Latest list of CGHS Hospitals & Revised Package Rates effective from 1.10.2014

Latest list of CGHS Hospitals & Revised Package Rates effective from 1.10.2014

Ministry of Health and Family Welfare published the detailed list of new Hospitals, Eye, Dental and Diagnostic Centres under Central Government Health Scheme. The fresh empanelment of private Health Care Orgnizations (HCOs) and revision of package rates applicable under CGHS Delhi and NCR.

The Directorate of General of Central Government Health Scheme issued an office memorandum, which states the revised rates and terms & conditions will come into effect from 1st October 2014. The new empanelment shall be for a period of two years from 1.10.2014.

• In Delhi 54 Hospitals, 72 Exclusive Eye Centres, 50 Diagnostic Centres, 32 Exclusive Dental Clinics.
• In Faridabad 5 Hospitals, 1 Exclusive Eye Centres, 1 Diagnostic Centres.
• In Gurgaon 9 Hospitals, 5 Exclusive Eye Centres, 3 Diagnostic Centres, 6 Exclusive Dental Clinics.
• In Ghaziabad 9 Hospitals, 2 Exclusive Eye Centres, 3 Exclusive Dental Clinics.
• In Noida 10 Hospitals, 3 Exclusive Eye Centres, 2 Exclusive Dental Clinics.

Click here to view the complete list of Health Care Organizations (HCOs) Empanelled under CGHS, Delhi & NCR with effect from 1.10.2014 and revised package rates for treatment procedure / investigation list as per office memorandum No.S.11045/36/2012-CGHS (HEC) dated the 1st October 2014.

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Message from CGHS Director regarding Indian and Imported medicines

Indian medicine cheaper than the imported medicine. Only the Indian medicine shall be supplied even if, an imported medicine has been prescribed.

Dear CGHS Beneficiary,

Off late there are apprehensions on the orders issued on 25th August 2014. It is clarified that intention is not to deny the availability of essential medicines to CGHS beneficiaries. CGHS is committed to provide quality health care to its beneficiaries.

In the meantime, steps are initiated to allow medicines from existing formularies of ECHS, ESI & AIIMS also. 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.

CGHS has already set up a mechanism to update the formulary on continuous basis.

With Regards,

sd/-
Director (CGHS)

Click to view the order…

Source: http://msotransparent.nic.in/writereaddata/cghsdata/linkimages/8936106293.pdf 

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Reimbursement when Pensioners take treatment immediately after Retirement before getting CGHS Cards

Reimbursement when Pensioners take treatment immediately after Retirement before getting CGHS Cards

Ministry of Health & Family Welfare has now decided to clarify the matter as follows :-

(I) The treatment taken and expenditure Incurred thereon within the grace period of three months from the date of retirement will be allowed and expenditure reimbursable subject to the condition that the beneficiary has either obtained or applied for CGHS pensioner card with all documents and requisite CGHS subscription within one month of expiry of the grace period of three months.

(ii) It is further clarified that the expenditure on treatment taken after the grace period of three months from date of retirement will not be reimbursable unless the beneficiary has obtained a valid CGHS card or has applied for CGHS pensioner card with all documents and requisite CGHS subscription prior to taking such treatment.

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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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CS(MA) Rules 1944 are not applicable to pensioners – Health Ministry

CS(MA) Rules 1944 are not applicable to pensioners – Health Ministry

Medical Facilities to Government employees

Central Government Health Scheme provides medical care to its beneficiaries which include serving as well as retired Central Government employees. The CGHS provides its services through a network of CGHS Wellness Centers which are in operation presently in 25 major cities of the country. Expenditure on medical reimbursement in respect of pensioners is borne by CGHS and in respect of serving employees it is borne by concerned Ministry/ department/office. The pensioner beneficiaries are eligible for credit facility for treatment in CGHS empanelled hospitals.

Central Services (Medical Attendance) Rules, 1944 are applicable to serving Central Government employees only who are residing in non-CGHS covered areas. Medical attendance is provided by the Authorized Medical Attendant appointed by concerned department. The CS(MA) Rules 1944 are not applicable to pensioners. As per these Rules, there is no provision for issue of medicines and medical reimbursement claims are to be settled by the concerned department/ Ministry.

The Health Minister stated this in a written reply in the LokSabha here today.

Source: PIB

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