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Health Ministry Simplifies Treatment Process at private hospitals under CGHS


Health Ministry Simplifies Treatment Process at private hospitals under CGHS

 

New Delhi: Bringing relief to lakhs of beneficiaries under the Central Government Health Scheme (CGHS) scheme across the country, the Ministry of Health and Family Welfare has announced Simplification of procedure for treatment at private hospitals empanelled under CGHS/CS (MA) Rules, 1944.

With the move, the government has also extended cashless facilities to CGHS pensioners, ex-employees and many others, who were earlier eligible for treatment only on credit basis. Moreover, the government has directed that the government dispensaries not refer a patient to a particular centre , rather shall specify the treatment procedure and mention ‘referred to any CGHS empanelled centre’. 

A office memorandum issued in this regard states that the  Ministry had received representations for simplification of procedure for undergoing treatment at private hospitals empanelled under CGHS. The matter had been examined and it has now been decided that CGHS beneficiaries are allowed to undergo treatment at private hospitals empanelled under CGHS of specific treatment procedures listed under CGHS rate list are advised by a Specialist in a Central Government / State Govt. Specialist hospital or a CGHS Medical Officer without any requirement of any other referral (permission) letter.

Private empanelled hospitals shall perform the treatment on cashless basis in respect of pensioners, ex-MPs, Freedom Fighters, Regular employees {both CGHS and CS (MA) beneficiaries} of this Ministry & other categories of CGHS beneficiaries, who are presently eligible for credit facility and shall enclose the prescription issued by Government Specialist or a CGHS Medical Officer, in original (or a self-attested photocopy) along with the hospital bill submitted to the competent authorities.

Serving government employees shall enclose the prescription issued by a Government Specialist or a CGHS Medical Officer in original (or a self-attested photocopy), while submitting the medical claim to the concerned Ministry /department/office for reimbursement.

CGHS Medical Officer / Government Specialist shall not refer the beneficiaries to any particular empanelled hospital by name but, shall specify the treatment procedure and mention ‘referred to any CGHS empanelled centre’.

These orders are applicable only in respect of treatment procedures for which CGHS rates are available, the directive specifies.

 




Source: self
6 comment(s) on Health Ministry Simplifies Treatment Process at private hospitals under CGHS

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  1. What about, when the procedures/ treatment is not available at impaneled pvt hospitals, but in pvt hosptals. the pvt hospitals do not have CGHS rate also. whether any furher permission is necessary from HOD.

  2. The Union Govt. decision is very good. The beneficiaries were forced to run govt. Hospitals I found that the Govt. Hospitals are conducting tests now and than beneficiaries has to attend early morning waiting hours for treatment and consulting Doctors and Test and collecting Test Reports finally there will not be referral letters. Advised for treatment after conducting tests.

  3. Why referral letter from only Govt Doctors? Why cant patient directly approach a CGHS empanelled hospital? Do you want Hospitals to now pay commission /Bribe to Govt. doctors? Empower the benefeciary to select a centre not the referring doctor.

  4. user
    Dr. Dharmendra Kumar November 21, 2017, 7:06 pm

    These are protocol to be maintained, if they directly go to empanelled hospital then there is no need of CGHS dispensaries and Hospitals. A simple health insurance policy is enough for a employee family at places with private or Govt tertiary care facility.

  5. You are right sir. This protocol will definitely kill my father. The doctors of Mint Colony, Kolkata centre inspite of the govt order, sent my father to SSKM, a govt. hospital. the govt is collecting money every month for CGHS facility. But i had to take my father to a govt hospital for a day long tour.

  6. Ethics on display thru this notification.
    Hope it is strictly enforced in letter &spirit.
    Sign Boards should be displayed at every cghs dispensary for effective implementation