Removal of medicines from CGHS list – Life saving medicines – Reg.

Removal of medicines from CGHS list – Life saving medicines – Reg.

Member of Parliament Shri.Sardar Sukhdev Singh Dhindsa asked some important questions in respect of CGHS beneficiaries regarding the life saving medicines and concerned minister has given reply on this issue as follows…

With a view to streamline the issue of medicines, an Office Memorandum was issued on 25.08.2014. Under the revised guidelines:

I. CGHS provides/ indents Medicines as per the CGHS formulary, which contains 622 branded medicines and 1447 generic medicines.

II. However, anti-Cancer and other related medicines also called Life-saving medicines, approved by Drug Controller General of India for use in India shall continue to be provided on a case to case basis.

(d) : The following measures have since been taken to overcome the inconvenience caused to the beneficiaries:

i) Since, many beneficiaries were undergoing treatment and were provided certain Insulin’s and Gliptins for anti-diabetic care, it has been decided to permit issue of such medicines to ensure continuity in treatment even though they are not included in the formulary (as an interim measure till the formulary is revised).

ii) The medicines included in the formularies of ESIC(Employees State Insurance Corporation)( 398 generic medicines) and ECHS( Ex-Servicemen Contributory Health Scheme) (517 Generic medicines) are also permitted under CGHS as an interim measure.

iii) Orders were also issued on 1.10.2014 delegating powers to CMOs i/c for providing essential medicines to CGHS beneficiaries. CMOs i/c can issue / indent medicines costing upto Rs1500 per week even though they are not included in any of the above formularies. However, in case the duration of treatment is for more than one week and the cost of medicines is more than Rs.1500/- approval of Additional Director of the concerned CGHS city must be obtained.

iv) Medicines are issued for upto three months at a time in case of chronic diseases and upto six months in case of a CGHS beneficiary going abroad. The revised Orders were issued in this regard on 21.10.2014.

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CGHS Hospitals under surveillance by the aegis of CGHS Officer to check irregularities including exploitation of patients

CGHS Hospitals under surveillance by the aegis of CGHS Officer to check irregularities including exploitation of patients

While replying to a question in Parliament today, Minster of Health & Family Welfare Shri Jagat Prakash Nadda said that to ensure that the terms and conditions of the Memorandum of Agreement are followed scrupulously by the empanelled hospitals, a monitoring cell under the aegis of a senior officer of CGHS has been established to check irregularities including exploitation of patients”,

Treatment by CGHS empanelled hospitals in emergency cases

Recently, the Government has amended the terms and conditions for empanelment of private hospital under the Central Government Health Scheme (CGHS). Now, the hospitals are empanelled as a whole, meaning that all facilities available in the hospital would be provided to CGHS beneficiaries. Disease – specific empanelment has now been stopped.

To ensure that the terms and conditions of the Memorandum of Agreement are followed scrupulously by the empanelled hospitals, a monitoring cell under the aegis of a senior officer of CGHS has been established to check irregularities including exploitation of patients. There are provisions in the MoA including issue of Show Cause Notice, issue of warning, recovery of amount charged illegally from the beneficiaries, also confiscation of part or whole of PBG (Performance Bank Guarantee), and ultimately removal from the CGHS list, that can be resorted to in appropriate cases

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