Credit to CGHS Beneficiaries in Empanelled Private Hospitals to Continue

Press Information Bureau

Government of India

Ministry of Health and Family Welfare

Press Note 

Credit to CGHS Beneficiaries in Empanelled Private Hospitals to Continue 

There have been reports in the Media that private hospitals on the panel of CGHS are denying credit facilities to the eligible CGHS beneficiaries for delay in settlement of hospitals bills. Lower package rates and inadmissible deductions etc. have also been reported to be the other reasons for withdrawal of agreed cashless /credit facilities. 

24 out of 407 Private hospitals empanelled under CGHS decided unilaterally to discontinue credit facility to the eligible categories of CGHS beneficiaries. Show Cause Notices stand issued to these Hospitals and the empanelment of five Hospitals has been suspended for a period of six months or till further orders, whichever is earlier. 

In this regard, the CGHS beneficiaries are advised not to be guided by misleading information as most of the private hospitals are continuing to extend the cashless facilities to the CGHS beneficiaries. The Ministry of Health and Family Welfare will ensure that the CGHS empanelled private hospitals continue to extend cashless /credit facilities to the eligible CGHS beneficiaries in compliance with the terms and conditions as laid down in the Memorandum of Agreement signed by them with CGHS. Ministry of Health and Family Welfare has already taken special steps for clearance of pending hospital bills on a priority basis and the pendency of bills is almost cleared. 

CGHS has already invited bids for revision of package rates through a transparent tender process, where the last date for submission of bids was 16th March, 2014. Steps are underway to conclude the tender process early. 

Private hospitals to stop CGHS cashless scheme from March 7

In a blow to government employees, including those who have retired, the Central Government Health Service has announced withdrawal of cashless medical service in private hospitals empanelled with the CGHS scheme from March 7. Patients will henceforth have to cough up hospital charges and later claim the amount from the government, according to the new rule.

The move will affect 50 lakh serving employees and over 30 lakh pensioners, as well as their family members. At a conservative estimate, the total number of persons affected could well be over two crore.

The move was necessary, said the Association of Healthcare Providers India (or AHPI, the nodal body of private empanelled hospitals) for a number of reasons, the main ones being CGHS owes these hospitals around Rs 200 crore in unpaid services as well as “unreasonably low” CGHS tariffs that haven’t been revised for the last four years. A doctor’s consultation fee, for example, remains Rs 58.

Also, AHPI says CGHS makes “illegal” deductions of 10% on all payments leading to losses for member hospitals. AHPI claims the amount runs up to Rs 180 crore.

In Karnataka, 20 hospitals, all in Bangalore, are empanelled with AHPI. HCG, Apollo hospitals, MS Ramaiah Memorial Hospital and Bangalore Baptist Hospital, among others, will not provide the cashless health scheme from March 7.

“When we were empanelled with the government, it was agreed upon that we will get 10% rebate on treatment charges if the government pays within seven days. But now, this deduction has been made applicable even when the amount is unpaid for years. That’s illegal. This has led to huge losses for member hospitals amounting to over Rs 180 crore over the past three years,” says Dr Alexander Thomas, CEO, Bangalore Baptist hospital, who represents AHPI in Bangalore.

Some hospitals have put up a public notice to this effect, reading, “CGHS tariffs are unreasonably low and not been revised for the last four years, threatening the very existence of the medical service providers.”

Dr Naresh Shetty of AHPI said, “The empanelled hospitals have been providing services under most difficult circumstances. They had to deal with steep hikes in electricity and water tariff, consumables, wages, taxes. We’ve been requesting a revision since June 2013 but there’s been no response.”

Official speak

The dues are just one issue. The bigger issue is that a doctor’s consultation charge of Rs 58 is appalling. The fees for several procedures are abysmally low. We don’t want to let down our beneficiaries but we have no choice. We ask the CGHS to consider the rates of the National Accreditation Board for Hospitals & Healthcare Providers. We’ve suggested that if at all CGHS were to take tender route, let CGHS decide the rates based on lowest bid received from NABH – accredited hospitals. Adopting rates like this would be logical and rational. Treating a patient can’t be made similar to selling onions and potatoes.

Source:http://timesofindia.indiatimes.com/india/Private-hospitals-to-stop-CGHS-cashless-scheme-from-March-7/articleshow/31438842.cms

Cashless Facility TO CGHS Beneficiaries

Central Government Health Scheme (CGHS) empanels private hospitals for providing inpatient medical treatment to its beneficiaries. They may avail the requisite treatment with prior permission for procedures advised by CGHS and other government specialists / CMO–in-charge. CGHS pensioner beneficiaries are entitled for cashless medical treatment in the CGHS empanelled private hospitals. The empanelled private hospitals under CGHS provide treatment to the pensioners on credit /cashless basis for the procedures for which they are empanelled.

However, in case of emergency conditions empanelled hospitals are expected to provide treatment to pensioners on credit basis, even for conditions for which they are not empanelled and they are expected to shift the patient to another empanelled hospital after stabilization as per the Memorandum of Agreement (MoA) signed with government.

In case of violation of the terms of the Memorandum of Agreement, suitable action, including depanelment can be initiated against errant hospitals.

This was stated by Shri Ghulam Nabi Azad, Union Minister for Health and Family Welfare in a written reply to the Lok Sabha today.

Source: PIB

Reimbursement of Medical Claims-Regarding

No. 21/26/2013-EC-X 

GOVERNMENT OF INDIA 

DIRECTORTE GENERAL OF WORKS 

CENTRAL PUBLIC WORKS DEPARTMENT

Nirman Bhawan, New Delhi 

Dated the 24th January, 2014

To 

1. All the CEs/SEs/SEs(Coord.)/EEs/DDG (Hort.)/DDOH.

Subject: Reimbursement of Medical Claims-Regarding

Sir, 

After repeated requests and making available of the required formalities for processing of reimbursement of medical claims, it has been observed that the medical reimbursement claims are still being received in this Directorate are forwarded/processed in a very casual manner resulting in delay in final settlement of claims of individuals and settling medical claims of different C.G.H.S. approved Hospitals.

To minimize the delay and to streamline the process of scrutinizing and submission of reimbursement of medical claims the stage wise steps required are appended below for action on the part of field units of this Directorate:-

1. The duly filled up Modified Check list for Reimbursement of Medical Claims and Medical Claims Form as per prescribed Performa.

2. The Copy of new CGHS card.

3. The Copy of Permission Letter from concerned office.

4. The Original Bills along with discharge/ Death summary from the Hospital.

5. Emergency Certificate in original from Hospital.

6. In case of death of CGHS Card Holder following documents as prescribed in modified checklist: 

i. Affidavit on stamp paper by claimant. 

ii. No objection from other Legal Heirs on stamp paper. 

iii. Copy of Death Certificate.

7. Whether any advance was granted in the medical Reimbursement Claim? If so, provide the details of the same and under which rules the facility was allowed to applicant.

8. Whether credit facility was granted for the treatment? If so provide the details of the same. Under which rule the credit facility was allowed to serving Govt. official?

9. Medical Reimbursement Claim has to be submitted in duplicate.

10. It has to be mentioned by the forwarding /concern office (Chief Engineer) as to whether the amount claimed for reimbursement is as per the CGHS prescribed rate or not and it has also need to be certified that there is no need of any relaxation of rules in the instant case.

11. Original pouch of Stent packets along with requisite documents prescribed by MOHFW from time to time needs to be enclosed in the MRC file in order.

12. The amount mentioned for stents and other consumables may please be checked as per ceiling rates fixed by MOHFW and the same may be indicated in the forwarding letter.

13. As per the observations of IFD and Works Division in the precedent cases the case requires to be submitted in line with the guidelines of precedent cases providing the details of amount charged by the hospital indicating the S.I. No. of the CGHS items with relevant instructions and thus arriving at the amount admissible.

The case may be submitted with the details of amount charged by the hospital indicating the S.I. No. of the CGHS items with relevant instructions and thus arriving at the amount admissible as per the below format:- 

(i) Name of the Hospital ……………………………… Period of treatment from ………..   to ………… 

(extracts of hospital recognition be placed in the file or instructions relating of treatment from non-empanelled hospital be placed in the file and it may be averred all stipulations have been complied with

S.No.

Particulars/Name Item/(SI. No. of the CGHS items list with extracts.

Amount Claimed

(Quantity X CGHS Rates)

Extracts of Relevant Instruction s of CGHS Placed at F/….

Amount Admissible as per CGHS rates

(ii) All relevant OMs pertaining to the case (item wise-reimbursement) may be placed in the file alongwith the Mb o Health & Family Welfare OM No. S-11011/23/2009/CGHS D-11 dated 17th August, 2010 and subsequent clarificatory OMs issued thereafter.

(iii) It may be indicated whether 10% discount has been availed and case may be put up as per prescribed format as mentioned above.

14. Clarification regarding admissible and non-admissible items under CGHS provided in Mb o Health & Family Welfare’s O.M. No.F.No.2-1/2012/CGHSNC/CGHS(P) dated 01st August, 2013 has to be complied with.

15. As per Ministry of Health and Family Welfare's Draft MOA F.No. D.12034/22/09/CGHS-Desk-I following has to be checked.

(i) DISCOUNT : Hospital shall also allow a discount of 10% on every cash payment.

(ii) CREDIT: On production of a valid permission by the CGHS beneficiary- the hospital shall provide credit facilities to the Members of Parliament, Pensioners, Ex-Members of Parliament, Freedom Fighters, Serving CGHS employees, serving employees of Ministry of Health & Family Welfare, serving employees of Directorate General of Health Services and such other categories of CGHS cardholders as notified by the Government. In case of emergency the hospital shall provide credit to all CGHS beneficiaries.

(iii) TREATMENT IN EMERGENCY: 

In emergency the hospital shall not refuse admission or demand an advance payment from the beneficiary or his family member and shall provide credit facilities to the patient whether the patient is a serving employee or a pensioner availing CGHS facilities, on production of a valid CGHS card and the hospital shall submit the bill for reimbursement to the concerned Deptt./Ministry/CGHS. The refusal to provide the treatment to bonafide CGHS beneficiaries in emergency cases without valid ground, would attract disqualification for continuation of empanelment.

The list of ailments which may be treated as emergency has been mentioned in the MOA for the Hospitals, which is illustrative only and not exhaustive, depending on the condition of the patient.

(iv) For serving employees (other than CGHS/ DGHS /Ministry of H&FW), the payment shall be made by the patient and he shall claim reimbursement from his office subject to the approved ceiling rates. The Private Hospital shall allow a discount of 10% on all payments made in cash.

(v) The treatment procedure shall be performed on the basis of the authorization letter issued by the Chief Medical Officer of the concerned CGHS dispensary in case of pensioners and by the administrative department / ministry in case of serving employees.

(vi) The Hospital agrees that during the In-patient treatment of the CGHS beneficiary, the Hospital shall not ask the beneficiary or his attendant to purchase separately the medicines / sundries / equipment or accessories from outside and shall provide the treatment within the package deal rate, fixed by the CGHS which includes the cost of all the items. Appropriate action, including removing from CGHS empanelment and / or termination of this Agreement, may be initiated on the basis of a complaint, medical audit or inspections carried out by CGHS teams / appointed TPA.

(vii) The hospital shall not refer the patient to other specialist / other hospital without prior permission of CGHS authorities. Prior intimation shall be given to CGHS whenever patient needs further referral.

(viii) Entitlement for various types of wards to CGHS beneficiaries has also been provided in the aforesaid MOA.

This issues with the approval of DDG (HQ)

Sd/- 

(Rahul Ranbir Singh) 

Deputy Director (Administration)

Source:http://cpwd.gov.in/WriteReadData/other_cir/9291.pdf

Extension of CGHS facility to State Govt Employees..?

While answering to a question in Parliament, Minister Shri.Ghulam Nabi Azad said that the Central Government Health Scheme is primarily meant for the Central Government employees and pensioners receiving salary / pension from Central Civil Estimates of Government of India. 

The State Government employees and other members of public are not eligible to join CGHS. However, no requests from State Governments including Kerala have been received for improvement in CGHS. 

CGHS is basically providing the dispensary services through its Wellness Centres manned by the General Duty Medical Officers. However, CGHS also provides the services of medical specialists through the Polyclinics and Central Government hospitals. In addition, the CGHS medical specialists also visit designated dispensaries on stipulated days in each week to provide medical consultation to the beneficiaries. Due to shortage of specialists in CGHS it is practically not feasible and financially viable to provide Specialist facilities in each CGHS Wellness Centre. Moreover, CGHS is also engaging contractual specialists against the vacant posts of specialists to provide the medical consultation services to its beneficiaries. 

CGHS has a dedicated wing of specialists at the Safdarjung Hospital, New Delhi for its beneficiaries. The CGHS beneficiaries are also allowed to consult specialists at Dr. RML Hospital and other Government hospitals in NCR in respective specialties. In addition, CGHS has empanelled a large number of private hospitals to provide inpatient medical care to its beneficiaries on the advice of Government specialists. 

As per the Terms & Conditions for empanelment under CGHS, all empanelled private hospitals are required to provide credit facilities to the CGHS beneficiaries in case of emergency. Pensioners and other specified category of beneficiaries are entitled for credit facilities under normal circumstances also. Non-compliance of the said provision attracts penalty as per the Memorandum of Agreement signed by them. 

Grant of fixed medical allowance to Defence civilians who residing in area not covered under CGHS.

OFFICE OF THE PR. CONTROLLER OF DEFENCE ACCOUNTS (PENSIONS)

DRAUPADI GHAT, ALLAHABAD- 211014

Circular No. 117

Dated: 16 /01/2014

Subject: Grant of fixed medical allowance to Defence civilians who residing in area not covered under CGHS.

Reference: This office circular No. 03 dated 30-03-1999.

Please refer to this office circular No. 03 dated 30.03.1999 under which Min. of PPG & P, Deptt of P & PW OM No. 45/57/97-P & PW (C) letters dated 24.08.1998 and 30.12.1998 were circulated for implementation of Govt. decision. As per P & PW OM dated 30.12.1998, pensioners who adopted Fixed Medical Allowance or medical facilities under CGHS or corresponding health scheme in accordance to P & PW OM No. 45/57/97-P & PW (C) dated 19.12.1997 circulated under this office circular no. G1/C/195/Vol-I/Tech dated 25.02.1998, can change their option once in the life time. As per existing procedure for change in option, pensioners submit their option to their PDA and PDAs take action accordingly.

In this context, it has been decided that pensioners who had originally opted for medical facilities under CGHS or corresponding health scheme may desire to change their option to draw Fixed Medical Allowance, in such cases Fixed Medical Allowance will be authorized by this office from the date of option, through Corr. PPO.

For issue of Corr. PPO, pensioners are required to submit their application with revised option (Specimen enclosed as annexure-A) to this office, duly supported with a certificate from PDA to the effect that above named pensioner has not opted for Fixed Medical Allowance (specimen of the certificate enclosed as Annexure-B).

In cases where pensioners have originally opted for Fixed Medical Allowance and now want to avail medical facilities, they will submit their revised option to their PDA and after receipt of revised option PDA will stop the payment of Fixed Medical Allowance from the following month of the receipt of the revised option and issue a certificate for stoppage of Fixed Medical Allowance.

Sd/-

 (S B Mathdevaru)

DyCDA (P)

Source:http://pcdapension.nic.in/6cpc/Circular-117.pdf

Deduction of CGHS contribution from Government Servant on change of Grade Pay by virtue of promotion/MACP — clarification reg.

Central Public Works Department

No. DG/ESTT/33

ISSUED BY THE AUTHORITY OF DIRECTOR GENERAL, CPWD  

Nirman Bhawan, New Delhi 

Dated the 16th January, 2014

OFFICE MEMORANDUM 

Sub : Deduction of CGHS contribution from Government Servant on change of Grade Pay by virtue of promotion/MACP — clarification reg.

It has been brought to our attention that the CGHS/DGHS guidelines regarding the monthly subscription/contribution are not being followed properly. It has been observed that in cases where pay of a Government employee is revised from a retrospective date consequent upon grant of MACP etc., CGHS contribution are also being recovered from the retrospective effect.

In this connection, attention is drawn to the clarification given by Ministry Ministry of Health & Family Welfare vide letter No.S11030/55/2011-CGHS(P) dated 26/10/2012 wherein it has been made clear that in cases where pay of a Govt. employee is revised from a retrospective date, resulting in change of amount of CGHS contribution payable, contribution at the higher slab rate may be recovered only from the date of issue of the order and not the date from which the pay is being effected. A copy of the said clarification is enclosed.

All offices of CPWID/PWD are requested to comply the aforesaid instructions strictly.

Encl : As above

( Raj Kumar )

Deputy Director (Admn)III

Source:http://cpwd.gov.in/

CGHS Hospitals will stop cashless treatment from 1st Febraury

The 800 hospitals in the country empanelled under the Central Government Health Scheme will stop cashless transactions from February 1, 2014, because, they claim, the government has not cleared arrears of Rs 600 crore.

The aggrieved hospitals have come together under the umbrella of the Association of Healthcare Providers India and had served notice to the CGHS office in New Delhi on December 13, 2013.

A meeting with the Union health secretary K.N. Desiraju on January 9 yielded no results.

A senior officer of AHPI said, “The amount has been budgeted in the health budget and it must be released. But it is not being done. Hence, the question is, where is it going?”

Since 2010, the hospitals have been complaining of 40 per cent unauthorised deductions in the payments. Now they have come together to put across their point to the government.

AHPI general secretary for AP Govind Hari says, “The problem started in 2002 when they started inviting tenders. In doing so, they reduced the cost of surgeries drastically. Also, orthopaedic treatment costs Rs 3,200 in Karnataka and Rs 10,000 in AP. These errors in terms of determining the cost put the hospitals in a spot.”

A senior member of the APHI said, “We want to quit as it has become more of a burden than a service as the clearance promise of 180 days is hardly followed.”

Additional director, CGHS, Dr Prasad, says, “We have not received any communication from the hospitals.” But senior officers in the Begumpet office of the department say there has been an assessment of the pending amount, and deliberations have started to sort out that matter.

Source : Deccan Chronicle

Eye tests in CGHS empanelled hospitals labs

GOVERNMENT OF INDIA
MINISTRY OF HEALTH AND FAMILY WELFARE
RAJYA SABHA

UNSTARRED QUESTION NO-1334
ANSWERED ON-17.12.2013

Eye tests in CGHS empanelled hospitals labs

1334 . SHRI BASHISTHA NARAIN SINGH

Will the Minister of HEALTH AND FAMILY WELFARE be pleased to state:

(a) whether the Eye Specialists visiting the CGHS dispensaries are referring eye tests to CGHS empanelled hospitals Diagnostic labs and imagaing centres in Delhi;

Reimbursement of medical expenses to pensioners where payment of FMA is allowed to staff working in the interior where AMA not available

No. 4/4/2013 -P&PW-(D)
Government of India
Ministry of Personnel, Public Grievances & Pensions
Department of Pension & Pensioners Welfare

Lok Nayak Bhavan, Khan Market,
New Delhi,
Dated the 6th December, 2013

OFFICE MEMORANDUM

Sub:- Reimbursement of medical expenses pensioners where payment of FMA is allowed to staff working in the interior where AMA not available – request of Shri Mukesh Singh.

   The undersigned is directed to forward herewith a representation dated 27.62013 of Shri Mukesh Singh in original received through Dept. of Expenditure vide letter No.164/EV/2013- Hindi dated 7.10.2013 for considering the grievances raised therein expeditiously in accordance with the extant rules/instructions under intimation to the representationist to whom a copy of this communication is also being endorsed.

Details of Dental Clinics in New Delhi under Central Government Health Scheme

Press Information Bureau 
Government of India 
Ministry of Health and Family Welfare

17-December-2013 18:46 IST 
Details of Dental Clinics in CGHS Dispensaries 
Central Zone : New Delhi

S.No.	Wellness Centers	Address
1	Dr. Z.H. Road (D44)	CGHS Building, Dr. Z.H. Road, New Delhi.
2	Chitra Gupta Road (D51)	CGHS Building, Near Aram Bagh, New Delhi.
3	Aliganj, Lodi Road .I (D9)	CGHS Building, Near LodhiRoad, New Delhi.
4	Kali Bari (D 76)	CGHS Building, Kali Bari Marg, DIZ Area, New Delhi.
5	CGHS DispensaryChanakyapuri	CGHS Dispensary Chanakyapuri, New Delhi.

   The dental services in CGHS Delhi have been outsourced in 13 Wellness Centres (5 under Central Zone and 8 under South Zone) for 22 dental procedures. The location wise details are as follows: 

Dialysis Facilities in Government Hospitals

Press Information Bureau
Government of India

Dialysis Facilities in Government Hospitals

   Although, health is a State subject and is primarily the responsibility of State Governments to provide health care including dialysis facilities for the patients, the Central Government through the hospitals under it, supplements the efforts of the State Government.

   Dialysis facility is available at the Central Government hospitals like All India Institute of Medical Sciences (AIIMS), Delhi, Dr. Ram Manohar Lohia Hospital, Delhi, Safdarjung Hospital, Delhi, Jawaharlal Institute of Post Graduate Medical Education and Research (JIPMER), Puducherry and Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh. Under Pradhan Mantri Swasthya Surakha Yojana (PMSSY), six new AIIMS have been set up and upgradation of identified medical colleges has been undertaken which will also improve health care facilities.

Irregularities in Medical Treatment

Press Information Bureau
Government of India

Irregularities in Medical Treatment

   In a special audit drive undertaken by all the Principal Controllers of Defence Accounts (PCsDA) to examine the bill processing procedures of Ex-servicemen Contributory Health Scheme (ECHS), PCDA, Western Command had raised observations relating to excess payment to ECHS empanelled hospitals amounting to Rs.15 crores. All the observations raised by the PCDA, Western Command were thoroughly analysed by Regional Centre, Chandigarh and it was noticed that most of the observations raised were due to incorrect interpretation of the policies. Wherever observations of the Controller of Defence Accounts were conceded to, the overpayments have been duly deducted from the concerned hospitals and suitable warnings issued to them.

Suspension of empanelment of ‘Saket City Hospital, New Delhi’ from the list of Hospitals/Centres empanelled under CGHS - reg.

Government of India
Ministry of Health & Family Welfare
Department of Health & Family Welfare
Nirman Bhawan, New Delhi
CGHS Division

No. S 11030/4/2013-CGHS (P)

Dated the 13th September, 2013

OFFICE MEMORANDUM

Sub: Suspension of empanelment of ‘Saket City Hospital, New Delhi’ from the list of Hospitals/Centres empanelled under CGHS - reg.

   The undersigned is directed to state that CGHS has empanelled private hospitals in various CGHS covered cities to provide inpatient healthcare facilities to its beneficiaries. Empanelment of the private hospitals is done under a contractual agreement between the Government of India and the private hospital on mutually agreed terms and conditions.

CGHS Facilities

Press Information Bureau
Government of India

   CGHS Facilities

   CGHS is basically providing the dispensary services through its Wellness Centres manned by the General Duty Medical Officers. However, CGHS also provides the services of medical specialists through the Polyclinics and Central Government hospitals. In addition, the CGHS medical specialists also visit designated dispensaries on stipulated days in each week to provide medical consultation to the beneficiaries. Due to shortage of specialists in CGHS it is practically not feasible and financially viable to provide Specialist facilities in each CGHS Wellness Centre. Moreover, CGHS is also engaging contractual specialists against the vacant posts of specialists to provide the medical consultation services to its beneficiaries. CGHS has a dedicated wing of specialists at the Safdarjung Hospital, New Delhi for its beneficiaries. The CGHS beneficiaries are also allowed to consult specialists at Dr. RML Hospital and other Government hospitals in NCR in respective specialties. In addition, CGHS has empanelled a large number of private hospitals to provide inpatient medical care to its beneficiaries on the advice of Government specialists.

Criteria for Setting up of CGHS Dispensary

Press Information Bureau
Government of India

Criteria for Setting up of CGHS Dispensary

   The criteria fixed for setting up a Central Government Health Scheme (CGHS) dispensary in a particular area are as under:
 
   (i) In an existing CGHS city: For opening of a new Allopathic CGHS dispensary in an existing CGHS city, there has to be a minimum of 2,000 Card holders (serving employees of Central Government and Central Civil pensioners).
 
   (ii) Extension of CGHS to a new City: For extension of CGHS to a new city there has to be a minimum of 6,000 Card holders.

INDEMNITY BOND FOR SETTLEMENT OF DUPLICATE HOSPITAL BILLS

   We, hereby give an undertaking that the original bills of hospital / diagnostic lab / imaging centre, the ID Nos. of which are appended are said to have been destroyed in a fire accident that took place on 11.08.2013 at UTI-ITSL New Delhi office and that we are now submitting the print outs of scanned copies of the above referred original documents/bills for consideration of payment.

   We also hereby give an undertaking that no claim shall be made against original documents / bills, of which printouts of the scanned copies are submitted herewith and we agree to indemnify against any loss that may be caused to CGHS due to final settlement of these claims on the basis of printouts of scanned documents/bills and this indemnity bond. We further give an undertaking that if original bill(s) is /are found, no claim shall be made against the same and that in the event of any inadvertent payment received against original bills in future, we agree to indemnify against any loss that may have been caused to CGHS due to final settlement of these claims.

REIMBURSEMENT OF MED CLAIM FOR EMERGENCY TREATMENT IN NON EMPANELLED HOSPITAL.

Central Organisation ECHS
Adjutant General’s Branch
Integrated Headquarters
Maude Line
Delhi Cantt - 110 010

B/49773/AG/ECHS/Rates policy

15th oct 2013

Reginal Centre ECHS
MUMBAI

REIMBURSEMENT OF MED CLAIM FOR EMERGENCY TREATMENT IN NON EMPANELLED HOSPITAL

   1. A Clarification was sought from the Chief Medical Officer (SAG), CGHS Mumbai on the rates at which the claims are settled of CGHS beneficiaries. The CGHS authorities have clarified vide their letter No 3(xiv)3/13 Genl/1958/13 dt 30 Aug 13 that reimbursement at 25% higher rate that the 2002 CGHS rates is applicable to those who have taken treatment in private non empanelled hospital through CGHS in Mumbai.

Private Hospitals threaten to stop CGHS treatment

   Cashless treatment may be stopped for central government employees
 
   Corporate hospitals across the country have threatened to stop cashless treatment to lakhs of Central Government employees from January 1. This will impact about 45 lakh employees of the Central Government and public sector agencies who are benefiting from the insurance scheme.

   Protesting against “unviable” rates being given to them under the Central Government Health Scheme (CGHS), the Association of Healthcare Providers (India) (AHPI) has said that it will give three months’ time to the Government to revise the rates.

Empanelment of private hospitals (including dental clinics and eve care centres) & Imaging Centre under CGHS Jabalpur.

GOVERNMENT OF INDIA
MINISTRY OF HEALTH & FAMILY WELFARE
OFFICE OF THE ADDITIONAL DIRECTOR
CENTRAL GOVT. HEALTH SCHEME
1544/A NAPIER TOWN
JABALPUR

No.6-8/13-Estt/CGHS/JBP/ 2101-13

Dated:-24.07.2013

OFFICE MEMORANDUM

Subject: Empanelment of private hospitals (including dental clinics and eve care centres) & Imaging Centre under CGHS Jabalpur.

   In reference to (I) the Ministry of Health & F.W. O.M. No. S.11011/23/2009-CGHS D.II/ Hospital Cell(Part IX) dated 14.02.2013 vide which the 'Continuous Empanelment Scheme' for private hospitals and diagnostic centres under CGHS was revived and (ii) Dte. General of CGHS Office Order No. S.11045/23/2013/CG HS D-ll(HEC)/CGHS(P)/(Pt.) dated 15.07.2013, vide which powers for empanelment & issuance of notifications have been delegated to all the ADs/JDs in respect of their respective CGHS cities, a list of additional private hospitals (including dental clinics and eye centres) and Imaging Centre has been finalized for a period of one year from the date of issue of this O.M. or till the next new empanelment, whichever is earlier. This list has been finalized after following the due process and terms & conditions as laid down in the O.M. dated 14.02.13 as well as signing of MOA and execution of Performance Bank Guarantee by them signifying acceptance of the terms and conditions of empanelment and rates notified under CGHS in 2010/2011 and subsequent orders.