List of Emergency Conditions in CGHS Treatment

The medical emergency conditions included under the purview of CGHS Act are enlisted below:

a) Acute Coronary Syndromes viz. (Coronary Artery By-pass Graft or Percutaneous Trans-Luminal Coronary Angioplasty) including Myocardial Infarction, Unstable Angina, Ventricular Arrhythmias, Paroxysmal Supra- Ventricular Tachycardia, Cardiac Tamponade, Acute Left-Ventricular Failure, Severe Congestive Cardiac Failure, Accelerated Hypertension, Complete Heart Block and Stokes-Adams Attack, Acute Aortic dissection. 

b) Acute Limb Ischemia, Rupture of Aneurism, Medical and surgical shock and peripheral circulatory failure. 

c) Cerebro-Vascular Attack, Strokes, sudden Unconsciousness, Head Injury, Respiratory failure, De-compensated Lung Disease, Cerebro-Meningeal Infection, Convulsions, Acute Paralysis, Acute Visual Loss. 

d) Acute Abdomen 

e) RTA (Road Traffic Accident) with injuries including fall 

f) Acute Poisoning

g) Acute Renal Failure 

h) Acute Abdomen in females including Acute Obstetrical and Gynecological Emergencies.

i) Heat Stroke

O.P.D. (Outdoor Patient Department) treatment and subsequent follow-up after hospitalization is not permitted in Private Hospitals and Diagnostic Centres recognized under CGHS. Exceptions for follow-up treatment are permissible in following conditions for a period of 3 to 6 months after conducting the surgical procedure, are as follows: 

a. Neuro-surgery 

b. Cardiac Surgery including Angioplasty 

c. Cancer Surgery, Radiotherapy and Chemotherapy 

d. Organ transplant viz. Kidney 

e. Knee replacement. 

f. RTA (Road Traffic Accident)

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.