	Kidwai Nagar (D12)	CGHS Own Building, 61-63, Kidwai Nagar.
7	Kalkaji-I (D42)	CGHS Maternity Centre &Dispy., Kalkaji.
8	Faridabad (D70)	CGHS Dispensary Building, NH-4, Faridabad.

ANNEXURE –B

Details of Expenditure on Outsourced Dental  Units in CGHS Delhi

(Figures in Rs)

Sr.No	Month	Central Zone	South Zone	Total
1	Oct-11	448956	-	448956
2	Nov-11	497881	-	497881
3	Dec-11	4043711	-	4043711
4	Jan-12	-	-	-
5	Feb-12	-	-	-
6	Mar-12	176163	-	176163
7	Apr-12	1179142	2586424	3765566
8	May-12	13006909	-	13006909
9	Jun-12	1303705	5290870	6594575
10	Jul-12	484770	1928530	2413300
11	Aug-12	3552947	7443269	10996216
12	Sep-12	2663951	941197	3605148
13	Oct-12	2425373	-	2425373
14	Nov-12	3272900	-	3272900
15	Dec-12	2359883	-	2359883
16	Jan-13	1740479	2075111	3815590
17	Feb-13	298461	2490650	2789111
18	Mar-13	6519138	14361771	20880909
19	Apr-13	2582860	2586424	5169284
20	May-13	5579933	3251084	8831017
21	Jun-13	2628854	12823634	15452488
22	Jul-13	4296128	7420154	11716282

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Clarification regarding admissible non-admissible items under CGHS

Clarification regarding admissible non-admissible items under CGHS

F.No. 2-1 /2012/CGHS/VC/CGHS(P)

Government of India

Ministry of Health & Family Welfare

Department of Health & Family Welfare

Nirman Bhawan, New Delhi

Dated the 1st August, 2013.

OFFICE MEMORANDUM

Subject : Clarification regarding admissible non-admissible items under CGHS

With reference to the above mentioned subject the undersigned is directed to draw attention to the Office Memorandum of even number dated 1st October 2012 issued by this Department in compliance of the directions of Hon'ble High Court of Delhi in the case of Shri Kanhiya Singh Vs U01 and others [W.P.(C) 9044/2011] clarifying admissibility / inadmissibility of items of expenditure for claiming reimbursement under CGHS. The same are being reproduced for a wider circulation and information in compliance of Hon'ble High Court's latest direction issued on 16.05.2013 in this case. The requisite clarifications regarding admissible and non- admissible items under CGHS are provided herewith as under:-

a) "CGHS Package Rate" shall mean and include lump sum cost of inpatient treatment / day care / diagnostic procedure for which a CGHS beneficiary has been permitted by the competent authority or for treatment under emergency from the time of admission to the time of discharge including (but not limited to) — (i) Registration charges, (ii) Admission charges, (iii) Accommodation charges including patients diet, (iv) Operation charges, (v) Injection charges, (vi) Dressing charges, (vii) Doctor / consultant visit charges, (viii) ICU / ICCU charges, (ix) Monitoring charges, (x) Transfusion charges, (xi) Anesthesia charges, (xii) Operation theatre charges, (xiii) Procedural charges / surgeon's fee, (xiv) Cost of surgical disposables and all sundries used during hospitalization, (xv) Cost of medicines, (xvi) Related routine and essential investigations, (xvii) Physiotherapy charges etc. (xviii) Nursing care and charges for its services.


b) Cost of Implants / stents / grafts is reimbursable in addition to package rates as per CGHS ceiling rates for Implants / stents / grafts or as per actual, whichever is lower, in case there is no ceiling rate prescribed under CGHS,


c) During In-patient treatment of the CGHS beneficiary, the hospital will not ask the beneficiary or his / her attendant to purchase separately the medicines / sundries / equipment or accessories from outside and will provide the treatment within the package rate, fixed by the CGHS which includes the cost of all the items.



d) In cases of conservative treatment / where there is no CGHS package rate, the above mentioned items are admissible-items wise at CGHS rates or as per AIIMS rates (if there is no CGHS rate) or as per actual (if there is no CGHS / AIIMS rate) available for any item.


e) Package rates envisage up to a maximum duration of indoor treatment as follows:
12 days for Specialized (Super Specialties) treatment;
7 days for other Major Surgeries;
3 days for Laparoscopic surgeries / normal deliveries; and
1 day for day care / Minor (OPD) surgeries.

However, if the beneficiary has to stay in the hospital for his / her recovery for a period more than the period covered in package rate, in exceptional cases, supported by relevant medical records and certified as such by hospital, the additional reimbursement shall be limited to accommodation charges as per entitlement , investigations charges at approved rates, and doctors visit charges (not more than 2 visits per day per visit by specialists / consultants) and cost of medicines for additional stay).

No additional charge on account of extended period of stay shall be allowed if that extension is due to infection on the consequences of surgical procedure or due to any improper proceed.


f) In addition to the above mentioned items, some patients may require additional facilities/ procedures, which are admissible with proper justification in deserving cases. Therefore, it is not possible to give a comprehensive list of items, which are not admissible.

However, the following items are not admissible:

Telephone charges
Toiletries
Sanitary napkins
Talcum powder
Mouth fresheners

2. It has also been decided to clarify that expenses incurred on medicines, consumables, sundry equipments and accessories etc., which are purchased from outside, based on specific authorization of treating doctor / staff of the concerned hospital will be reimbursable if they are not falling under the list of non-admissible items. In case the empanelled hospital has asked a CGHS beneficiary for purchase of the said items over and above the package rates, reimbursement shall be made to the beneficiary and the amount shall be recovered from the pending bills of hospital.



3.  This Office Memorandum is issued in compliance of the directions of Hon'ble High Court of Delhi in W.P. (C) 9044/2011 [Sh. Kanhiya Singh Vs UOI and others].

sd/-

[V.P. Singh]

Deputy Secretary to Government of India

Source: http://msotransparent.nic.in/writereaddata/cghsdata/mainlinkfile/File609.pdf

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