CGHS Bhawan, New Delhi-66
Dated: 4th August, 2023

OFFICE MEMORANDUM

Subject: Empanelment of private hospitals under CGHS Delhi & NCR.

With regard to this Directorate’s Office Memorandum dated 13.09.2022 regarding empanelment under continuous empanelment scheme 2022, 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 as per the list attached (Six HCOs – Annexure-A) have also been empanelled under CGHS in Delhi & NCR with issuance of this order. The newly empanelled hospitals may be treated as included in the existing list of empaneltled health care organization under CGHS on same terms and conditions as have been indicated in the Office Memorandum dated 26.12.2017. The empanelment shall be till 30.09.2024 as with other empanelled HCOs or till finalization of new empanelment whichever is earlier. HCOs would claim NABH/NABL rates only for those investigations which are NABH/NABL accredited.

Encl: As above

[Dr. Manoj Jain]
Additional Director (HQ)

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02 JUL 2019

Government has received some complaints in this regard. As and when such complaints are received, Show Cause Notice is issued to erring hospital and in case of unsatisfactory explanation from the hospital, suitable action is taken as per terms of empanelment, which includes penalty of 15% of Performance Bank Guarantee or even suspension of empanelment. Vide circular No. Z 15025/ 46/2019/ DIR/ CGHS dated 25th June 2019, Nodal Officers appointed by CGHS require to carry out surprise/random check of empanelled hospitals and diagnostic centres to ensure their compliance with the terms and conditions of empanelment and to examine the complaints against the hospitals and diagnostic centres.

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

PIB

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List of Private Hospitals in India (Recognised under CS(MA) Rules, 1944) Central Government Employees and Pensioners belonging to Non-CGHS places are covered by Central Services Medical Attendance Rules 1944 as far as reimbursement of medical expenses Out-Patient and In-Patient treatment are concerned.

Ministry of Health and Family Welfare has approved following private hospitals under CS(MA) Rules, for reimbursing package rates when Central Government Employees and Pensioners taking medical treatment in these hospitals…

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In a good news for lakhs of beneficiaries under the Central Government Health Scheme (CGHS), the Government is in the process of revising the rates of medical procedures offered by empanelled hospitals and diagnostic centres and giving them early payment assurance to encourage more medical institutions join the scheme.

The Ministry of Health and Family Welfare has floated e-tenders for empanelment of hospitals and decided that the rates of various medical procedures would be fixed by an average of rates quoted in e-tenders instead of the old system where the lowest quotation became the rate.

Rates of all medical procedure centres under CGHS would be revised by April next year.

Not just that, the Government is also revising its policy by providing empanelled hospitals assured upfront payment of 70 per cent of the total bill within five days of its presentation and balance admissible amount within a maximum period of 30 days.

The direction for a 10 per cent deduction in case of early/cash payment to hospitals under CGHS has also been done away with, highly-placed sources in the Ministry told PTI.

“These measures will put an end to the problems of delayed payments which discourage hospitals from getting empanelled under the scheme,” a Health Ministry official said.

Under the new policy finalised by the Ministry, the category of super specialty hospitals empanelled under the CGHS has also been done away with.

“Now, hospitals, exclusive eye hospitals/centres, exclusive dental clinics and diagnostic centres shall be empanelled for all facilities available in the health care organisation as approved by National Accreditation Board for Hospitals/National Accreditation Board for Labs and the Quality Council of India and shall not be empanelled for selected specialities/facilities,” the new policy says.

The changes will help rope in more hospitals, clinics and diagnostic centres under the CGHS as many renowned and big hospitals were shying away from being empanelled under the scheme due to pending payments and low rates for medical procedures.

Sources said payments of bills amounting to around Rs 100 crore of private hospitals are pending with the government under CGHS alone, even though hospitals are crying hoarse that pending payments are to the tune of over Rs 400 crore.

Officials, however, say this huge amount is not pending under CGHS and it may include payments under ECHS, ESI and health bills of other big departments like Delhi Police and others.

Source : www.business-standard.com
[http://www.business-standard.com/article/pti-stories/govt-to-revise-rates-for-cghs-empanelled-hospitals-113122900482_1.html]

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GOVERNMENT OF INDIA
Office of the Additional Director CGHS
2nd Floor S.R.House, Ashram Road, Ahmedabad-380009

CGHS/AHMD/PVT.HOS/EMPANELMENT/860

16/07/2013

OFFICE MEMORANDUM

The undersigned is directed vide Directorate General of Central Govt. Health Services New Delhi Office Order No.S.11045/23/2013/CGHS D.II9HEC)/CGHS(p)/(pt) dtd. 15-7-2013 to Invite reference to Ministry of Health & Family Welfare Office Memorandum no.S.11011/23/2009-CGHS D.II/Hospital Cell (Part.IX) dated 14/2/2013 vide which continuous empanelment scheme was initiated for empanelement of private hospitals/diagnostic centers under CGHS.

In response to the O.M. dtd. 14/2/2013 the following hospitals/diagnostic centres have applied for emapanelment under CGHS, Ahmedabad :-

1. Apollo Hospitals International

2. Shalby Hospitals

3. Nidhi Hopspitals

4. Parekhs Hospitals

5. Diva Eye Institute

6. Vasan Eye Care hospital

7. Supratech Micropath Laboratory & Research Centre Ahmedabad

On recommendation of the committee, constituted for verification of application, the above hospitals/diagnostic centers who are signed MOU and submitted Performance Bank Guarantee are empanelled as per Annexure under CGHS, Ahmedabad. The HosptiaIs/Diagnostic centers will treat CGHS beneficiaries and charge at the revised rates per MOU from the date of issue of this office memorandum.

sd/-
(Dr.M.L.Verma)
Additional Director
CGHS : AHMEDABAD

Source: www.msotransparent.nic.in
[http://msotransparent.nic.in/writereaddata/cghsdata/mainlinkfile/File614.pdf]

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Government of India
Office of the Additional Director, Central Government Health Scheme,
Kendriya Sadan Parisar, Block-B, Ground Floor, Sector-10, Vidhyadhar Nagar, Jaipur.

No: CGHS/JPR/RPH&DC/2013/(Admn.)/6520-6641

Dated: 31.07.2013.

OFFICE MEMORANDUM

In pursuance of Office Memorandum No. S.11011/23/2009 CGHS D.II / Hospital Cell (Part IX)
dated 14.02.2013 it is informed that the following Hospitals the speciality added / change of category by the empanelled allowed to them with immediate effect :-

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While answering a question in Lok Sabha, the Minister of Health and Family Welfare Shri.Ghulam Nabi Azad said that some private hospitals in Delhi NCR are no longer on the list of CGHS empanelled private hospitals.

The details are as under:

1. The following hospitals have opted not to renew their empanelment with CGHS after completion of two years of empanelment. Accordingly they have been removed from CGHS panel w.e.f. 13.02.2013:

(i) Escort’s Heart Institute & Research Centre, New Delhi

(ii) Max Super Specialty Hospital , New Delhi

2. Empanelment of following two hospitals have been suspended:

(i) Max Devki Devi Heart & Vascular Institute, New Delhi (w.e.f. 13.02.2013) as the hospital stopped credit facility to eligible CGHS beneficiaries;

(ii) Bapu Nature Cure Hospital, New Delhi (w.e.f.12.09.2013) on account of deficiency in services.

In addition, the following hospitals in Delhi NCR have been removed w.e.f. 18.12.2012 from the CGHS panel for non-compliance of the terms and conditions of their empanelment with CGHS.

(i) Garg Multispecialty Dental & Research Centre, Ghaziabad

(ii) Jain Hospital, Jagriti enclave, New Delhi

(iii) Kalra Hospital, New Delhi

(iv) Orthonova Hospital, New Delhi

GHS beneficiaries already admitted and undergoing inpatient treatment with prior permission at the time of removal are permitted to complete their treatment at those hospitals.

There is no provision for allowing regular treatment from any private non empanelled hospitals under normal circumstances.

Government has revived continuous empanelment scheme on 14.2.2013 for empanelment of more number of eligible hospitals under CGHS.

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S-11045/40 /2012/CGHS/HEC/CGHS (P)
Government of India
Ministry of Health & Family Welfare
Department of Health & Family Welfare

Nirman Bhawan, New Delhi
Dated the 22nd February, 2013

OFFICE MEMORANDUM

Subject : Regarding tests investigations at private hospitals / diagnostic laboratories / imaging centres empanelled under CGHS.

The undersigned is directed to refer to the Office Memorandum of even no. dated 1st January, 2013 on the above subject wherein it has been provided under Para 3 that the serving government employees / CGHS beneficiaries shall submit medical prescription in original while claiming reimbursement of expenses incurred on diagnostic tests and investigations, from their office. Keeping in view the inconvenience and difficulties faced by the serving employees / CGHS beneficiaries in submission of prescription in original, it has been decided to relax the above condition and to allow a self attested photocopy of the medical prescription to claim reimbursement of medical expenses incurred on getting diagnostic tests / investigations carried out from a CGHS empanelled hospital / diagnostic laboratory / imaging centre on a valid prescription issued by a CGHS Medical Officer / Govt. Specialist, without a permission letter issued from the Department concerned.

2.The Serving beneficiaries will not require any permission from their Department for getting the diagnostic tests / investigations carried out in a CGHS empanelled private hospital /diagnostic laboratory / imaging centre in respect of investigations for which CGHS rates are available. They will get the prescribed tests done on payment basis and claim reimbursement from their Office. However, the serving employees of Ministry of Health and Family Welfare are eligible for credit facility from the CGHS empanelled private hospitals / diagnostic laboratories and imaging centres in terms of this Ministry’s OM No. Rec.1- 008/Gr./CGHS/Delhi/CGHS (P) dated 10.06.2008.

3.The medical prescription issued by a CGHS Medical Officer / Government Specialist prescribing diagnostic tests / investigations shall be treated as valid for a single use within a period of two weeks from the date of prescription. However the medical prescription shall remain valid beyond two weeks for undertaking diagnostic tests / investigations if specifically prescribed by the CGHS doctor / Government Specialist about the date or period by which the prescribed tests are to be conducted for a routine check up or follow up treatment. The medical prescription would require revalidation or issue of a fresh prescription from the prescribing CGHS doctor/Government Specialist for getting the prescribed tests done after expiry of the validity period of two weeks or as prescribed by the CGHS doctor / Govt Specialist, as the case may be.

sd/-
[V.P..Singh]
Deputy Secretary to the Government of India

Source : www.msotransparent.nic.in/cghsnew/index.asp
[http://msotransparent.nic.in/writereaddata/cghsdata/mainlinkfile/File578.pdf]

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EMPANELLED HOSPITALS UNDER CGHS

Whether the Government proposes to substantially increase the number of empanelled hospitals under the Central Government Health Scheme (CGHS) to ensure effective coverage of the scheme..?

The below information was given by the Minister of Health and Family Welfare Shri.Ghulam Nabi Azad in a written reply in Lok Sabha…

Government empanels private hospitals under CGHS periodically and last such empanelment under e-tender and continuous empanelment scheme was completed in 2011. 486 Private hospitals and 134 Diagnostic centres are empanelled under CGHS as on date.

Government appointed UTI-ITSL as Bill Clearing Agency for speedy settlement of the bills of empanelled private hospitals and diagnostic centres. Under this arrangement, hospitals and diagnostic centres are required to submit their bills electronically to UTI – ITSL after discharge of the patient, followed by submission of the bills in physical format. UTI– ITSL makes payments to the hospitals and diagnostic centres as per the approved CGHS package rates within ten days of receipt of the physical bills. To enable UTI – ITSL to make payments to hospital, an advance of Rs.70 crore has been placed at the disposal of UTI-ITSL as a Rolling Fund by CGHS. After UTI-ITSL makes payments to the hospitals, the bills are submitted to CGHS periodically for scrutiny and final settlement. The final settlement amount is then recouped to UTI-ITSL.

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