CGHS

Z 15025/12/2020 /DIR/CGHS
Government of India
Ministry of Health & Family Welfare
Directorate General of CGHS

Nirman Bhawan, New Delhi
Dated the 30th September, 2020.

OFFICE MEMORANDUM

Sub: Reimbursement of cost of OPD Medicines: Special Sanction in view of COVID-19- till 31st December 2020- regarding

In view of the Corona Virus Disease (COVID-19), all out efforts are made by the Government to contain its impact by instituting measures at community as well as at individual level.

2. In this regard the undersigned is directed to draw attention is the OM of even number dated 27.03.2020, 29.04.2020, 29.05.2020 and 24th August 2020 vide which an option has been provided to CGHS beneficiaries getting medicines for Chronic diseases, to purchase medicines based on the prescription held (prescribed by CGHS Medical Officers/ CGHS Specialists /other Govt. Specialists/ Specialist of empanelled hospital) till 30th September 2020, irrespective of Non-Availability certificate from CGHS or otherwise. However, several representations are received in the Ministry seeking extension of the period in view of the continued ‘Lock Down’.

Also read: CGHS medical facilities reimbursement to Central Government pensioners

3. The matter has been reviewed by the Ministry and it is now decided, in continuation of the earlier OM on the subject , that CGHS beneficiaries getting medicines for Chronic diseases shall be permitted to purchase medicines based on the prescription held (prescribed by CGHS Medical Officers/CGHS Specialists /other Govt. Specialists/ Specialist of empanelled hospital) till 31st December 2020 on the same conditions as per the earlier OM dated 27.03.2020. It is also clarified that the CGHS Wellness Centres are functional and CGHS beneficiaries also have the option to collect medicines through CGHS Wellness Centres as per normal practice, instead of purchasing from market.

4. Issued with the approval of Integrated Finance Division, MoHFW vide CD No 1558 dated 30.09.2020.

(Dr. Sanjay Jain )
Director, CGHS

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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:

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

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Issue of OPD Medicines for CGHS beneficiaries going abroad

No.1-40/2019-CGHS/C&P/DIR/CGHS
Government of India
Ministry of Health and Family Welfare
Department of Health & Family Welfare
Directorate General of CGHS

Nirman Bhawan, New Delhi 110 011
Dated the 19th August , 2019

OFFICE ORDER

Subject: – Issue of OPD Medicines for CGHS beneficiaries going abroad

With reference to the above subject the undersigned is directed to draw attention to Circular No 4-20/2003 – C&P Section dated the 28th April , 2005 vide which guidelines were issued for supply of OPD Medicines for upto ‘6’ months to CGHS beneficiaries , who are going to stay abroad and to state that the matter has been reviewed by this Ministry and it is now decided in modification of the earlier guidelines that hereinafter, Chief Medical Officer I/C of concerned CGHS Wellness Centre is empowered for issue of OPD medicines for upto six months to the CGHS beneficiaries visiting abroad, subject to submission of the following documents:

(a) Copy of valid CGHS Card.

(b) Valid prescription for six months.

(c) Documentary Proof of going abroad like ticket , visa etc.

(Dr. Atul Prakash)
Director, CGHS

Source: CGHS

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Post-operative Follow-up treatment from Hospitals empanelled under CGHS in respect of critically ill CGHS beneficiaries

Z.15025/35/2019/DIR/CGHS/ CGHS(P)
Government of India
Ministry of Health & Family Welfare
Department of Health & Family Welfare

Nirman Bhawan, New Delhi
Dated the 29th May , 2019.

OFFICE MEMORANDUM

Sub: Post-operative Follow-up treatment from Hospitals empanelled under CGHS in respect of critically ill CGHS beneficiaries-regarding

With reference to the above mentioned subject the undersigned is directed to state that in view of the difficulties being faced by critically ill CGHS beneficiaries in getting post-operative follow-up treatment at CGHS empanelled hospitals, the matter was reviewed and it has now been decided that critically ill CGHS beneficiaries shall be permitted for follow up treatment in CGHS empanelled hospitals as per the details given under:

i. Permission for post-operative follow-up treatment in respect of the following post – operative conditions requiring frequent Consultations from Specialists at private hospitals empanelled under CGHS, need not be re validated from time to time and follow-up treatment may be under taken at CGHS rates without time limit.

ii. The consultation /investigations are permitted under these follow-up cases. The conditions covered are:

a. Post Cardiac Surgery Cases including Coronary Angioplasty
b. Post Organ Transplant Cases (Liver, Kidney, Heart, etc.,)
c. Post Neuro Surgery Cases/Post Brain Stroke cases requiring regular follow-up treatment
d. End Stage Renal Disease/follow up cases of Liver Failure
e. Cancer treatment
f. Auto-immune disorders like Rheumatoid Arthritis requiring regular follow-up
g. Neurological disorders like Dementia, Alzheimer’s disease, Parkinsonism, etc.,

Medicines prescribed are to be procured from CGHS Wellness Centre.

iii. The beneficiaries shall have to submit a self-attested photo copy of the permission letter to the hospital to enable the hospitals to provide credit facility in respect of pensioners and other categories of CGHS beneficiaries entitled for credit facility. Serving employees (and their dependents) who may not be entitled for cashless facilities shall enclose a self-attested photo copy of permission letter to claim reimbursement from the concerned Ministry /Department. Permission in respect of Pensioner CGHS beneficiaries, Ex-MPs (and other categories of CGHS beneficiaries, whose medical expenditure is borne by CGHS) etc., shall be granted by CGHS. Permission in respect of Hon’ble Members of Parliament shall be granted by Rajya Sabha Secretariat/Lok Sabha Secretariat as the case may and by concerned Ministry /Department in respect of serving beneficiaries and by concerned Autonomous Body / Statutory Body in respect of serving /pensioner beneficiaries

iv. However, if any non-listed investigations / procedures are advised permission from competent Authority shall be required, except in emergency.

These orders are in supersession of the earlier guidelines on the subject.

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

Source: CGHS

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Clarification regarding Oxygen Charges for treatment at private hospitals under CGHS.

B-12014/01/2016/-JCM/EHS Section
Government of India
Ministry of Health & Family Welfare
Department of Health & Family Welfare

545-A Nirman Bhawan, New Delhi
Dated the 12th April , 2019.

OFFICE MEMORANDUM

Sub: Clarification regarding Oxygen Charges for treatment at private hospitals under CGHS

With reference to the above mentioned subject the undersigned is directed to clarify that the CGHS rate for ‘Oxygen’ for treatment in the Private Hospitals were revised w.e.f 01 .10.2014 and the rate is Rs. 58 per Hour in NABH (National Accreditation Board for Hospitals & Healthcare Providers) Accredited Hospitals and Rs 50 per Hour in non-NABH Accredited hospitals and is at Code No 512 in the CGHS Rate list , which is available on CGHS Website at cghs.gov.in

sd/-
[ Rajeev Attri ]
Under Secretary to Government of India

Source: CGHS

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No.S.11011/20/2014-CGHS (P)/EHSS
Government of India
Ministry of Health & Family Welfare
Department of Health & Family Welfare
EHS Section

Nirman Bhawan, New Delhi
Dated: the 23 November, 2016

OFFICE MEMORANDUM

Subject: Delegation of powers to Heads of Departments in various Ministries/Departments for settling permission cases and post facto approval relating to referral system and medical reimbursement under CGHS – Enhancement of ceiling rate from Rs. 2 Lakhs to Rs. 5 Lakhs without consultation of IFD of concerned Ministry – Reg.
The undersigned is directed to refer to this Ministry’s OM No. S.12020/4/97-CGHS (P), dated 27.12.2006 and its clarification issued vide this Ministry’s OM No. S.11011/20/2014-CGHS (P), dated 20.06.2014, wherein financial powers were delegated to the Heads of Departments/Ministries to settle all such cases where there is no relaxation of rules involved and admissibility of claim was worked out with reference to the CGHS approved rate list and guidelines.

2. This Ministry has been receiving requests from different Ministries/Departments for enhancement of delegation of financial powers to Head of Departments to settle medical claims/medical advance cases involving financial implications upto Rs. 5 Lakhs without referring the case to Internal Finance Division (IFD).

3. The matter regarding enhancement of delegation of financial powers to the Heads of Departments/Ministries has been examined in this Ministry and it has been decided with the approval of the competent authority to enhance the existing limit of Rs. 2 Lakhs to Rs. 5 Lakhs to settle all cases where there is no relaxation of rules and the entitlement was worked out with reference to the rate list prescribed.

In respect of cases involving payment exceeding Rs. 5,00,000/- (Rupees 5 Lakhs only) but as per the prescribed rate list, the concerned Departments/Ministries may settle such cases in consultation with their respective Internal Finance Division. Only in those cases where the settled scheme/rules are required to be relaxed, should the case be referred to the Ministry of Health and Family Welfare.

4. This issue with concurrence of Internal Finance Division vide FTS No. 91725, dated 01.11.2016.

(Sunil Kumar Gupta)
Under Secretary to the Govt. of India
(Tel 2306 1986)

Source: www.cghs.gov.in

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Government of India
Ministry of Health & Family Welfare
Department of Health & Family Welfare,
Nirman Bhawan, Maulana Azad Road,
New Delhi 110 001

No. S-11011/16/2012-CGHS(P)

Dated the 8th April 2015

Sub: Promotion of prescription of generic drugs by medical practitioners – reg

Reference is invited to MoHFW OJVI. No. H-11013/4/2010-DFQC dated 19th May 2011 followed by a Circular No. H-11013/7/2012-CGHS (P) dated 8th February 2013 and No.S-11011/16/2012-CGHS(P) dated 3rd May 2013 emphasizing the need of prescribing generic drugs. in this regard, it is reiterated that all Specialists/Doctors working in CGHS are hereby directed to ensure that generic drugs are prescribed to the maximum extent possible with a view to make medical treatment cost effective and affordable.

sd/-
(Bindu Tewari)
Director (CGHS-P)

Source: http://msotransparent.nic.in/writereaddata/cghsdata/mainlinkfile/File983.pdf

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No. 2-2/2014/CGHS(HQ)/PPTY/CGHS(P)
Government of India
Ministry of Health & Family Welfare
Department of Health & Family Welfare

Nirman Bhawan, New Delhi
Dated: the 13th March, 2015

OFFICE MEMORANDUM

Subject: Clarification regarding issue of Medicine under CGHS

With reference to the above mentioned subject the under signed is directed to state that the situation arising out of issue of office memorandum NO 2-2/2014/CGHS(HQ)/PPTY/CGHS(P) dated the 25th August, 2014 has been engaging the attention of government for quite some time. Although the guidelines were modified subsequently vide Office Memorandum of even number date 01.10.2014 and 23.12.2014, this Ministry is in receipt of representations seeking clarifications. The matter has been reviewed and it has now been decided to withdraw the OM of even no. dated 25.08.2014.

(Sunil Kumar)
Under Secretary to the Govt. of India

Source: http://msotransparent.nic.in/writereaddata/cghsdata/mainlinkfile/File953.pdf

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Subject: Revision of Income limit for dependency for the purpose of providing CGHS coverage to family members of the CGHS covered employees subsequent to implementation of recommendations of the VI CPC-Clarification regarding.

The undersigned is directed to refer to the above mentioned subject and to state as follow:

(MS Section),Nirman Bhavan,
New Delhi.

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F. No. S. 11011/20/2014-CGHS (HEC)
Directorate General of Central Govt. Health Scheme
Ministry of Health & Family Welfare

Nirman Bhavan, New Delhi
Dated, 16th July, 2014

CLARIFICATION

It has been brought to the notice of the undersigned that some of the CGHS empanelled Health Care Organizations have started charging new CGHS rates 2014 which have been placed on CGHS website for information and acceptance only. Since these rates have not yet been notified by Ministry of Health and Family Welfare, the empanelled HCOs cannot charge these new rates and CGHS 2010 rates would prevail. Charging these new rates 2014 from CGHS beneficiaries by empanelled health care organizations would amount to overcharging and suitable action including recovery of overcharged amount and forfeiture of performance bank guarantee would be initiated against those HCOs by CGHS.

Dr. (Mrs.) Sharda Verma
Director (CGHS)

Source: http://msotransparent.nic.in/writereaddata/cghsdata/mainlinkfile/File712.pdf

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