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You are here: Home / CGHS / NCJCM Staff Side Meeting of COVID-19 PATIENTS: FIXATION OF PACKAGE RATE, REIMBURSEMENT, CGHS CASHLESS TREATMENT

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NCJCM Staff Side Meeting of COVID-19 PATIENTS: FIXATION OF PACKAGE RATE, REIMBURSEMENT, CGHS CASHLESS TREATMENT

July 20, 2020 by admin Leave a Comment

NCJCM

NCJCM Staff Side Meeting of COVID-19 PATIENTS CGHS CASHLESS TREATMENT
CGHS CASHLESS TREATMENT

F. No. B-12012/1/ 2020-EHS
Government of India
Ministry of Health & Family Welfare
Department of Health Family Welfare
(EHS Section)

Nirman bhawan, New Delhi
Dated the 13th July, 2020

OFFICE MEMORANDUM

Subject: Minutes of the meeting with Staff Side, National Council.

The undersigned is directed to circulate herewith the Minutes of the Meeting with Staff Side of National Council (JCM) on the submitted agenda items, held on 09.07.2020 under me chairpersonship of Secretary (HFW). in Committee Room No. 155-A, Nirman Bhawan, New Delhi, for information and necessary action

(BIMAL KUMAR)
Deputy Secretary to Government of India


MINUTES OF THE MEETING WITH STAFF SIDE, NATIONAL COUNCIL (JCM) ON THE SUBMITTED AGENDA ITEMS, HELD ON 09.07.2020 UNDER THE CHAIRPERSONSHIP OF SECRETARY (HFW)

A meeting was convened under the chairpersonship of Secretary (HFW) with Staff Side, National Council (JCM) on 09.07.2020 at 11:30 am, in Committee Room No. 155-A, Nirman Bhawan, New Delhi, on the agenda items pertaining to COVID-19 and other related matters of Staff welfare in respect of Central Government Health Scheme (CGHS) and Central Services (Medical Attendance) [CS(MA)] Rules, 1944.

List of participants is enclosed at Annexure – ‘A’.

2. The Chairperson welcomed all the participants. Opening the discussions, Secretary (HFW) thanked all central government employees who have been working tirelessly during the ongoing COVID pandemic to keep moving the work of Government. She also outlined the steps taken by the Ministry of Health & Family Welfare (MoHFW) regarding treatment and care of both Non-COVID and COVID positive patients during the pandemic period. After a brief round of introduction, Joint Secretary (CGHS) briefed about the agenda items raised by Staff Side and these items were taken up one by one for discussion.

At the outset, Shri Shiva Gopal Mishra, Secretary, National Council expressed his gratitude towards Secretary (HEW) for holding this Meeting at a short notice as well as proactively taking decisions for the benefit of central government employees. He also brought out the problems being faced by government employees.

Thereafter, discussion on the agenda began and action taken thereon is as under:

Agenda No.IssueAction Taken
1FIXATION OF PACKAGE RATE FOR TREATMENT OF COVID-19 PATIENTS: In spite of the repeated instructions from your Ministry, the CGHS beneficiaries are facing lot of difficulties and problem in getting treatment of COVID-19 Virus infection. The Hospitals are charging between Rs. 1 Lakh to 2 Lakh for PPEs Kits alone. All put together the CGHS empanelled hospitals are charging more the Rs. 3 lakhs from each patient. Since there is no package rate prescribed by the Ministry of Health and Family Welfare for the COVID-19 infection treatment, the Hospitals are abnormally charging from the CGHS beneficiaries. Such incidences have been brought to our notice from the Central Govt. Employees working in Chennai and Hyderabad. To avoid such type of abnormal charges being levied by the CGHS Empanelled Hospitals, it is essential that the Ministry of Health may finalize a package rate of the treatment of COVID-19 infection. Considering the urgency in the matter a favorable decision may be taken at the earliest.The proposal regarding fixation of rates for COVID-19 treatment at private hospitals empanelled under CGHS is already under process. Secretary (HFW) directed that order may be issued immediately.
ii.REIMBURSEMENT OF COVID -19 TEST CHARGES LEVIED BY CGHS EMPANELLED HOSPITALS. This is to inform you that in spite of your instructions to all the Chief Secretaries of the State Governments, even now some of the Private hospitals, especially CGHS empanelled private hospitals are refusing to give medical treatment to the Central Govt, employees. The CGHS empanelled Hospital whichever is at present giving treatment for other diseases is insisting that before admitting the patient for treatment, the patient have to undergo COVID-19 tests and for that purpose the hospital are charging almost Rs.10,000, which include the testing charges and the PPE charges both for the patients and for the care taker. At present, there is no provision for reimbursement of this COVID-19 test charges either under the CS (MA) Rules or under CGHS Rules.In view of the above it is requested that Ministry of Health may issue necessary instructions for reimbursing the COVID-19 testing charges being levied by the CGHS empanelled Private hospitals.In case of CGHS beneficiaries, orders regarding CGHS rates applicable for COVID -19 test is already notified vide OM Z.15025/18/ 2020/DIR/CGHS dated 10.06.2020 ( Annexure-I). Joint Secretary (CGHS) informed that similar order for COVID-19 test will be issued shortly for CS (MA) beneficiaries.
iiiREIMBURSEMENT OF OPD MEDICINES TO CS (MA) BENEFICIARIES IN VIEW OF COVID-19. The Ministry of Health and Family Welfare vide its OM Dated 27th March 2020 have issued instructions that Considering the guidelines for maintaining social distancing between individuals, the CGHS beneficiaries are permitted to purchase medicines based on the prescription already with them. However this benefit has not been extended to CS (MA) beneficiaries. Majority of the Defence Civilian Employees are governed under CS (MA) Rules. Therefore it is requested that the CS (MA) beneficiaries also may be permitted to procure medicine from the local Pharmacy and to reimburse the same with the existing prescription and for new cases by not insisting for AMA’s prescription. Medicines purchased based on the prescription from a Registered Medical Practitioner may be allowed to be reimbursed till the COVID-19 Pandemic is down.MoHFW vide OM No. S.11011/12/2020 – EHS dated 01.04.2020 (Annexure-II) has issued instructions that CS (MA) beneficiaries getting medicines for chronic diseases may purchase medicines from the local pharmacy till 30.04.2020, based on the prescription of Authorized Medical Attendant, already held by the beneficiaries. The medical claim for reimbursement shall be submitted by the beneficiary to the concerned Ministry / Department/ Organization for further processing. This special sanction was further extended by OMs dated 05.05.2020 and 03.06.2020 (Annexure-II) and this special sanction of local purchase is allowed upto 31.07.2020. 
ivREFUSAL OF TREATMENT / CASHLESS TREATMENT BY CGHS EMAPNELLED HSOPITAL Instances have come to our notice from different cities that after the declaration of Nationwide lockdown as a preventive measure against the spread of COVID-19 Virus some of the CGHS recognized the hospitals are refusing for giving treatment to the Central Govt. Employees including Defence Civilian employees. Some of the Hospitals are admitting the patients with the conditions that they will not be given cashless treatment and that they should deposit the treatment charges in advance, in case they want medical attention. You will appreciate when the whole country is in crisis and the medical community is struggling to save human beings from the COVID-19 Virus, we fail to understand how these corporate hospitals are refusing to treat the Govt. Employees and their families. Therefore it is requested that you may kindly intervene in the matter and necessary instructions may please be issued to all the CGHS empanelled hospitals to compulsorily give medical treatment to all the central government employees and pensioners by extending the Cashless treatment facilities.Joint Secretary (CGHS) stated that Advisory to CGHS empanelled hospitals is already in place and notified vide OM No. 15025/18/2020 /DIR/CGHS dated 09.06.2020 (Annexure-III). It was assured by the chair that advisory will be reiterated.
CGHS CASHLESS TREATMENT

In addition to above, some other issues were also taken up for discussion, which are summarized below:-

(a) Provision of immunity boosting drugs/ medicines

Staff Side requested the Ministry to make arrangement for the supply of immunity boosting drugs/ medicines to the beneficiaries.

JS(CGHS) informed the Staff side that there are number of AYUSH dispensaries under CGHS and the beneficiaries may avail the services of these dispensaries to obtain such immunity boosting Homeopathy / Ayurveda formulations.

(b) Extension of Health Insurance facility under COVID-19 to all central government employees.

Staff side requested that the insurance scheme under COVID-19 provided to Health Care workers by the Ministry of Health & Family Welfare be extended to all central government employees.

On this, the chairperson apprised the Staff side that this is beyond the purview/ mandate of this Ministry.

(c) Different food charges levied by Railways empanelled hospitals

Staff side members raised the issue of different food charges being levied by Railways empanelled hospitals.

On this, the chair assured Staff side members that this issue would be forwarded to Ministry of Railways for action as deemed fit.

The meeting concluded with a vote of thanks to the Chair and the Participants.

Source: NCJCM

Filed Under: CGHS Tagged With: cashless treatment, CGHS, CGHS Cashless Treatment, CGHS Clarification, COVID-19, COVID-19 CGHS CASHLESS TREATMENT, COVID-19 PATIENTS, Empanelment under CSMA Rules, FIXATION OF PACKAGE RATE, JCM, National Council Meeting, NCJCM, Reimbursement

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