No.S.11011/29/ 2019-EHS
Government of India
Ministry Of Health & Family Welfare
Department of Health & Family Welfare

Nirman Bhawan, New Delhi – 110 108
Dated: the 13th September,2019

OFFICE MEMORANDUM

Subject: Emergency treatment in CGHS empanelled Hospitals

The extant instructions under CGHS provide that under emergency conditions, a CGHS beneficiary can get admission in any CGHS empanelled Hospital without any prior permission. It has, however, been brought to the notice that the Hospitals deny admission or insist on referral memo from CGHS Wellness Centre even in emergency conditions.

2. In accordance with the Memorandum of Agreement between the CGHS empanelled Hospital and the Government of India, refusal to provide treatment to bonafied CGHS beneficiaries in emergency cases and other eligible categories of beneficiaries on credit basis, without valid ground, would attract disqualification for continuation of empanelment.

Also check:  CGHS medical facilities reimbursement to Central Government pensioners

3. It is, therefore reiterated that in emergency the empanelled hospitals will not refuse admission or demand an advance payment from the CGHS beneficiary or his family member and will provide credit facilities to the patient.

(Rajeev Attri)
Under Secretary to the Govt. of India
(Tel.011 – 2306 1883)

Source – CGHS

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Kendriya Vidyalaya Sangathan
18, Institutional Area, Shaheed Jeet Singh Marg, New Delhi-16.

F.No.110239/51/Cir./2013/KVS(Budget)

Dated 03.04.2013

The Deputy Commissioner
Kendriya Vidyalaya Sangathan
All Regional Offices.

Subject : Govt. employees and the members of their family take treatment from any hospital recognized by the State Government / CGHS / CS (MA) Rules – regarding.

Sir,
I am to refer to the subject cited above and to state that references have been received by this office as to whether Govt./KVS employees covered under CS(MA)Rules can avail treatment from Hospitals recognized under CGHS Scheme. In this connection, it is informed that the orders issued by the Govt. of India Ministry of Health and family welfare vide OM No. S.14025/7/2000-MS, dt 28th March, 2000 and No.S.14021/06/2005-MS dt. 4th January, 2007 were already circulated to all the Units of the Sangathan for reference and further action vide KVS letter No.161-3/99-2000/KVS/Budget dt.26.7.2000 and Letter No.125-21/2006-07/KVS (Budget) dt. 22.5.2007 (copy enclosed). However the said orders are once again circulated to all the Units of the Sangathan for reference and further action.

Yours faithfully,
sd/-
(S.Muthusivam)
Asstt. Commissioner (Fin.)

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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 15th January, 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 and to further lay down the procedure for getting the diagnostic tests / investigations carried out at the CGHS empanelled private hospitals / diagnostic laboratories / imaging centres on a valid prescription issued by a CGHS Medical Officer / Government Specialist, without a referral / permission letter from the Department concerned or CMO-in-charge of CGHS Weliness Centre, as the case may be.

2. The CGHS empanelled private hospitals / diagnostic laboratories / imaging centres shall perform the investigations /diagnostic tests as prescribed by the CGHS Medical Officer /Government Specialist on cashless basis to the CGHS pensioner beneficiaries, ex-MPs, freedom fighters and other eligible categories of CGHS beneficiaries, who are presently eligible for credit facility, at CGHS approved rates, only in respect of the tests / investigations for which CGHS rates are available.

3. 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.

4. For providing cashless facilities to the eligible CGHS beneficiaries, the empanelled private hospital / diagnostic laboratory / imaging centre shall obtain the prescription either in original or self-attested copy of the prescription and self attested photocopies of the CGHS card of the patient and the CGHS card of the main CGHS card holder beneficiary and enclose the same with their bills for claiming payment from CGHS or the Department concerned, as the case may be. The hospital / diagnostic laboratory / imaging centre shall
however, verify the self attested copies from the original prescription / CGHS cards, before allowing the credit facility to the eligible CGHS beneficiary.

5. 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 unless specifically provided otherwise by the Government Specialist in the prescription, about the date or period after which the prescribed tests are to be conducted for a 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, as indicated above.

6. The CGHS empanelled private hospitals / diagnostic laboratories / imaging centres shall provide cashless facilities to the serving CGHS beneficiaries entitled for credit facilities in terms of this Ministry’s OM No Rec.1-2008/ Gr./CGHS/Delhi/CGHS (P) dated 10.06.2008, on submission of a self attested photocopy of his / her identity card issued by the Department / Ministry, alongwith self attested photocopies of the CGHS card of the patient and the main cardholder. The hospital / diagnostic laboratory / imaging centre shall enclose the above documents with their bills to the Department concerned for claiming payment.

sd/-
(V.P.Singh)
Deputy Secretary to the Government of India

Source: www.msotransparent.nic.in
[http://msotransparent.nic.in/writereaddata/cghsdata/mainlinkfile/File561.pdf]

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