CGHS Package Rates for 15 Investigations under CGHS 2020

CGHS Package Rates for 15 Investigations under CGHS 2020

CGHS

S-1101110912019/ Addg.HQ/ CGHS
Government of India
Ministry of Health and Family Welfare
Department of Health & Family Welfare
Directorate General of CGHS

Nirman Bhawan, New Delhi
Dated the 14th January,2020

OFFICE MEMORANDUM

Subject: Notification of CGHS Rates for 15 Investigations under CGHS

With reference to the above mentioned subject the undersigned is directed to draw attention to the Office memorandum No S.11045/ 36/2012-CGHS (HEC) dated 01.10.2014 vide which CGHS package rates for various treatment procedures and investigations were notified by the Government for Health Care Organizations (HCOs) empanelled under CGHS and to state that representations from various stake holders regarding non-availability of CGHS rates for some of the investigations have been received in this Ministry. The matter was reviewed and it is now decided to notify CGHS package rates for the following investigations and their inclusion in CGHS rate list as under:

S. No.	Name of Unlisted Investigations/ Unlisted Implant	Recommended Rates (in Rupees)
1.	Kappa Lambda Light Chains, Free, Serum	3500/-
2	Serum IGE level	300/-
3	NT-Pro BNP	1800/-
4	CECT Chest	2500/-including CD
5	MRI-Prostate (Multi-parametric)	6000/-including CD
6	HCV RNA Quantitative	1500/-
7	Tarcolimus	2300/-
8	Protein Creatinine Ratio, Urine	120/-
9	Fibroscan Liver	1000/-
10	HLA B27 (PCR)	500/-
11	Montoux Test	175/-
12	Procalcitonin	1800/-
13	TORCH Test	1120/
14	Lntracoronary OCT (AIIMS Rates)	65000/-+GST
15	FFR Wire cost (AIIMS Rates)	Wire as per AIIMS rates of Rs. 23500 + GST And procedure charges as per existing CGHS rates of Rs. 15000 for NABH and Rs. 12750 for Non NABH hospitals

The rates for investigations from S.No.1 to S.No.13 are for Non-NABL/ Non-NABH accredited HCOs. The rates for NABL/ NABH accredited HCOs shall be 15% more. The rates from S.No.14 &15 shall be common for both NABH-accredited /Non-NABH accredited HCOs.

Also check: CGHS medical facilities reimbursement to Central Government pensioners

These rates shall come in to force from the date of issue of the letter.

This issues with concurrence of Integrated Finance Division of Ministry of Health & Family Welfare vide CD No 3495 dated:13.01.2020.

Sd/-(Dr. Manoj Jain)
Addl. DDG (HQ), CGHS

Read this: CGHS - Medical benefits to dependent parents of Central Government Employees

Read More

CGHS – Medical benefits to dependent parents of Central Government Employees

CGHS – Medical benefits to dependent parents of Central Government Employees

CGHS

Medical benefits to dependent parents of Central Government Employees

 13 DEC 2019

For availing of medical facilities under Central Government Health Scheme (CGHS), parents are deemed to be dependent on the Central Government employee if they are normally residing with the employee and their monthly income from all sources including pension/ family pension does not exceed Rs. 9,000 plus the amount of Dearness Relief thereon. This condition of dependency is applicable to Pensioners of State Government(s) as well.

Also check: CGHS medical facilities reimbursement to Central Government pensioners

Regarding any scheme for providing medical facility to the dependent parents of employees of private sector, The Employees’ State Insurance (ESI) Act, 1948 read with ESI (Central) Rule, 1950 provides for medical benefits to the dependent parents of the Insured person i.e. an employee who works in a factory/ establishment having 10 or more workers & registered under the said Act and drawing salary less than Rs. 21,000 per month (Rs. 25,000 in case of persons with disability). Income limit for dependency of parents from all sources is Rs. 9,000 per month. The ESI Act is not applicable to Central Government employees and their dependents.

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

PIB

Read More

CGHS: Opening of CGHS Wellness Centre at Varanasi

CGHS: Opening of CGHS Wellness Centre at Varanasi

A Central Government Health Scheme (CGHS) Wellness Centre has startedfunctioning at Type -III Govt. Quarters 98-100 at Kendriya Colony Bada Lapur, Sindhoura Road , Chandmari , Varanasi from 19th February, 2019

Government of India
Ministry of Health and Family Welfare
Department of Health & Family Welfare
Directorate General of CGHS

No S. 11012/15/2015-CGHS-l/I

Nirman Bhawan, New Delhi 110011
Dated the 19th February, 2019

OFFICE ORDER

Subject: Opening of CGHS Wellness Centre (Allopathic) at Varanasi

This is for information of all eligible Central Govt. employees/ Central Govt. Pensioners, ex-MPs and other eligible stakeholders that a Central Government Health Scheme (CGHS) Wellness Centre has started functioning at Type -III Govt. Quarters 98-100 at Kendriya Colony , Bada Lapur, Sindhoura Road , Chandmari , Varanasi from 19th February, 2019 to provide comprehensive medical facilities.
The CGHS Wellness Centre (1) at Varanasi shall cover all eligible Central Govt. Employees residing within 5 km radius of the Wellness Centre and eligible pensioners and ex-MPs , etc., living in and around Varanasi as per CGHS guidelines.

The CGHS beneficiaries shall be able to avail the CGHS facilities through the Wellness Centre from 0730 a.m. to 02.00 p.m. on all days, except Sundays and Gazetted holidays.

The CGHS wellness Centre shall be under the administrative control of Addl Director, CGHS, Allahabad (Tel No 0532-256 0578).

(Dr. Atul Prakash)
Director, CGHS

Read More

CGHS: Demarcation of CGHS Patna covered area under CGHS Wellness Centre

CGHS Wellness Centre

Demarcation of CGHS Patna covered area under CGHS Wellness Centre

GOVERNMENT OF INDIA
MINISTRY OF HEALTH & FAMILY WELFARE
OFFICE OF THE ADDITIONAL DIRECTOR
CENTRAL GOVERNMENT HEALTH SCHEME
54 SOUTH CHHAJUBAGH PATNA-800 001.

No.5-2/2018-19/Covered Area/CGHS(PAT.)/ 3355

Dated the 17th April 2018.

 OFFICE MEMORANDUM

Subject :- Demarcation of CGHS Patna covered area under CGHS Wellness Centre - reg.

With reference to the above noted subject the undersigned is to state that the demarcation of CGHS
Patna covered area has been reviewed and now it has been decided that under mention areas will be covered by the CGHS Patna:-

West :- Danapur Cantt. Area to Danapur Railway Station, Khagaul along Danapur-Khagaul Road and adjoining areas upto 500 Metre.

North :- Upto the Bank of Ganga River

East :- Upto the Sabalpur along Patna Bypass Road and adjoining area upto the Beur, Patna area.

South :- Anishabad-Janipur Road including

Phulwarishariff and along AIIMS-Khagaul Road upto the Khagaul and adjoining area. The serving Central Government Employees residing  outside the CGHS covered areas shall be covered under
CS(MA) Rules. However, the serving Central Government Employees residing within the Municipal limits of the city, shall be given a onetime choice to opt for CGHS (instead of CS(MA) Rules) from the nearest CGHS Wellness Centre.

Sd/-
(Dr. Shib Shankar Shah)
Additional Director, CGHS

Source: CGHS

Read More

CGHS Delhi & NCR: New Empanelment of Private Hospitals including Dental Clinics and Eye Centres and Diagnostic Centre

CGHS Delhi & NCR: New Empanelment of Private Hospitals including Dental Clinics and Eye Centres and Diagnostic Centre

No: S.11011/03/2018-CGHS (HEC)
Government of India
Directorate General of Central Government Health Scheme
Department of Health & Family Welfare

Nirman Bhawan, New Delhi.
Dated the 11th April, 2018

OFFICE ORDER

Subject: Empanelment of private hospital (including dental clinics and eye centres) and diagnostic centres under CGHS Delhi & NCR.

In continuation of this Directorate's Office Memorandum of even no. dated 26.12.2017 regarding empanelment under continuous empanelment scheme, the undersigned is to convey that in addition to the list of the hospitals (including dental clinics & eye centres) and diagnostic laboratories already empanelled, the hospitals (including dental & eye centres) and diagnostic laboratories as per the list attached (22 HCOs) have also been empanelled under CGHS in Delhi & NCR with issuance of this order. The newly empanelled hospitals (including dental clinics & eye centres) and diagnostic laboratories may be treated as included in the existing list of empanelled health care organization under CGHS on same terms and conditions as have been indicated in the Office Memorandum dated 26.12.2017.

Encl: As above

[Dr. D.C. Joshi]

Director (CGHS)

Sr. No.	Name of the Hospital	Address & Tel. No.	NABH/ NABL QCI Recommended	Empanelled for
1.	Delhi Heart Hospital	176, Jagriti Enclave, Bhartendu Harish Chandra Marg, Near Karkardooma Metro Station, Delhi - 110092. Tel. No. 011-22157272, 43014288	QCI Recommended	General Medicine, Respiratory Medicine, Non-Interventional Cardiology
2.	East Delhi, Medical Centre,	1-550, G.T. Road, Mansarovar Park, Delhi - 110032. Tel. No. 011- 22583204, 22596736	QCI Recommended	General Medicine, Gynae & Obs., Orthopedics and joint replacements, General Surgery, Medical & Surgical Oncology, Neurology & Neuro Surgery, Nephrology, Gastroenterology, Eye and Diagnostics.
3.	Rosewood Hospital (A unit of JLKD Healthcare Pvt. Ltd.	5, JL Block, Roshan Garden, Najafgarh, New Delhi - 110043. Tel. No. 011-25322537,	QCI Recommended	General Medicine, Gynae & Obs., Orthopedics and joint replacements, General Surgery, Neurology & Neuro Surgery, Gastroenterology, Dental, Eye, ENT and Diagnostics.
4.	New Balaji Hospital	Plot - 734, Haldauni More, Main Dadri Road, Greater Noida-201306. Tel. No. 8285124442.	QCI Recommended	General Medicine, Gynae & Obs., Orthopedics and joint resplacements, General Surgery, ENT, Eye and Diagnostics.
5.	Universal Centre of Health Science	Bypass Road, Molarband Extension, Badarpur, New Delhi-110044. Tel. No. 8800800500	QCI Recommended	Cardiology & Cardiothoracic Surgery, General Medicine, General Surgery, Orthopedic surgery including Joint replacement, Urology, Nephrology (including Dialysis), Gastroenterology & Chemotherapy only) and Diagnostics.
6.	Sonia Hospital (A unit of Altius Healthcare Pvt. Ltd.)	1, Gulshan Park, Main Rohtak Road, Nangloi, Delhi. Tel. No.8750060177	QCI Recommended	General Medicine, General Surgery, Gynae & Obst., Orthopedic surgery including Joint replacement, Gastroenterology Neurology, Urology, Nephrology (including Dialysis),
7.	Hope Imaging & Diagnostics	D-40, Shyam Park Extension, Jindal Market, Sahibabad, Ghaziabad - 201005. Tel. No. 0120-4215167.	NABL Accredited	Laboratory Investigation
8.	Total Diagnostics Care	I-1 Kailash Park, Opp. Metro Pillar No. 330, Kirti Nagar, New Delhi - 110015, Tel. No. 011-49074841, 43	NABH Accredited	X- ray, OPG, USG, Colour Doppler, MRI, CT Scan, Mammography and Laboratory Investigation
9.	Itek Vision Centre (A unit of Skiffle Healthcare Services Ltd.)	B-1A/22, Sector-51, Ground Floor, Noida - 201301. Tel. No. 0120-4288757.	QCI Recommended	Exclusive Eye Care Centre
10.	Vistech Eye Centre (A unit of Jasola Healthcare LLP)	Plot No. 2, Pocket-I, Jasola Vihar, New Delhi - 110025. Tel. No. 011-41080233	QCI Recommended	Exclusive Eye Care Centre
11.	Dev Eye Centre (A unit of Skiffle Healthcare Services Ltd.)	R-10, Vakil Colony, Sector-12, Pratap Vihar, Ghaziabad - 201009. Tel. No. 0120- 2740340.	QCI Recommended	Exclusive Eye Care Centre
12.	Shyama Super Speciality Eye Hospital.	B- 139 A, West Vinod Nagar, Narwana Road, I.P. Extension, opp. Press Apartment, Delhi-110092, 011- 45631535	QCI Recommended	Exclusive Eye Care Centre
13.	Sai Eye Care and Medical Centre	H-98/1, Sector-12, Pratap Vihar, Near BSNL Telephone Exchange, Ghaziabad-201009. Tel. No. 0120-6525264	QCI Recommended	Exclusive Eye Care Centre
14.	Delhi Eye Care	4-17, Second Floor, Balraj Khanna Marg, East Patel Nagar, New Delhi. Tel. No. 011 -45629416	QCI Recommended	Exclusive Eye Care Centre
15.	Dento Hub	GG-1/23B, Vikas Puri, New Delhi-110018. Tel. No. 011-45110704	QCI Recommended	All Available Dental Care Facilities
16.	Dr. Ashok Dentistree	23-Panchkuian Road, Below R.K. Ashram Metro Station, Opp. Pilar No.12, Pharganj, New Delhi - 110055. Tel. No. 011- 23585474	NABH Accredited	All Available Dental Care Facilities
17.	The Healing Touch, … Dental Care	First Floor, Behind Mother Dairy, Chetak Complex, Pocket B & E, Market, Dilshad Garden, Delhi- 110095. Tel. No. 8860529040.	NABH Accredeted	All Available Dental Care Facililties
18.	Jain Dental Centre	F-1-9, Mandir Marg, Near Happy English School, Krishna Nagar, Delhi- 110051. Tel. No.9810924515	NABH Accredited	All Available Dental Care Facilities
19.	Faces N Braces Dental Clinic	D-85, Lower Ground Floor, Near Saket Metro Station Gate No.3, New Delhi- 110017. Tel. No. 011-65154151.	QCI Recommended	All Available Dental Care Facilities
20.	Crystal Dental Centre (A unit of Crystal Dental Care Pvt. Ltd.	31, Community Centre, Basant Lok, Vasant Vihar, New Delhi - 110057. Tel. No.011- 41603131	NABH Accredited	All Available Dental Care Facilities
21.	R.P.S. Memorial Multispeciality Dental Clinic,	D-660 B, Main 100 Feet Road, Chander Lok Colony, Shahdara, Delhi - 110093. Tel. No. 9899221971	NABH Accredited	All Available Dental Care Facilities
22.	Teerthanker Aadinath Bright Dental Care	11, 12/1513, Wazir Nagar, Bhishampitah Marg, Kotla Mubarkpur, New Delhi-110003. Tel. No. 7351114255.	QCI Recommended	All Available Dental Care Facilities

Source: CGHS

Read More

Empanelment and De-Panelling of Private Hospitals under CGHS

Empanelment and De-Panelling of Private Hospitals under CGHS

CGHS empanels eligible private hospitals as and when they apply and sign Memorandum of Agreement as per terms and conditions of empanelment under tender process/continuous empanelment scheme.

Some private hospitals have opted out of CGHS. The details are at Annexure.

The above statement said in a written reply to a question in Parliament on 20.3.2018 by the Minister of State for Health and Family Welfare Shri Ashwini Kumar Choubey.

No.	CITY	No. of Hospitals opted out from CGHS during the last 3 years	Names of Hospitals	Reasons for opting out
1	AHMEDABAD	3	(i) Nidhi Hospital (ii) Anand surgical (iii) Sidhi Vinayak	Due to technical problem and delay in payment.
2	BANGALORE	3	(i) Vasan Eye Care, Nagarbhavi	Change in Management
			(ii) Medihope Super Speciality Hospital	Inability to provide certain service
			(iii) Shirdi Sai Hospital Pvt. Ltd.	Due to renovation
3	CHANDIGARH	1	Centre For Sight	Low CGHS rates.
4	GUWAHATI	4	(i) Guwahati Neurological Research Centre Hospital	Due to technical reasons
			(ii) International Hospitals
			(iii) Nemcare Hospitals
			(iv) Primus imaging Pvt. Ltd.
5	NAGPUR	3	(i) Suretech Eye Hospital	Did not want QCI recommendation to continue.
			(ii) Suretech Diagnostic Centre
			(iii) Zenith Hospital
6.	PUNE	16	(i) Bhandari Dental Clinic	Low CGHS rates for dental procedure
			(ii) Ace Hospital	Could not obtain QCI recommendation
			(iii) Sant Dyaneshwar Hospital	Could not obtain QCI recommendation
			(iv) Sai Sneha Hospital	Could not obtain QCI recommendation
			(v) Colony Nursing Home	Could not obtain QCI recommendation
			(vi) Sangamerkar Hospital	Could not obtain QCI recommendation
			(vii) Ruby Hall Clinic	Delay in payment
			(viii) Ruby Hall Clinic Wanowarie	Delay in payment
			(ix) Sahydari Hospital Nagar Rd.	Delay in payment
			(x) Shyadri Hospital Karve Rd	Delay in payment
			(xi) Janagir Hospital	Delay in payment
			(xii) Meivision Diagnostic Centre	Could not obtain QCI recommendation
			(xiii) Rakshak Hospital	Could not obtain QCI recommendation
			(xiv) Dhanashree Hospital	Could not obtain QCI recommendation
			(xv) Kavade Nursing Home	Could not obtain QCI recommendation
			(xvi) Vasan Eye Hospital	Change in Management.
7	DELHI & NCR	10	(i) Deepak Memorial Hospital	No reasons specified by the hospitals for opting out.
			(ii) Delhi Max Hospital, Pitampura
			(iii) Dr. A. Lalchandani pathology laboratories
			(iv) Mahajan Imaging Centre, Pusa Road, New Delhi
			(v) Mahajan Imaging Centre, B1, Vasant Kunj
			(vi) Dr. P. Bhasin path Lab (p) Ltd, Dwarka, New Delhi.
			(vii) Alchemist Hospital, Gurgaon
			(viii) Max Hospital, Gurgaon.
			(ix) Max Hospital, Noida
			(x) Apex Diagnostic, Gurgaon
			TOTAL 40

Read More

Delay in Payment to Empanelled Hospitals

GOVERNMENT OF INDIA
MINISTRY OF HEALTH AND FAMILY WELFARE
LOK SABHA

UNSTARRED QUESTION NO: 4758
ANSWERED ON: 23.03.2018

Delay in Payment to Empanelled Hospitals

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

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

(a) whether there is a delay in the payment to empanelled hospitals under Government sponsored health programmes such as Central Government Health Scheme (CGHS) and Rashtriya Swasthya Bima Yojana (RSBY);

(b) if so, the details thereof and the reasons therefor;

(c) whether CGHS and RSBY has been effective in reducing the burden of out of pocket spending of poor households, if so, the details thereof; and

(d) the total number of beneficiaries and total funds allocated under CGHS and RSBY over the last four years, State/UT wise including Bihar?

ANSWER
THE MINISTER OF STATE IN THE MINISTRY OF HEALTH AND
FAMILY WELFARE
(SHRI ASHWINI KUMAR CHOUBEY)

(a) & (b): Under CGHS there is some delay in payment to empanelled hospitals. Following are the reasons for delay in settlement of hospital bills under CGHS:-
i. Resource constraints particularly in the last quarter of Financial Year.
ii. Need for consultation with Specialists in some cases.
iii. Time taken in scrutinizing of Hospital bills.

Under RSBY, Insurance Companies make payment, as due and admissible, to the empanelled hospitals as per their claim. Details are not maintained at Central level.

(c): Under CGHS, the beneficiaries, who are primarily Central Government Employees and Pensioners, are provided health facilities including OPD, medicines, reimbursement of expenditure incurred on hospitalization etc. and they do not have to incur out of pocket expenditure. They have to bear additional expenditure only if they opt for specific brand of implants costing more than CGHS rates.

Under RSBY, claims amounting to Rs. 5012.17 Crore have been settled since 2011-12 to 2016-17, which may be construed as a reduction in out of pocket expenditure for the beneficiaries under RSBY, who have availed the hospitalization benefits.

(d): There are 32,53,219 number of CGHS beneficiaries as on 13.03.2018.
The total funds allocated under CGHS over the last four years is as under:-

Year Funds Allocated (Rupees in Crores)
2013-14 1772.75
2014-15 1734.02
2015-16 1872.29
2016-17 2026.91

Under RSBY no funds are allocated to States. Funds as central share of premium are released on receipt of proposals from State Governments. The State-wise list of beneficiaries under RSBY over the last four years including Bihar is at Annexure.

Source : LokSabha

Read More

Fixed Medical Allowance - MoD Orders

Fixed Medical Allowance - MoD Orders

Ministry of Defence
Department of Defence
D(Civ-II)

MoD ID No.12(10)/2017/D(Civ-II)

Dated: 13.02.2018

Subject: Grant of Fixed Medical Allowance to Central Government Civil Pensioners residing in areas not covered under Central Government Health Scheme-reg.

A copy of Deptt of Pension & Pensioners Welfare O.M.No.4.34.2017-P&PW(D) dated 31.01.2018 on the above mentioned subject is forwarded for information and necessary action.
Encl.As above

(Pawan Kumar)
Under Secretary to the Govt of India

Source: www.mod.gov.in

Read More

Grant of Fixed Medical Allowance to Central Government Civil Pensioners residing in areas not covered under CGHS

Grant of Fixed Medical Allowance to Central Government Civil Pensioners residing in areas not covered under Central Government Health Scheme

 

F.No.4/34/2017-P&PW(D)
Government of India
Ministry of Personnel, Public Grievances and Pensions
Department of Pension and Pensioners Welfare

3rd Floor, Lok Nayak Bhawan,
Khan Market, New Delhi
Dated: 31/01/2018

OFFICE MEMORANDUM

Sub: Grant of Fixed Medical Allowance to Central Government Civil Pensioners residing in areas not covered under Central Government Health Scheme -reg.

The undersigned is directed to refer to this Department’s OM No.38/99/99-P&PW(C) dated 17-4-2000 on the subject mentioned above and to say that in accordance with the instructions contained therein, Central Government Civil Pensioners, residing in an area not served by any CGHS dispensary or any corresponding Health Schemes administered by other Ministries/Departments, as the case may be, even though their places of residence may fall within the limits of a CGHS covered cities, are required to submit the following documents for claiming Fixed Medical Allowance:

a) An undertaking in the prescribed format.

b) A certificate from the Medical Authorities of CGHS or from authorities of corresponding Health Schemes of the concerned Ministries/Departments, as the case may be, that the area where the pensioner is residing is not served by any dispensary under CGHS or the corresponding Health Scheme administered by the Ministry/Department.

2. Keeping in view the difficulties being faced by the pensioners in obtaining the required certificate from the concerned Medical Authorities, the matter has been reconsidered in consultation with the Ministry of Health and Family Welfare. It has now been decided that the pensioners, residing in areas not covered by CGHS or any corresponding Health Schemes administered by other Ministries/Departments, as the case may be, would no longer be required to submit a certificate referred to in para 1 (b) above.

However, such pensioners would continue to submit an undertaking in the following format:

I , a retired employee of ____ (Office Address) declare that I am residing at (Residential Address indicated in PPO) , which area is not covered under CGHS or any corresponding Health Scheme administered by the Ministry/Department of , (as the case may be). I have also not obtained and do not wish to obtain a CGHS Card for availing out-door facilities under CGHS/Corresponding Health Scheme of other Ministries/Departments from any dispensary situated in an adjoining area.

3. A Central Government Civil Pensioner is also required to fill the enclosed Form along with above mentioned undertaking.

4. All the pension disbursing authorities are required to obtain the above undertaking along with the Form, as mentioned in Para 3 above, from such pensioners before sanctioning Fixed Medical Allowance. An entry to this effect should also be made in their PPOs.

sd/-
(Sanjay Wadhawan)
Deputy Secretary to the Govt. of India

Authority: www.pensionersportal.gov.in

Read More

7th CPC: MoH&FW removed monetary ceiling for direct consultation with Specialists in Central Government /State Government Municipal Hospitals

7th CPC: MoH&FW removed monetary ceiling for direct consultation with Specialists in Central Government /State Government Municipal Hospitals

No. S.11011/11/2016- CGHS (P)/EHS
Government of India
Ministry of Health and Family Welfare
EHS Section
Nirman Bhawan, New Delhi

Dated the 5th December, 2017

OFFICE MEMORANDUM

Sub: Revision of rates of subscription under Central Government Health Scheme due to revision of pay and allowances of Central Government employees and revision of pension/ family pension on account of implementation of recommendations of the Seventh Central Pay Commission. 

The undersigned is directed to draw attention to Para 3 (F) of this Ministry’s OM No. 5.11011/16/2016-CGHS (P)/EHS, dated 09.01.2017 regarding monetary ceiling for direct consultation with specialist in Central Government/State Government/Municipal Hospitals, wherein it was mentioned that ”The monetary ceiling for determining the entitlement for direct consultation with Specialists in Central Government / State Government / Municipal Hospitals will continue at the existing rates until revision of the same after consultation with Ministry of Finance."

2. The matter has been examined in consultation with Department of Expenditure, Ministry of Finance and it has been decided to remove monetary ceiling for direct consultation with Specialists in Central Government /State Government Municipal Hospitals and there is no bar on direct consultation with Specialists in Central Government/State Government/Municipal Hospitals.
3. Other contents of the above said OM will remain unchanged.

(Rajeev Attri)
Under Secretary to the Government of India

Read More

Opening of a Central Govt. Health Scheme, wellness Centre (allopathic) at Agartala

Opening of a Central Govt. Health Scheme, wellness Centre (allopathic) at Agartala

GOVERNMENT OF INDIA
Ministry of Health and Family Welfare
Office of the Additional Director,
Central Govt. Health Scheme
Nongrim Hills: Shillong - 793 003

No. CGHS/ESTT/RECTG/61/1089-99

Dated: Shillong, the 28th July, 2017.

NOTIFICATION

Sub: Opening of a Central Govt. Health Scheme, wellness Centre (allopathic) at Agartala

This is for information to all eligible Central Govt. employees/ pensioners and other stake holders that, a Central Govt. Health Scheme (CGHS) Wellness Centre sanctioned vide Govt. of India, Min. of Health & Family Welfare, CGHS (P) Division Order No. S.11045/1/2013/HEC, New Delhi dated 17 th November 2014 will be functioning by 1st of August 2017 at quarter no. T/V/1, Kunjaban Extension, New Capital Complex, Agartala to provide comprehensive medical facilities.

The scheme will cover the Agartala city and all eligible Central Govt. employees and their dependent family members, Central Govt. pensioners and their dependents and others eligible as per CGHS guideline residing in Agartala city.

The beneficiaries will be able to avail the CGHS facilities through the Wellness Centre during the office hours i.e. from 7:30 am to 02:00 pm in all working days except Sundays & holidays.

To,
1. The CMO I/C, CGHS WC Agartala - for necessary action
2. The Chairman, CGEWCC, Agartala - for wide circulation to all eligible Central Govt. offices
3. The Secretary, Central Govt. Pensioners’ Association, Agartala

Additional Director
CGHS, Shilong

Copy to:-
- PPS to AS&DG, CGHS, MOH&FW, Nirman Bhawan, New Delhi
- PS to Director, CGHS, MOH&FW, Nirman Bhawan, New Delhi
- The Addl. DDG (HQ), CGHS, MOH&FW, Nirman Bhawan, New Delhi
- The Additional Directors, CGHS of all cities
- The Nodal Officer, MCTC, CGHS Wellness Center Building, Kalibari New Delhi 110001 - with request for uploading in CGHS website.
- The Director Health Services, Agartala
- Local newspaper of Agartala - for publication

Read More

CGHS doctors to be trained on administrative matters

CGHS doctors to be trained on administrative matters

New Delhi: The government today launched the first ever induction training programme for medical officers recruited under the Central Government Health Scheme (CGHS) to make them aware about service rules and regulations and to train them on administrative and managerial aspects.

The objective is also to educate them about proper utilisation of resources and inform them about various ethical and legal issues.

Health Minister J P Nadda urged the doctors to attend the nine-week programme with an open mind, stating the training would help them in carrying out their duties more efficiently in the long run.

"It is not only about treating patients. You will also have to look after some administrative issues and deal with files. That is when you will face problem and this training will come handy," Nadda said.

The course, Nadda said, also aims at ensuring soft skills among these doctors so that they deal and communicate with the relatives of the patients in a calm and composed manner.

Around 231 doctors will undergo the training programme, which has been designed by the National Institute of Health and Family Welfare.

PTI

Read More

CGHS Subscription as per 7th CPC - Clarification for Pensioners Superannuating on 31.1.2017

CGHS Subscription as per 7th CPC - Clarification for Pensioners Superannuating on 31.1.2017

"It is clarified that those employees superannuating on or before 31.1.2017 and had submitted their application on or before 31.1.2017 may be allowed the subscription at the prevalent rates applicable as on 31.1.2017 vide OM No.S.No.S.11011/2/2008-CGHS(P) dated 20.5.2009".

No.S.11011/11/2016-CGHS(P)/EHS
Government of lndia
Ministry of Health and Family Welfare
EHS Section

Nirman Bhawan, New Delhi
Dated the 9 February, 2017

OFFICE MEMORANDUM

Sub: Revision of rates of subscription under Central Government Health Scheme due to revision of pay and allowances of Central Government employees and revision of pension/ family pension on account of implementation of recommendations of the Seventh Central Pay Commission- clarification reg.

Attention is drawn to this Ministry's OM of even No. dated 9th January, 2017 and a subsequent OM of even no. dated 13/7/2017, on the subject mentioned above.

2. This Ministry has been receiving several representations w.r.t applicability of CGHS rates to pensioners superannuating on 31.1.2017. The matter has been examined in this Ministry and it is clarified that those employees superannuating on or before 31.1.2017 and had submitted their application on or before 31.1.2017 may be allowed the subscription at the prevalent rates applicable as on 31.1.2017 vide OM No.S.No.S.11011/2/2008-CGHS(P) dated 20.5.2009. Pensioners applying for CGHS pensioner card on annual/lifetime basis after 31/1/2O17 will have to pay as per the revised rates effective from 1.2.2017 vide OM of even No. dated 13.1.2017.

3. This issues with the approval of the Competent Authority.

sd/-
(Bindu Tewari)
Director

Authority : http://cghs.gov.in/

Read More

7th Pay Commission recommendations on CGHS - Govt orders will be effective from 1st February 2017 - Ministry of Health issues modification OM

7th Pay Commission recommendations on CGHS - Govt orders will be effective from 1st February 2017 - Ministry of Health issues modification OM

No. S.11011/11/2016- CGHS (P)/EHS
Government of India
Ministry of Health and Family Welfare
EHS Section

Nirman Bhawan, New Delhi

Dated the 13th January, 2017

OFFICE MEMORANDUM

Sub: Revision of rates of subscription under Central Government Health Scheme due to revision of pay and allowances of Central Government employees and revision of pension/ family pension on account of implementation of recommendations of the Seventh Central Pay Commission.

In partial modification to this Ministry's OM of even No. dated 9th January, 2017 on the subject mentioned above, the undersigned is directed to say that the revised rates will be effective from 1st February 2017 instead of 1st January, 2017.

2. Other contents of the above said OM will remain unchanged.

(Sunil Kumar Gupta)

Under Secretary to the Government of india

Download Office Memorandum No. S .11011/11/2016- CGHS (P)/EHS dated 13.01.2017 issued by Ministry of Health and Family Welfare

Read More

Prescription of Timelines under CGHS for settlement of Medical claims of Pensioner CGHS beneficiaries : Maximum of 45 days to 90 days prescribed

Prescription of Timelines under CGHS for settlement of Medical claims of Pensioner CGHS beneficiaries : Maximum of 45 days to 90 days prescribed

CGHS circular for prescribing Timelines for settlement of Medical Claims

Government of India
Ministry of Health and Family Welfare
Department of Health & Family Welfare
Directorate General of CGHS
Office of the Director, CGHS

No: Z.15025/79/1/DIR/CGHS

545-A Nirman Bhawan, New Delhi
Dated the 5th October, 2016

OFFICE MEMORANDUM

Subject : Prescription of Timelines under CGHS for settlement of Medical claims of Pensioner CGHS beneficiaries.

With reference to the above subject the undersigned is directed to state that it has now been decided to define ‘Time Lines’ for processing and settlement of medical claims of pensioner CGHS beneficiaries as per the details given under:

Medical Claims not requiring Special approvals

i. Issue of Serial No. for Medical Claim at CGHS WC : same day

ii. Submission of physical bill to Office of AD : within 7 days

iii. Processing of Claims by Dealing Asst. and submission to CMO(R&H) : within 10 days

iv. Processing of Medical claims by CMO(R&H) : within 7 days

v. Sanction of Addl. Director and return to CMO : within 3 days

vi. Preparation of Bill and submission to P&AO : within 7 days

(Total within 45 days)

Medical claims

requiring approval of higher authorities

Total time within 60 days in Delhi

Total time within 90 days in other cities

Medical claims

requiring opinion of specialists

Total time 60 days

Medical Claims requiring STC approval for full reimbursement

1st STC meeting may be conducted within 90 days

Chief Medical Officer in charge shall thoroughly check the papers initially for the completeness of the requisite documents before accepting the claim papers to ensure that the claim papers are not returned subsequently for want of some documents.

(D.C.Joshi)
  Director, CGHS

Download CGHS Circular No: Z.15025/79/1/DIR/CGHS dated 05.10.2016

Read More

NO CGHS Funds for next 2 Months

NO CGHS Funds for next 2 Months

Health Ministry – Started in 1954, the CGHS — with approximately 30 lakh beneficiaries — covers retired and serving central government employees, MPs and their immediate families across 25 Indian cities.

The health ministry has no money left in the Central Government Health Scheme (CGHS) account for the next two months till funds according to the revised estimate are released. Having exhausted the Rs 1,600 crore that was initially allocated, the ministry has now asked for Rs 450 crore more.

The crisis in CGHS, one of the oldest health schemes run by the government, was precipitated by successive budget cuts, said sources.

Started in 1954, the CGHS — with approximately 30 lakh beneficiaries — covers retired and serving central government employees, MPs and their immediate families across 25 Indian cities. A total of 945 private hospitals and 165 diagnostic centres are empanelled with CGHS, which means that treatment in these hospitals for specified conditions are reimbursed by the government. Expenses at government hospitals are automatically covered for CGHS card holders.

“Funding for CGHS has been steadily going down, in 2013-14 it was Rs 1,832 crore, in 2014-15 it was Rs 1,798 crore and this year it was Rs 1,600 crore which we have exhausted. More funds will come only in January which is when the demands submitted under revised estimates are released. So the next two months will be difficult. We have asked for another Rs 450 crore for the rest of the year,” a source said. The matter was discussed at a presentation given to Health Minister J P Nadda on Tuesday, along with a host of measures to increase the beneficiary base and make transactions easier through the use of technology.
While instructions were issued to start clearing bills at one go instead of the earlier practice of 10 per cent payment in first instalment and the rest later, the ministry realises that the Rs 80-90 crore corpus that was handed out to UTIITSL for payment purposes is hardly sufficient.

“We need at least a couple of hundred crores corpus for the payments to continue without any hitch. We are looking at how to raise that money from other sources if possible,” said an official. The fund crunch hit at a time when the ministry was in the process of clearing private hospital bills to the tune of several hundred crores, pending for years. The pendency had led to a mass exodus of hospitals a couple of years ago, drastically reducing the number of private institutions empanelled with CGHS.

However, unfazed by the fund shortage, officials said this was only a “temporary phase”.

Source: The Indian Express

Read More

7th Pay Commission – Advantages to Government or Employees?

7th Pay Commission – Advantages to Government or Employees?

The Central Government employees are scheduled to get salary hikes on the basis of the recommendations by January 1, 2016. According to sources, the house rent allowance too would see an increase by 20 per cent. But the most significant recommendation is that 5 to 6 per cent of the annual increment would be performance-based. There is also likely to be a provision of retiring under-performing employees by the age of 55 or 30 years of service, whichever is more.

 

The Finance ministry has already opened its stand saying, the Seventh Pay Commission will be mindful of the fiscal concerns of the government while giving its report on new pay scales and remunerations for central government employees and pensioners.

 

So the question which arises in everybody’s mind is, for whom the 7th Pay Commission is for? Is it for the Central Government employees or for the Government? For Whose benefit is it working?

 

For example there is a rumour floating around that the CGHS facility is going to take its last breath after 7th CPC. The Seventh Pay commission is planning to propose health insurance scheme to replace Central Government Health Scheme (CGHS) at highly subsidized rates.

 

The pay panel will ask the central government to urge the insurance industry to come up with feasible health insurance solution for the central government employees and pensioners. The IRDA, the insurance regulatory body of India, will be compelled to ask the health insurance companies to offer a basic insurance to every central government employee and pensioner, regardless of age or medical condition and will not be allowed to make a profit of this basic insurance.

 

Health insurance would be available for central government employees and pensioners till death, the insured employees and pensioners will have to pay 50% of the premium from their salaries and pensions and the remaining 50% premium may be paid by the central government.

 

The CGHS is financed mainly through the Centre’s tax revenues. Though beneficiaries do contribute a share of their wages towards premium, ranging from Rs 600 to Rs 6,000 a year depending on their pay scale, this accounts for just about 5 per cent of the total expenditure. The government shells out the remaining 95 per cent.

However, now the Government is looking for ways to end the CGHS in its current form and to move to an insurance based health scheme to cut costs.

 

Recently, the CG Employee’s Welfare Ministry released an announcement which has created confusion and fury among the CG employees.

 

In the announcement it has been said that the senior officials have to analyse the service record and decide whether employees who have completed thirty years of service or reached their 50th year should continue their service or be advised to leave service after three months notice.

 

Does it take a management to learn that an official or an employee is unfit to continue in service when he has reached his 50th year? Does it take thirty years of continuous service to assess the efficiency of an employee?

 

Then what is the need for a probation period? After serving the Government for 30 years or till his 50th year, if somebody is asked to quit just like that, giving some damn reason when he is old, appears rather inhumane.

 

Unlike in the private sector, the pay hike in government is a once-in-10-years-affair. The Government need not and should not compare the Government employees with the private sector. The private sector works on profit mode, but the government organisations work in the service mode.

 

The NJCA at the Meeting of the Confederation held at Hyderabad on 09th October 2015 while endorsing the decision of the National Joint Council of Action (Railway, Defence & Confederation) to organize massive protest dharna at Jantar Mantar, New Delhi on 19th November 2015 and also Nationwide Protest Demonstration in front of all works spot & offices, has decided to further intensify the protest action against the negative attitude of the Government for the Unwarranted intervention of the Finance Ministry in the independent functioning of the Pay Commission by issuing a statement asking the 7th CPC to factor into its report the fiscal concern of the government and thereby to pressurize the commission not to recommend wage rise on the basis of a sound and scientific formulation and Causing engineered delay by the Government in the submission of 7th CPC report by granting four months extension upto 31st December 2015, even when the Pay Commission was ready to submit its report within the stipulated time i.e. 28th August 2015.

 

Source : GConnect.in

Read More

Seventh Pay commission likely to introduce health insurance

7th Pay commission likely to introduce health insurance 

New Delhi: In a move that could benefit more than 50 lakh central government employees and 56 lakh pensioners, the Seventh Pay commission is planning to propose to introduce health insurance scheme to replace Central Government Health Scheme (CGHS) at highly subsidized rates.

Seventh Central Pay Commission Chairman Justice Ashok Kumar Mathur

The pay panel has already held detailed discussions about this with various stakeholders, including organisations, federations, groups representing civil employees as well as Defence services.

The pay panel will ask the central government to urge the insurance industry to come up with feasible health insurance solution for the central government employees and pensioners. The IRDA, the insurance regulatory body of India, will be compelled to ask the health insurance companies to offer a basic insurance to every central government employee and pensioner, regardless of age or medical condition and are not allowed to make a profit off this basic insurance.

The serving central government employees in non-CGHS areas are provided healthcare facilities under the CS(MA) Rules, 1994, but pensioners are not covered under these rules.

The pensioners are, however, entitled to a fixed medical allowance of Rs 500 per month. The pensioners residing in non-CGHS areas have the option to become a CGHS member in any CGHS-covered city of their choice to avail the medical facilities under the CGHS Scheme.

Health insurance would be available for central government employees and pensioners till death, with the insured employees and pensioners will have to pay 50% of the premium from their salaries and pensions and the remaining 50% premium may be paid by the central government.

The health insurance would cover a family of six the employee and pensioner himself or herself, the spouse, two children and two parents. The maximum sum assured for family in a year could up to Rs 5 lakh.
Under the CGHS, the annual per capita expenditure is more than Rs 5,000. In contrast, the National Rural Health Mission (NRHM), which caters to the rural masses, spends just Rs 180 per head.

The CGHS is financed mainly through the Centre’s tax revenues. Though beneficiaries do contribute a share of their wages towards premium, ranging from Rs 600 to Rs 6,000 a year depending on their pay scale, this accounts for just about 5 per cent of the total expenditure. The government shells out the remaining 95 per cent.

So, the central government also wanted for ending the CGHS in its current form and to move to an insurance-based health scheme to cut costs.

TST

Read More

DoPT organized Free Health Check-up Camp for Central Government employees and their dependents

DoPT organized Free Health Check-up Camp for Central Government employees and their dependents

DoPT organized Free Health Check-up Camp for the benefit of Central Government employees and their dependents at Samaj Sadan, Grih Kalyan Kendra, R.K. Puram, Sector-4, New Delhi on 8th August, 2015 (10.00 AM to 2.00 PM).

No.12015/1/2015-Welfare
Government of India
Ministry of Personnel, Public Grievances and Pensions
Department of Personnel & Training

Lok Nayak Bhavan, Khan Market
New Delhi, Dated 07.08.2015

CIRCULAR

Subject: Free Health Check-up Camp for the benefit of Central Government employees and their dependents at Samaj Sadan, Grih Kalyan Kendra, R.K. Puram, Sector-4, New Delhi on 8th August, 2015 (10.00 AM to 2.00 PM).

Department of Personnel and Training, Government of India is organizing Free Health Check-up, Eye Check-up and Blood Donation Camps at Samaj Sadan, Grih Kalyan Kendra, R.K. Puram, Sector-4, New Delhi on 8th August, 2015 (10.00 AM to 2.00 PM) for the benefit of Central Government employees and their dependents.

Details of the Camps are as follows :-

S.No.	Types of Check-Ups	In Association with
1.	Health Check-Up(This includes free OPD consultation by renowned Doctors on Cardiac, Orthopedics and Gynecology/ Free tests of Sugar (Randum), BP, Height, Weight, BMD, PAP Smear & ECG.	Rockland Hospital, New Delhi.
2.	Eye Check-Up	Sharp Sights Centre, New Delhi.
3.	Blood Donation-Camp	Red Cross Society.

2. All are requested to avail the facility of free Health Check-up Camps for Free Health Check-up, Eye Check-up and Blood Donation Camps.

sd/-
(Chirabrata Sarkar)
Under Secretary (Welfare)

Authority: www.persmin.gov.in

Read More

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

Read More