CONFEDERATION OF CENTRAL GOVT. EMPLOYEES & WORKERS
1st Floor, North Avenue PO Building, New Delhi – 110001

Ref: Confd./ CGHS/2022

Dated – 27.01.2022

To
Shri Alok Saxena
Director General
C.G.H.S.
Ministry of Health & Family Welfare
Government of India, New Delhi

Sub: Revision of rates of C.G.H.S. for empanelled Hospitals.

Sir,

We are receiving so many representations that so many C.G.H.S. empanelled hospitals in various metro cities are denying to provide treatment to C. G. H. S. beneficiaries on the existing rates which have not been revised since 2014. More and more hospitals are withdrawing from the panel of CGHS.

It has caused more sufferings to the Central Govt. Employees and pensioners as they are deprived from the treatment.

It is therefore requested to kindly cause necessary action to revise the rates so that the existing empanelled hospitals should not withdraw and efforts should be made to bring some more hospitals in the panel of CGHS.

An early action is highly solicited.

With regards,
Yours sincerely,
(R. N. Parashar)
Secretary General

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S-11011/09/2019/ Addl.DDG(HQ)/CGHS
Government of India
Ministry of Health & Family Welfare
Directorate General of CGHS

Nirman Bhawan, New Delhi
Dated the 11th February , 2021.

OFFICE MEMORANDUM

Sub: CGHS Rates for 21 Treatment procedures/ Investigations in continuation of 2014 CGHS rates.

With reference to the above-mentioned subject, the undersigned is directed to draw attention to the Office Memoranda No S- 11011/09/2019/ Addl.DDG(HQ)/ CGHS dated 14.01.2020 and 03.06.2020 vide which CGHS rates have been notified by the Government for 15 and 25 investigations and procedures respectively for treatment at CGHS empanelled Health Care Organizations (HCOs) and to state that it is now decided to notify CGHS package rates for another 21 investigations/ treatment procedures as per the details given under and shall be treated as part of CGHS package Rates 2014.

2. The rates for investigations from S.No 1 to S.No 21 are for NABL/ NABH Accredited The rates for non-NABL/ non-NABH Accredited HCOs shall be 15% less.

CGHS Package Rates for 15 Investigations under CGHS

3. The rates shall come into force from the date of issue of O.M.

5. This issues with the concurrence of Integrated Finance Division, MoHFW vide CD No 2643 dt 08.02.2021.

sd/-
(Dr. G.D. Palia)
Addl. DDG(HQ), CGHS

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Tele 25683476
Mil 36833

Central Organisation ECHS
Adjutant General’s Branch
Integrated Headquarters
Ministry of Defence (Army)
Thimayya Marg, Near Gopinath
Circle. Delhi Cantt-110010

B/49770/AG/ECHS/ Treatment

11 Nov 2020

IHQ of MoD (Navy)/Dir ECHS (N)
DAV Subroto Park
All HQ Command (Med)
All HQ Command (ECHS)
AMA ECHS Embassy of India. Nepal
All Regional Centres

RATES FOR TREATMENT AT PRIVATE HEALTH CARE ORGANIZATIONS (HCOs) EMPANELLED UNDER ECHS-IN VIEW OF THE COVID-19 PANDEMIC

1. Refer to this HO letter No B/49773/AG/ECHS/Rates/Policy dated 29 Jul 2020.

2. It was promulgated vide above letter that rates for treatment for Coved-19 in private empanelled hospital in respect of ECHS beneficiaries in a city shall be as per the package rates prescribed by the concerned state government. In case no such rates have been prescribed by the state government in any ECHS city, the rates prescribed by government of NCT Delhi shall be applicable till rates are notified by the concerned state government.

3.The rates for NCT Delhi have been promulgated vide Govt of NCT Delhi order No 52/DGHS/ PH-IV/COVID-19/ 2020/prsecyhfw/ 14450-14649 dt 20 Jun 2020. The prescribed maximum per day package rates for covid related treatment in private hospitals in NCT of Delhi are as below

4 .As laid down the above rates are inclusive of PPE rates indicated. The rates of PPE will be applicable in all caws/ states where PPE cost are not specified by respective State Govts.

5.ECHS empanelled Health Care Organizations (HCOs) shall perform the treatment/ test on cashless basis in respect of ECHS beneficiaries and submit the bills to ECHS through UTIITLS. The reimbursement for the cost of expenditure on the test at approved rates shall be reimbursed.

6.These order comes into effect from 29 Jul 2020. the date of issue of this letter at para No 1 above

(Panchal Kalpeshkumar S)
Lt Col Jt Dir (Med) for Dir (Med)

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F No. 6-S2/CGHS/ GR.CELL/2020/ DIR/CGHS
Government of India
Ministry of Health & Family Welfare
Directorate General of CGHS

Nirman Bhawan, New Delhi
Dated the 10th July , 2020.

OFFICE MEMORANDUM

Sub: CGHS rates for treatment at private healthcare organizations empanelled under CGHS -in view of the COVID-19 Pandemic.

With reference to the above mentioned subject the undersigned is directed to state that In view of the current Corona Virus Disease (COVID-19) Pandemic this Ministry is in receipt of representations seeking clarifications and guidelines regarding rates applicable for treatment in private healthcare organizations empanelled under CGHS, This matter has been reviewed by the Ministry and it is now decided to issue guidelines and rates for treatment / investigations at Private healthcare organizations empanelled under CGHS as per the details given under:

2. a) CGHS rates for treatment for COVID-19 in Private empanelled hospitals in respect of CGHS beneficiaries in a City shall be as per the package rates prescribed by the concerned State Government. In case no such rates have been prescribed by the State Government in any CGHS City, the rates Prescribed by Govt. of NCT Delhi shall be applicable, till rates are notified by the concerned State Government.

• For non COVID related treatment in private hospitals empanelled under CGHS the Normal CGHS package rates shall be admissible. CGHS beneficiary shall undergo COViO-19 test as per the approved rate before elective treatment procedure.
• For treatment, under emergency – the patient shall be treated in Isolation ward till the COVID-19 test results is not available and rates as per isolation ward rates for one day shall be applicable.
• If the beneficiary is COVID-19 negative, he/ she shall be shifted to normal wards and normal CGHS rates will be applicable and if COVID-19 positive, he/she shall be under treatment in COVID ward and Prescribed rates shall be applicable.
• COVID test shall be permitted as per ICMR guidelines, and CGHS rate shall be as per the rates fixed by concerned State Government or actual, whichever may be less. If State Government has not notified such rates in any CGHS City, the rates prescribed by ICMR are applicable till rates are notified by State Government.

3. It is once again reiterated that all CGHS empanelled hospitals , which are notified as COVID-Hospitals by State Governments shall provide treatment facilities to CGHS beneficiaries as per the CGHS norms and as per the rates prescribed above, for all COVID related treatments.

Also check: Reimbursement of one pulse oximeter per family allowed under ECHS to fight COVID-19

Similarly, it is again reiterated that all the CGHS empanelled hospitals, which are not notified as COVID Hospitals shall not deny treatment facilities / admission to CGHS beneficiaries and shall charge as per CGHS norms, for all other treatments.

Suitable action shall be taken in case of violation of the guidelines.

CGHS empanelled healthcare organizations shall perform the treatment / test on Cashless basis in respect of pensioners, etc, and submit the bills to CGHS through UTI-ITSL. The reimbursement for the cost of expenditure on the test at approved rate shall be reimbursed by concerned Ministry / Department / Organization in respect of serving employees and beneficiaries of Autonomous Bodies,

4, These orders come into effect from the date of issue till further orders.

5. This issues with the concurrence of Integrated Finance Division, MoHFW vide CD No 805 dt 10.07.2020.

Also check: Revision of CGHS Rate for rt PCR Test for COVID-19

(Dr. Sanjay Jain)
Director, CGHS

Source: CGHS

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Tele 25684645
Telefax : 011-25684946
Email :jditechs1@echs.gov.in

Central Organisation ECHS
Adjutant General’s Branch
Integrated Headquarters of
MoD (Army), Thimayya Marg,
Near Gopinath Circle,
Delhi Cantt- 110 010

B/49711-NSC/AG/ECHS/Gen Corr

22 Jun 2020

IHQ of MoD (Air Force)
IHQ of MoD (Navy)
HQ West Comd (A/ECHS)
HQ South Comd (A/ECHS)
HQ East Comd (A/ECHS)
HQ Central comd (A/ECHS)
Northern Comd (A/ECHS)
South West Comd (A/ECHS)
All Area Headquarters
All Regional Centres

EXTENSION OF VALIDITY OF TEMPORARY SLIP UPTO 31 DEC 2020

1. Please refer to Central Organisation ECHS letter No. B/49711-
New Smart Card/ AG/ECHS dated 30 Aug 2019.

Also check: CGHS – NOTIFICATION OF CGHS RATES FOR 25 INVESTIGATIONS APPLICABLE IN ECHS HCOs

2. All Ex-Servicemen/ Primary beneficiaries who apply online for new 64 Kb ECHS Cards have been permitted to download online temporary slip as per category given at Para 2 of CO, ECHS letter No B/49711-New Smart Card /AG/ ECHS dated 19 Dec 2018 (copy attached).

3. Due to backlog in printing of Cards and disruption in distribution of 64 Kb ECHS Cards due to COVID-19, the Competent Authority has approved the extension of the validity of online temporary slip till 31 Dec 2020. All the temporary slips endorsed as “valid upto 30 Jun 2020” will need no further validation from OIC Polyclinic and will be deemed as valid till 31 Dec 2020. All Polyclinics and empanelled hospitals may be informed accordingly to accept the same.

4. It may also be noted that all temporary slips will be collected back at the time of issue of 64 Kb Cards by issuing tin HQ.

(JP Chahal)
Col
Dir (Stats & Automation)
for MD ECHS

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Central Organisation, ECHS
Adjutant General’s Branch
Integrated Headquarters
Ministry of Defence (Army)
Thimayya Marg, Near Gopinath
Circle, Delhi Cantt-110010

B/49773/AG/ECHS/Rates/Policy

10 Jun 2020

IHQ of MoD (Navy)/Dir ECHS (N)
DAV Subroto Park
All HQ Command (A/ECHS)
AMA ECHS, Embassy of India, Nepal
All Regional Centres

NOTIFICATION OF CGHS RATES FOR 25 INVESTIGATIONS APPLICABLE IN ECHS HCOs

1. Govt of India, Min of Health & Family Welfare vide their OM No S-11011/09/2019/ Addl. DDG(HQ)/ CGHS dated 03 Jun 2020 has notified CGHS package rates for the following investigations and their inclusion in CGHS rates list (copy attached) :-

Also check: Refund of the expense of ‘Pulse Oximeter’ for the COVID-19 family Positive CGHS Beneficiary under Home Treatment

2. The rates for investigations from S No 1(a) to 1(z) are for NABL/ NABH accredited “COs. The rates for Non-NABL/ Non-NABH accredited HCOs shall be 15% less.

3. The revised rates mentioned in above be disseminated to the ECHS Polyclinics, Empanelled HCOs and to the SEMOs.

4. The rates would be applicable from the date of issue of this letter.

(Anupam N Adhaulia)
Col
Dir (Med)

Source: ECHS

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CGHS

S-1101110912019/ Addg.HQ/ CGHS
Government of India
Ministry of Health and Family Welfare
Department of Health & Family Welfare
Directorate General of CGHS

Nirman Bhawan, New Delhi
Dated the 14th January,2020

OFFICE MEMORANDUM

Subject: Notification of CGHS Rates for 15 Investigations under CGHS

With reference to the above mentioned subject the undersigned is directed to draw attention to the Office memorandum No S.11045/ 36/2012-CGHS (HEC) dated 01.10.2014 vide which CGHS package rates for various treatment procedures and investigations were notified by the Government for Health Care Organizations (HCOs) empanelled under CGHS and to state that representations from various stake holders regarding non-availability of CGHS rates for some of the investigations have been received in this Ministry. The matter was reviewed and it is now decided to notify CGHS package rates for the following investigations and their inclusion in CGHS rate list as under:

The rates for investigations from S.No.1 to S.No.13 are for Non-NABL/ Non-NABH accredited HCOs. The rates for NABL/ NABH accredited HCOs shall be 15% more. The rates from S.No.14 &15 shall be common for both NABH-accredited /Non-NABH accredited HCOs.

Also check: CGHS medical facilities reimbursement to Central Government pensioners

These rates shall come in to force from the date of issue of the letter.

This issues with concurrence of Integrated Finance Division of Ministry of Health & Family Welfare vide CD No 3495 dated:13.01.2020.

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

Read this: CGHS – Medical benefits to dependent parents of Central Government Employees

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Ministry of Defence

Measures to Improve ECHS

18 NOV 2019

An additional allotment of Rs.3,500/- crores have been sought to overcome the problem.

Following steps have been taken to check and curb the misuse of funds in ECHS and inflated bill being raised by empanelled hospitals:

Also check: VERIFICATION OF ONLINE APPLICATION FOR ECHS CARDS BY RECORD OFFICE

•     Strict monitoring of bills is done and they are restricted to CGHS rates. Disciplinary action is taken against defaulting hospitals which includes suspension of referrals/financial penalties/disempanelment.
•     A detailed SOP for taking action against empanelled hospitals has been issued on 10.10.2019 by Department of Ex Servicemen Welfare, Ministry of Defence.

This information was given by Raksha Rajya Mantri Shri Shripad Naik in a written reply to ShriRajeev Chandrasekharin Rajya Sabha today.

PIB

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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: Consultation from Specialists at CGHS empanelled hospitals in respect of CGHS beneficiaries aged 75 years and above -regarding

With reference to the above mentioned subject the undersigned is directed to state that the matter related to relaxation of consultation norms in respect of elderly CGHS beneficiaries was under consideration of this Ministry and it has now been decided that hereinafter, CGHS beneficiaries aged 75 years and above shall be permitted to seek direct OPD Consultation from Specialists of private hospitals empanelled under CGHS without referral from CGHS Wellness Centre.

2. If any investigations / procedures are advised and are required in emergency, no other authorization is required and the same may be undertaken. However, in non-emergency conditions approval of competent authority is required if any non-listed investigations | procedures are advised. Medicines prescribed are to be procured from CGHS Wellness Centre.

3. Private hospitals empanelled under CGHS shall provide such facilities on cashless basis at CGHS rates to pensioners, ex-MPs , Members of Parliament and such other Categories of CGHS beneficiaries , who are eligible for treatment /investigations on credit basis. More than 75 year old dependents of serving CGHS beneficiaries, who are otherwise not eligible for Cashless treatment shall claim the reimbursement from concerned Ministry /Department. Beneficiaries of Autonomous Bodies /Statutory Bodies covered under CGHS shall claim reimbursement from the respective organization.

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

Sd/-
Dr.Manoj 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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