Posts Tagged ‘CGHS’

Booking of CGHS Recovery into Heads of Defence Accounts

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Booking of CGHS Recovery into Heads of Defence Accounts

CGHS

OFFICE OF THE CONTROLLER GENERAL OF DEFENCE ACCOUNTS
ULAN BATAR ROAD, DELHI CANTT -110 010

No. A/1/11336/OBS/2017-18

Dated: 09.07.2018

To
PCsDA/CsDA (through website)

Subject: Booking of CGHS Recovery into Heads of Defence Accounts.

As per list of Major & Minor Heads of Accounts, recovery on accounts of CGHS contribution should be booked under Receipt Head 0210.01.103.00.00 {code heads 094/16-Defence, 095/16-MoD(Civ) & 098/20-CSD}.

2. However, Test Audit of pay bills pertaining to Defence Civilians in one of our Controller Offices revealed that a recovery of CGHS subscription is being booked under MH-0076, Minor Head 800-Other receipts (code head 01/575/30). Similarly, CGHS contribution of Civilians of Navy and Air Force is being booked under MH-0077, Minor Head 800-other receipts (code head 01/670/30) and Major Head 0078, Minor Head 800-Other receipts (code head 01/710/30) respectively.

3. While your office is booking a significant amount under the code head 094/16, it may be possible that the recovery on account of Defence Civilians not being booked under the appropriate heads.

4. It is therefore, requested to review the booking on account of recovery of CGHS contribution by your office and furnish the practice being followed and code heads being used by your office for booking of said recovery in r/o both DAD & Non-DAD subscribers. The review may be completed by 27.06.2018.

(Sumit Gajbhiye)
Sr.ACGDA (A&B)

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Relaxation of Rules for consideration of reimbursement in excess of the approved rates pertaining to medical claims

Government of India
Ministry of Health and Family Welfare
Department of Health & Family Welfare
EHS Section

No: Z. 15025/38/2018/DIR/CGHS/EHS

Nirman Bhawan, New Delhi
Dated the 22nd May, 2018

OFFICE MEMORANDUM

Subject: Relaxation of Rules for consideration of reimbursement in excess of the approved rates pertaining to medical claims

 

With reference to the above mentioned subject the undersigned is directed to draw attention to the Office Memorandum No, 4-18/2005- C&P [Vol.1- Pt (1)l, dated the 20th February 2009 and to slate that it has now been decided to modify the Para 3 (2) of the above referred Office Memorandum as per the details given under the Succeeding paragraphs.

 

a) The requests for full reimbursement which fall under the following defined criteria shall be examined by Directorate General of CGHS and submitted to AS&OG (CGHS) for consideration of approval. And the recommendation of AS&DG (CGHS), the concurrence of internal Finance Division and approval of Secretary. Ministry of Health & Family Welfare are required for reimbursement in excess of CGHS rates:

1) Treatment was obtained in a private unrecognized hospital under emergency and the patient was admitted by others when the beneficiary was unconscious or severely incapacitated and was hospitalized for a prolonged period.

2) Treatment was obtained ill a private unrecognized hospital under emergency and was admitted for prolonged period for treatment of Head injury, Coma, Septicemia, Multi. organ failure, etc.

3) Treatment was obtained in a private unrecognized hospital under emergency for treatment of advanced malignancy

4) Treatment was taken under emergency in higher type of accommodation as rooms as per his/her entitlement are not available during that period.

5) Treatment was taken in higher type of accommodation under specific conditions for isolation of patients to avoid contacting infections

6) Treatment was obtained in a private unrecognized hospital under emergency when there is a strike in Govt hospitals.

7) Treatment was obtained in a private unrecognized hospital under emergency while on official tour to non-CGHS covered area.

b) The requests non CGHS beneficiaries. having a valid CGHS Card at the time of treatment, in respect or the following conditions shall be considered by a High Powered Committee constituted by Ministry of Health & Family Welfare:

(i) Settlement of medical claims in relaxation of rules

(ii) Approval for air-fare with or without attendant on the advice of treating doctor for treatment in another city even though he/she is not eligible for air travel / treatment facilities are available in city of residence

(iii) Representations from CGHS beneficiaries seeking full reimbursements under special Circumstances, which are not notified.

c) The other terms and conditions mentioned in the OM No. 4-18/2005- C&P[Vol.1- Pt(1)] dated the 20th February 2009 shall remain unchanged.

(Rajeev Attri)
Under Secretary to Government of India

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CGHS: Notification of Nodal Officer of Private Health Care Organizations (HCOs) empanelled under CGHS Delhi & NCR

CGHS: Notification of Nodal Officer of Private Health Care Organizations (HCOs) empanelled under CGHS Delhi & NCR

F. No. Misc-53/CGHS/Gr.Cell/2018
O/o the Additional Director, CGHS (HQ)
Sector-12, R. K. Puram, New Delhi-110022

Date: 29th June, 2018

 OFFICE MEMORANDUM

 Sub: Notification of Nodal Officer of Private Health Care Organizations (HCOs) empanelled under CGHS Delhi & NCR.

In compliance with direction of National Human Right Commission (NHRC) and in accordance with Clause No. 9 of Memorandum of Agreement (MOAN, signed between CGHS and Pvt. HCOs. Wherein it is stated that –

“Empanelled Health Care Organizations shall notify two Nodal Officers for CGHS beneficiaries, one of them being of the rank of Deputy MS/Addl. MS, who can be contacted by CGHS beneficiaries in case of any eventuality”.

All the HCOs empanelled under CGHS Delhi/NCR are hereby directed to submit the names of 2 Nodal Officer, who can be contacted at the time of emergency by CGHS beneficiaries. The reply should reach the undersigned, within 7 days.

The names of the Nodal Officer along with the telephone number should be put up on the Admission Counter/Help Desk Counter for the CGHS beneficiaries to take the help in case of any difficulty.

This issues with the approval of the Competent Authority.

Encl: Annexure-A.

S/d,

Dr. Sanjay Jain
Additional Director, CGHS (HQ)
Delhi.

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Extension of validity period of empanelment of already empanelled Health care Organizations under CGHS

Extension of validity period of empanelment of already empanelled Health care Organizations under CGHS

F.No:S-11045/36/2016-CGHS (HEC)

Government Of India
Directorate General of Central Govt. Health Scheme
Ministry Of Health & Family Welfare

Nirman Bhawan, New Delhi
Dated the 28th June,2018

OFFICE ORDER

Sub: Extension of validity period of empanelment of already empanelled Health care Organizations under CGHS.

With reference to above mentioned subject attention is drawn to office order dated 01.04.2018 whereby empanelment of all existing empanelled health care organizations under CGHS was extended till 30.06.2018

In this regards it has been now decided to extend empanelment of all Health Care Organizations already empanelled under CGHS for a further period of three months w.e.f 01.07.2018 till 30.09.2018 or till next empanelment whichever is earlier on same terms conditions and rates on which they are presently empanelled.

S/d,
(Dr.D.C.Joshi)
Director (CGHS)
Tel: 011-23062800

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NFIR’s PNM item No. 30/2018 – Revision of criteria for Diet Charges for patients admitted in Railway hospitals

NFIR’s PNM item No. 30/2018 – Revision of criteria for “Diet Charges” for patients admitted in Railway hospitals

Railway-Hospitals-NFIR

GOVERNMENT OF INDIA
MINISTRY OF RAILWAYS
(RAILWAY BOARD)

No. 2005/H/23/6

New Delhi, dated : 13.06.2018

General Managers
All Indian Railways
(Including PUs & RDSO)

Sub: NFIR’s PNM item No. 30/2018 – Revision of criteria for “Diet Charges” for patients admitted in Railway hospitals – regarding.

Ref: This office letter of even number dated 29.10.2010.

The issue of revision of criteria for free/concessional diet for patients admitted in railway hospitals has been engaging the attention of Ministry of Railways for some time. In the meantime, Ministry of Health & Family Welfare, Govt. of India vide their Office Memorandum no S.11011/11/2016-CGHS (P)/EHS dated 09.01.2017 have revised the criteria for diet charges respect of CGHS medical beneficiaries. The Basic pay ceiling for free diet in respect of CGHS beneficiaries has been revised as under:

(i) Basic pay / pension / family pension eligible for free diet – Rs. 44,900/-
(ii) Basic pay/pension/family pension eligible for free diet in case of those suffering from TB or mental diseases – Rs. 69,700/-.
(iii) No provision for concessional diet.

After careful consideration in the matter, it has been decided that the criteria of diet charge fixed by Ministry of Health & Family Welfare for CGHS beneficiaries be adopted mutatis-mutandis for Railway beneficiaries. Accordingly, the revised criteria for diet charges in respect of Railway Medical beneficiaries would henceforth be as under:

(I) Monetary ceiling limit of Rs. 44,900/- (after implementation of 7th CPC) of basic pay/pension/family pension for the purpose of providing free diet to railway medical beneficiaries;

(II) Removal of provision of concessional diet charges contained in instructions dated 29.02.2010; and

(III) Monetary ceiling s. 69,700/- of basic pay/pension/family pension for the purpose of providing free diet to railway medical beneficiaries suffering from Tuberculosis (TB) or mental disease.

This issues with the concurrence of Finance Directorate in the Ministry of Railways.

S/d,
(R.S.Shukla)
Joint Director, Health
Railway Board

Source : NFIR

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Change in nomenclature of Nursing Staff in CGHS

Change in nomenclature of Nursing Staff in CGHS

A.60011/13/2017-CGHS-II
GOVERNMENT OF INDIA
Ministry of Health & Family Welfare
(CGHS-II Section)

Nirman Bhawan, New Delhi
Dated the 4th June, 2018

ORDER

Subject: Change in nomenclature of Nursing Staff in CGHS-regarding.

In continuation of this Ministry’s order of even No dated 08.03.2017 & 10.10.2017 on the subject cited above, the nomenclature of following Nursing Staff of Ayurvedic System in CGHS has been changed as mentioned against each, with immediate effect:-

Sl.No. Existing Nomenclature of the post New Nomenclature
1. Staff Nurse (Ayurvedic) Nursing Officer (Ayurvedic)
2. Nursing Sister (Ayurvedic) Senior Nursing Officer (Ayurvedic)

2. The change in nomenclature as mentioned above doesn’t involve change in duties and responsibilities and any additional financial benefits.

3. This issues with the approval of Competent Authority.

(Dharminder Singh)
Under Secretary to the Govt. of India

To,
1. The Additional Director, CGHS, Delhi for compliance.
2. The PS to AS&DG(CGHS), Ministry of Health & Family Welfare
3. The Director (CGHS), Ministry of Health: & Family-Welfare.
4. The Director (EHS), Ministry of Health 84 Family Welfare.
5. Sh. Frank Ellis, Secretary General, AlCGl-lSEA,‘ CGHS, Pune. I

Copy to:-

1. The Nodal Officer, MCTC, CGHS for uploading in the website of CGHS.

Source: CGHS

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Relaxation of Rules for consideration of reimbursement in excess of the approved rates pertaining to medical claims – CGHS Orders

Relaxation of Rules for consideration of reimbursement in excess of the approved rates pertaining to medical claims – CGHS Orders

Government of India
Ministry of Health and Family Welfare
Department of Health & Family Welfare
EHS Section

No.Z.15025/38/2018/DIR/CGHS/EHS

Nirman Bhawan, New Delhi
Dated the 22nd May, 2018

OFFICE MEMORANDUM

Subject: Relaxation of Rules for consideration of reimbursement in excess of the approved rates pertaining to medical claims

With reference to the above mentioned subject the undersigned is directed to draw attention to the Office Memorandum No. 4-18/2005- C&P [Vo]. l-Pt (1)], dated the 20th February 2009 and to state that it has now been decided to modify the Para 3 (2) of the above referred Office Memorandum as per the details given under the succeeding paragraphs.

a) The requests for full reimbursement which fall under the following defined criteria shall be examined by Directorate General of CGHS and submitted to AS&DG (CGHS) for consideration of approval. After the recommendation of AS&DG (CGHS), the concurrence of Internal Finance Division and approval of Secretary, Ministry of Health & Family Welfare are required for reimbursement in excess of CGHS rates:

1) Treatment was obtained in a private unrecognized hospital under emergency and the patient was admitted by others when the beneficiary was unconscious or severely incapacitated and was hospitalized for a prolonged period.

2) Treatment was obtained in a private unrecognized hospital under emergency and was admitted for prolonged period for treatment of Head Injury, Coma , Septicemia, Multi-organ failure , etc.

3) Treatment was obtained in a private unrecognized hospital under emergency for treatment of advanced malignancy

4) Treatment was taken under emergency in higher type of accommodation as rooms as per his/her entitlement are not available during that period.

5) Treatment was taken in higher type of accommodation under specific conditions for isolation of patients to avoid contacting infections

6) Treatment was obtained in a private unrecognized hospital under emergency when there is a strike in Govt. hospitals.

7) Treatment was obtained in a private unrecognized hospital under emergency while on official tour to non-CGHS covered area.

b) The requests from CGHS beneficiaries. having a valid CGHS Card at the time of treatment, in respect of the following conditions shall be considered by a High Powered Committee constituted by Ministry of Health & Family Welfare:

(i) Settlement of medical claims in relaxation of rules

(ii) Approval for air-fare with or without attendant on the advice of treating doctor for treatment in another city even though he/she is not eligible for air travel treatment facilities are available in city of residence

(iii) Representations from CGHS beneficiaries seeking full reimbursements under special Circumstances, which are not notified.

c) The other terms and conditions mentioned in the OM No. 4-18/2005- C&P[Vol. l-Pt(1)] dated the 20 February 2009 shall remain unchanged.

sd/-
(Rajeev Attri)
Under Secretary to Government of India

Source: www.cghs.gov.in

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Comprehensive procedure, guidelines and check list for empanelment of private hospitals

Comprehensive procedure, guidelines and check list for empanelment of private hospitals

GOVERNMENT OF INDIA
MINISTRY OF RAILWAYS
(RAILWAY BOARD)

No.2016/H-1/11/58/Policy

New Delhi, dated 25.4.2018

The General Managers,

All Indian Railways & Production Units,

Sub: Comprehensive procedure, guidelines and check list for empanelment of private hospitals.

Ref:- SER’s letter no.CMD/SER/Hosp. Tie-up/2303 Dated 14.11.2017.

PCMD/SER vide their letter under reference had sought necessary guidelines to be followed while empanelling private hospitals in consequence of powers delegated to the GMs for empanelment of private hospitals vide Railway Board letter no. 2017/Trans/01/Policy dated 18/10/17 and to the DRM’s for divisions and CWMs for workshops vide letter no.2017/Trans/01/Policy/Pt 1 dated 30/11/17. Such powers are to be exercised by the delegated officers in person and shall not be delegated below. Hence now no proposal for empanelment is required to be sent to Railway Board.

A comprehensive guideline for procedure and checklist to be followed while empanelling private hospitals are being issued as per Annexure enclosed. Any new guidelines issued from MoH & FW as and when issued shall be duly incorporated and advised.

This is in surprise of all earlier guidelines issued from Railway Board on this subject.

This issues with the concurrence of the Finance Directorate of the Ministry of Railways.

(Mrs. H.K. Sanhotra)

Joint Director-II/Health

Comprehensive Procedure Guideline & Check List For Empanelment of Private Hospitals

The empanelled hospitals have been broadly categorised into two groups:-

A. CGHS / E$l / ECHS empanelled hospitals and Government of India / Public Sector Undertaking hospitals like of SAIL, BHEL, Coal India, etc.

B. Other private hospitals which are neither empanelled by CGHS, ECHS & ESI nor are run by Government of India Public Sector Unit. (PSU).

The following guide lines and check list are to be kept in consideration while empanelling hospitals by Railways. The point common to both these types of hospitals are given below:-

1. Justification for the proposal mentioning the present status of Railway Hospital i.e. number of Doctors & Paramedical on roll vis. a vis. sanctioned strength, services provided by it, any future plan for expansion, no. of Honorary Consultants/Visiting Specialists (specialty wise) & CMPs and despite existing facilities why referral services are still required.

2. Justification for empanelment with technical aspect i.e. number of beds/ facilities/specialties/services offered/medical set up etc. at the proposed hospital.

3. Total number of Railway beneficiaries catered by the Railway Hospital.

4. In the Specialties Specialties for which Railway hospital do not have facilities if there are any reputed Government Hospitals rendering services in those specialties.

5. In CGHS covered states/cities, hospitals should be empanelled only at CGHS rates (in case of Government of India, PSU hospital their own rate) or even lower or some discount etc offered by them. Names of the hospital empanelled by CGHS / ECHS /ESI can be obtained from respective website. Even in places not covered by CGHS, all out efforts should be made to empanel hospital on CGHS (city-specific) rates only. In case of any deviation from CGHS rates, justification to be given by MD / CMS / CMO in charge, duly concurred by Associate Finance before being approved by Competent Authority.

6. Comparative statement of package rates as well as diagnostic charges of the proposed hospital with (i) other empanelled hospitals in the city and (ii) the CGHS rates of that city or the nearest city in tabulated form.

7. Two copies of rate list of hospital duly verified by competent authority. After approval, one copy along with sanction letter to be sent to HQ for uploading on Zonal website.

8. Concurrence of the Associate Finance as applicable along with their verbatim comments

9. Proposal to be sent for approval of GM /DG (RDSO) /DRM /CAO /CWM as the case may be (both for the first time and as well as further renewals).

10. Validity of empanelment will be two years or till it is empanelled or revoked by CGHS / ECHS /.ESI whichever is earlier and for Government of India PSU hospitals too it will be for two years, Same for non CGHS / ECHS / ESI hospitals too. Overall performance of the hospital, patient’s feedback etc. to be kept in mind while extension

11. Further extension may be done with mutual consent of both parties, arid will be sanctioned by GM /DG (RDSO) /DRM /CAO /CWM as the case may be (also see para

A((a) & B(d)).

A. CGHS / ESI/ ECHS empanelled hospitals and Government of India / Public Sector Undertaking hospitals like of SAIL’ 3HEL, Coal India, etc. –

(a) In case of CGHS / ECHS / ESI empanelled & Government of India/PSU run hospitals, a letter of willingness from the hospital be obtained and can be empanelled any time Rates as and when revised by CGHS can be agreed to.

B. Other private hospitals which are neither empanelled by CGHS, ECHS & ESI

a) An open advertisement should be floated once a year or as per requirement for empanelment of private hospitals.

b) Empanelment of such hospitals should be considered only if there is no other CGHS/ ECHS / ESI nor any hospital run by Government of India – Public Sector Undertaking like SAIL, BHEL, Coal India etc. empanelled hospital, preferably within a vicinity of 5kms from the hospital already empanelled.

c) Search committee should be constituted by MD / CMS / CMO, consisting of 3 doctors of at least JAG level and they may co-opt another doctor of particular speciality when required. They will visit the hospitals and give clear justification for approving this hospital.

d) For any increase in rates, at the time of extension same should be justified by MD/CMS/CMO and concurred by Associated Finance and accepted by the concerned competent authority. If such increase in rates is more than 5%, the proposal duly justified by medical in charge and vetted by associate finance and approval of DRM /CWM in case of Division and workshops to be sent to Headquarters for sanction of General Manger. In case of headquarter controlled Central hospitals and Pus, General Manager / DG*(RDSO) will approve such proposals. However, no enhancement in rate is permissible during that period of recognition of two years.

Source: http://www.cghs.gov.in/

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Prescription of Timelines under CGHS for settlement of Medical claims of Pensioner CGHS beneficiaries

Prescription of Timelines under CGHS for settlement of Medical claims of Pensioner CGHS beneficiaries

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.15025/38/2018 /DIR/CGHS

545-A Nirman Bhawan, New Delhi
Dated the 14th May, 2018

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 draw attention to the OM No Z 15025/79/1/DlR/CGHS dated the 5th October 2016 and to state that it has now been decided to review the timelines prescribed for processing and settlement of medical claims of pensioner CGHS beneficiaries in compliance of the directions of Hon’ble Supreme Court of India in their Judgement in the WP(CiviI) No 694 of 2015 between Shiva Kant Jha Vs UOI delivered on 13th April 2018 and in supersession of the earlier guidelines as per the details given under:

Medical Claims not requiring Special approvals

Pensioner CGHS beneficiaries shall submit the Medical claims to the CMO I/C of the CGHS Wellness Centre , where the CGHS Card is enrolled . CMO I/C of CGHS Wellness Centre issues Serial Number and sends the claim papers to the office of the Addl. Director, CGHS for processing. The Bills shall be processed by the Dealing Asstants and CMO and after the approval by the Additional Director, the bill for payment shall be sent to the Pay & Accounts Office for payment to the beneficiary by ECS. The payment shall be completed within 30 days of submission of the Medical claim papers at the CGHS Wellness Centre.

Medical claims reguiring approval of higher authorities

Total time within 45 days in Delhi
Total time within 60 days in other cities

Medical claims reguiring opinion of specialists

Total time 45 days

2. 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.

3. If approval of Directorate or Ministry is involved, the Addl. Directors shall submit only e-file with self-contained note and recommendation, enclosing only relevant scanned documents. Care shall be taken not to regret medical claims of pensioner CGHS beneficiaries on minor technical objections if , they fall under procedural lapses, which can be condoned.

Sd/-
(Dr.D.C.Joshi)
Director, CGHS

Source: cghs.gov.in

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Eligibility of Permanently Disabled Unmarried Son of a CGHS Beneficiary to avail CGHS Facility

Eligibility of Permanently Disabled Unmarried Son of a CGHS Beneficiary to avail CGHS Facility

Permanently Disabled CGHS Facility

No. 4-24/96-C&P/CGHS (P)/EHS
Government of India
Ministry of Health & Family Welfare
Department of Health & Family Welfare
EHS Section

Nirman Bhawan, New Delhi.
Dated: the 7th May, 2018

OFFICE MEMORANDUM

Subject: Eligibility of Permanently Disabled Unmarried Son of a, CGHS Beneficiary to avail CGHS facility – Reg.
The undersigned is directed to refer to this Ministry’s Office Memoranda of even number dated 31.05.2007, 29.08.2007 and. 02.08.2010 vide which the entitlement of the son of a CGHS beneficiary beyond the age of 25 years was conveyed. As per the two Office Memoranda under reference, it was indicated that an unmarried son of a CGHS beneficiary suffering from any permanent disability of any kind (physical or mental) will be entitled to CGHS facility even after attaining the age of 25 years.

2. Since then this Ministry is in receipt of several representations for inclusion of more conditions in , view of modification to the PWD Act, 1995 by “The Rights of Persons with Disabilities Act, 2016 (Act No. 49 of 2016)” as notified by WHO Law and Justice, Govt. of India on 27.12.2016. The matter has been reviewed by the Ministry and it is now decided that for the purpose of extending the CGHS benefits to dependent unmarried son of CGHS beneficiary beyond 25 years of age , the definition of ‘Permanent Disability’ shall include the following conditions:

I. Physical disability:

A. Locomotor disability including

a) Leprosy cured person- suffering from loss of sensation in hands or feet as well as loss of sensation and paresis in the eye and eye-lid but with no manifest deformity or suffering from manifest deformity and paresis or having extreme physical deformity as well as advanced age which prevents him/her from gainful occupation

b) Cerebral palsy – caused by damage to one or more specific areas of the brain usually occurring before, during or immediately after birth.

c) Dwarfism- a medical genetic condition resulting inLan adult height of 147 cms or less;

d) Muscular dystrophy – a. group of hereditary genetic muscle diseases characterized by progressive skeletal muscle weakness

e) Acid attack victims – disfigured due to‘ violent assaults by throwing acid or similar corrosive substance

B. Visual impairment:

a) Blindness – where a person has any of the following conditions alter best correction:
(i) Total absence of sight or
(ii) Visual acuity less than 3/60 or less than 10/200(Snellen) in the better eye with best possible correction
(iii) Limitation of field of vision subtending an angle of less than 10 degree

b) “Low vision” means any of the following conditions:

(i) visual acuity not exceeding 6/18 or less than 20/60 upto 3/60 upto 10/200 (Snellen) in the bettereye with best possible corrections; or
(ii) limitation of the field. of vision subtending an angle of less than 40 degree upto 10 degree

C. Hearing Impairment

(a) “deaf” means persons having 70 db hearin g loss in speech frequencies in both ears;

(b) “hard of hearing” means persons having 60 db to 70 db hearing loss in speech frequencies in both ears;

D.Speech and Language disability” – permanent disability arising out of conditions such as Laryngectomy or aphasia affecting one or more components of speech and language due to organic or neuronal causes.

II. Intellectual disability- characterized by significant limitation both in intellectual functioning (reasoning, learning, problem solving) and in adaptive behavior , which cover a range of every day, social and practical skills , including, social and practical skills , including-

(a) “Specific language disabilities” a heterogeneous group of conditions Wherein there is deficit in processing language, spoken. or written, that may manifest itself as a difficulty to comprehend, speak, read, write, spell, or to do the mathematical calculations and includes conditions such as perceptual disabilities, dyslexia, dysgraphia, dyscalculia, dyspraxia and developmental aphasia

(b) “Autism spectrum disorder” – a neuro-developmental disorder typically appearing in the first three years of life that significantly affects a person’s ability to communicate, understand. relationships and relate to others, and frequently associated with unusual or stereotypical rituals or behaviour.

III. Mental behaviour

Mental illness“- a substantial disorder of thinking, mood, perception, orientation or memory that grossly impairs judgement, behaviour, capacity to recognize reality or ability to meet the ordinary demands of life, but does not include retardation.

IV. Mental Retardation

V. Disability caused due to

(a) Chronic neurological conditions such as
(i) Multiple Sclerosis
(ii) Parkinson’s disease

(b) Blood disorder
(i) Haemophila
(ii) Thalassemia
(iii) Sickle Cell Disease

VI. Multiple Dis-abilities ( more than “one of the above disabilities)- including deaf blindness

3. Bench Mark Disability- unmarried permanently disabled and financially dependent sons of CGHS beneficiaries suffering 40% or more of one or more-disabilities as certified by a Medical Board shall be eligible to avail CGHS facilities even after attaining the age of 25 years.

4. This OM will be effective from the date or its issue.

Sd/-
(Rajeev Attri)
Under Secretary to the Govt. of India

Source: CGHS.GOV.IN

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CGHS: Additional List of Private Hospitals in Delhi & NCR

CGHS: Additional List of Private Hospitals in Delhi & NCR

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 hospitals (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 clinics & 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.

sd/-

[Dr. D.C. Joshi]

Director (CGHS)

Source: http://www.cghs.gov.in/

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CGHS: Issue of Medicines prescribed by Specialists beyond the period

Clarification regarding issue of Medicines prescribed by Specialists beyond the period for which the medicines had been advised – CGHS Orders

“Medical Officers of CGHS can issue the same medicines to CGHS beneficiaries prescribed by the Specialists even after the expiry of the validity of the prescription in Chronic diseases”

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

No:Z.15025/33/2018/DIR/CGHS

Nirman Bhawan, New Delhi 110 011
Dated the 1st May, 2018

Office Memorandum

Subject: Clarification regarding issue of Medicines prescribed by Specialists beyond the period for which the medicines had been advised

With reference to the above subject the undersigned is directed to state that this Ministry is in receipt of representations from CGHS beneficiaries, particularly from Senior Citizens regarding refusal of CGHS for issue of medicines prescribed by Specialists, immediately on expiry of the period for which the prescription has been issued.

The matter has been reviewed by the competent authority in view of the difficulties faced by the CGHS beneficiaries and it is now decided that Medical Officers of CGHS can issue the same medicines to CGHS beneficiaries prescribed by the Specialists even after the expiry of the validity of the prescription in Chronic diseases, where the clinical condition is stable and CGHS shall not insist on immediate re validation by Specialists.

However, in cases of Chemotherapy and immunosuppressant treatment regular follow up from Specialists would be advisable.

These guidelines are in super session of the guidelines issued earlier on the subject.

sd/-
(Dr D.C.Joshi)
Director, CGHS

Source: Confederation

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Demarcation of CGHS Patna covered area under 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
demarcation-of-cghs-patna-covered-area

Source: CGHS

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Medical Treatment facilities to Central Government Employees and Pensioners

Reimbursement of Medical Treatment in non-empanelled hospitals to CG Employees and Pensioners – Supreme Court Judgment [WP (Civil) No. 694 of 2015]

In view of the verdict of Hon’ble Supreme Court with regard to the medical treatment of Central Government Employees and Pensioners in non-empanelled hospitals, the Secretary, National Council (Staff Side), JCM has requested the Central Government to kindly take appropriate steps to implement the above judgment in its true perspective so as to ensure better health care to the Central Government Employees and Pensioners.

Shiva Gopal Mishra
Secretary

Ph.: 23382286
National Council (Staff Side)
Joint Consultative Machinary
for Central Government Employees
13-C, Ferozshah Road, New Delhi – 110001
E Mail : nc.jcm.np@gmail.com

No. NC-JCM-2018/Health

April 23, 2018

The Secretary
Government of India
Ministry of Health and Family Welfare
Nirman Bhavan, New Delhi – 110 001.

Subject : Medical Treatment facilities to Central Government Employees and Pensioners

Reference : Judgment of the Hon’ble Supreme Court in WP (Civil) No. 694 of 2015 delivered on 13th April, 2018

Sir,

The Staff Side of the National Council (JCM) is repeatedly representing to the Government about the difficulties being faced by the Central Government Employees and Pensioners in availilng Medical Treatment from CGHS Hospitals and also from un-empanelled hospitals during emergency. In many cases the CGHS empanelled hospitals charges over and above the charges fixed for different treatment and procedure and the same is denied and disallowed from the Medical Claims of the Employees and Pensioners thereby subjecting the CGHS beneficiaries are forced to take treatment to save their life from various un-empanelled hospitals. The claims from these hospitals are also rejected and the CGHS beneficiary has to bear the entire cost of the treatment. Against these the affected employees and Pensioners have approached different Courts in different parts of the Country and in all those cases the judgments are given in favour of the Employees.

At present the Hon’ble Supreme Court in its above referred Order has given an historical judgment with regard to the medical treatment of Central Government Employees and Pensioners and the Hon’ble Supreme Court has also given various directions to your Ministry for implementation in a time bound manner. The relevant portion of the judgment is given below for your kind ready reference.

“13) It is a settled legal position that the Government employee during his life time or after his retirement is entitled to get the benefit of the medical facilities and no fetters can be placed on his rights. It is acceptable to common sense, that ultimate decision as to how a patient should be treated vests only with the Doctor, who is well versed and expert both an academic qualification and experience gained. Very little scope is left to the patient or his relative to decide as to the manner in which the ailment should be treated. Specialty Hospitals are established for treatment of specified ailments and services of Doctors specialized in a discipline are availed by patients only to ensure proper, required and safe treatment. Can it be said that taking treatment in Specialty Hospitals by itself would deprive a person’ to claim reimbursement solely on the ground that the said Hospital is not included in the Government Order. The right to medical claim cannot be denied merely because the name of the hospitals is not included in the Government Order. The real test must be the factum of treatment. Before any medical claim is honoured, the authorities are bound to ensure as to whether the claimant had actually taken treatment and the factum of treatment is supported by records duly certified by Doctors/Hospitals concerned. Once, it is established, the claim cannot be denied on technical grounds. Clearly, in the present case, by taking a very inhuman approach, the officials of the CGHS have denied the grant of medical reimbursement in full to petitioner forcing him to approach this Court.

16) Further, with regards to the slow and tardy pace of disposal of MRC by the CGHS in case of pensioner beneficiaries and the unnecessary harassment meted out to pensioners who are senior citizens, affecting them mentally, physically and financially, we are of the opinion that all such claims shall be attended by a Secretary level High Powered Committee in the concerned Ministry which shall meet every month for quick disposal of such cases. We, hereby, direct the concerned Ministry to device a Committee for grievance redressal of the retired pensioners consisting of Special Directorate General, Directorate General, 2 (two) Additional Directors and 1 (one) Specialist in the field which ‘shall ensure timely and hassle free disposal of the claims within a period of 7 (seven) days. We further direct the concerned Ministry to take steps to form the Committee as expeditiously as possible. Further, the above exercise would be futile if the delay occasioned at the very initial stage, i.e., after submitting the relevant claim papers to the CMO-I/C, therefore, we are of the opinion that there shall be a time frame for finalization and disbursement of the claim amounts of pensioners. In this view, we are of the opinion that after submitting the relevant papers for claim by a pensioner, the same shall be reimbursed within a period of 1 (one) months.”

In view of the above observations and directions by the Hon’ble Supreme Court we request you to kindly take appropriate steps to implement the above judgment in its true perspective so as to ensure better health care to the Central Government Employees and Pensioners. We have already forwarded many Agenda Points for discussion with the Ministry of Health vide our Letter No. NC-JCM-2017/Health dated 26/04/2017 and 01/09/2017. We regret to inform you that till date Ministry of Health has not convened the meeting with the Staff Side of National Council (JCM). You are therefore requested to convene a meeting with the Staff Side of National Council (JCM) in which the above issue can also be discussed.

Awaiting for your favourable response please.

Thanking you,

Yours Faithfully,
(Shiva Gopal Mishra)
Secretary

Source: Confederation

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

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

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Clarification regarding demarcation of CGHS covered areas under CGHS Wellness Centre

Clarification regarding demarcation of CGHS covered areas under CGHS Wellness Centre

Government of India
Ministry of Health & Family Welfare
Department of Health & Family Welfare
Directorate General of CGHS
Nirman Bhawan, Maulana Azad Road
New Delhi 110 011

No. C 14012/02/2018/CGHS-III/DIR
Dated: 6th April, 2018

OFFICE MEMORANDUM

Subject:- Clarification regarding demarcation of CGHS covered areas under CGHS Wellness Centre

With reference to the above subject the undersigned is directed to state that in some of the CGHS Cities the areas covered under CGHS were not specified resulting in inconvenience to the beneficiaries. The matter has been reviewed and it is now decided that hereinafter the coverage of CGHS shall be limited to the areas within 5 km (approx.) radius of the CGHS Wellness Centres , in all CGHS covered Cities , where such demarcations were not specified. The Additional Director, CGHS concerned City shall notify such areas covered under CGHS Wellness Centres.

The serving Central government employees residing outside the CGHS covered areas shall be covered under CS(MA) Rules. However, in all CGHS covered cities 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.

S/d,
(Dr.D.C.Joshi)
Director, CGHS

Signed copy

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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

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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

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Extension of CGHS to all Extension of CGHS to all retired employees of Kendriya Vidyalaya residing in Delhi/NCR

CGHS Facilities to Retired KV Employees

KENDRIYA VIDYALAYA SANGATHAN

F.No.11086/01/2012-KVS HQ(Admn.II)/75-85

Dated: 20.03.2018

OFFICE MEMORANDUM

Subject: Extension of CGHS to all retired employees of Kendriya Vidyalaya residing in Delhi/NCR- regarding.

Consequent upon KVS’s proposal on the subject vide letter dated 29.09.2017, the Deputy Secretary (UT), Ministry of Human Resource Development vide his letter No.F.3-5/2011-UT-2 dated 02.02.2018 to be reqd with MHRD’s letter of even number dated 19.03.2018 has conveyed the decision of Ministry of Health and Family Welfare, Government of India, New Delhi regarding extension of CGHS facilities to all retired employees of Kendriya Vidyalaya Sangathan (KVS) residing in Delhi/ NCR.

2. Accordingly, medical facility under the CGHS is to all retired employees of Kendriya Vidyalaya Sangathan residing in Delhi/ NCR.

The terms and conditions mentioned in the Office Memorandum or even number dated 21.08.2015 will remain the same.

sd/-
(U.N.KHAARE)
ADDITIONAL COMMISSIONER (ACAD/ADMN.)

Source: http://kvsangathan.nic.in

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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

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