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.

Administrative Functioning of CGHS Unani

        Central Government Health Scheme provides the healthcare facilities to its beneficiaries predominantly in the Allopathic system of medicine as per their demand. AYUSH system of medicine is a very small component under CGHS. The Unani system is an even smaller component of AYUSH. There are 10 small units of Unani system consisting of one or two Unani doctors and pharmacists attached to main CGHS Wellness Centres in Delhi, Kolkata, Lucknow, Hyderabad and Bangalore.

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.

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.

Extension of CGHS facilities to permanently disabled dependent brother of a CGHS beneficiary - reg.

Government of India
Ministry of Health & Family Welfare
Department of Health & Family Welfare
Nirman Bhawan, Maulana Azad Road
New Delhi 110 108

No. S 11011/13/2012-CGHS (P)
Dated the 25th July, 2013

OFFICE MEMORANDUM

Sub: Extension of CGHS facilities to permanently disabled dependent brother of a CGHS beneficiary - reg.

   The undersigned is directed to state that dependent brother of a Central Government employee is presently entitled for CGHS coverage upto the age of becoming a major. Ministry of Health and Family Welfare has been receiving requests from CGHS beneficiaries for removal of the upper age-limit in the case of disabled dependent brother so as to provide them the CGHS facilities without any age limit as has been provided to disabled son of a CGHS beneficiary.

Medical facilities for in-patient treatment and post-operative follow-up treatment to ECHS beneficiaries residing in districts not covered by ECHS.

No. 22D (09)12013/US (WE)/D (Res)
Government of India
Deptt of Ex-Servicemen Welfare
Ministry of Defence
New Delhi

Dated the 21st August, 2013

To
The Chief of the Army Staff
The Chief of the Naval Staff
The Chief of the Air Staff

Subject:- Medical facilities for in-patient treatment and post-operative follow-up treatment to ECHS beneficiaries residing in districts not covered by ECHS.

Sir.
   1, The undersigned is directed to invite attention to Govt. of India, Ministry of Defence letter No. 24(48)/03/US(WE)D(Res) dated 19th December, 2003 and to state that keeping in view, the difficulties being faced by the ECHS beneficiaries residing in districts not covered by ECHS it has now been decided to liberalise the ECHS Rules as follows to enable them to avail medical facilities for in-patient treatment and post- operative follow-up treatment:-

Notification of fresh empanelment of Private Hospitals & Diagnostic Centers under Contentious Empanelment Scheme of CGHS, Chandigarh.

GOVERNMENT OF INDIA
Ministry of Health & Family Welfare
(CENTRAL GOVT HEALTH SCHEME)

O/O ADDITIONAL DIRECTOR, CGHS, CKANDIGARI4
4th floor, Kendriya Sadan
SECTOR-9A, CHANDIGARH—160009
No: AD/CGHS/CHD/RMRCB/20l3/4879 - 4908

Tele Nos: (0) 0172-2740716
AD Fax No.0172 —2740555
Dated: 30.08.2013

OFFICE MEMORANDUM

Subject : Notification of fresh empanelment of Private Hospitals & Diagnostic Centers under Contentious Empanelment Scheme of CGHS, Chandigarh.

   In response to Ministry of Health & Family Welfare, Govt. of India, Nirman Bhawan, New Delhi’s O.M No. S.11011/23/2009—CGHS D.II/Hospital Cell (Part IX) dated 14.02.2013 & letter No. S.11045/23/2013/CGHS D.II (HEC)/CGHS(P)/Pt) dated 15.07.2013 for continuous fresh empanelment of private hospitals & diagnostic centers for city of Chandigarh, a committee consisting of two senior most CMOs headed by undersigned and selected the private hospitals & diagnostic centers for Chandigarh. The qualified list of Hospitals & Diagnostic Centers is according to category and purpose attached as Annexure “I” with this O.M.

Empanelment of private hospitals (including dental clinics and eye care centres and diagnostic centres under CGHS, Nagpur.

Govt. of India
Ministry of Health & Family Welfare
Office of the Additional Director,
Central Govt. Health Scheme,
Seminary Hills, Nagpur - 440 006.

No. CGHS/NP/Admn/Hosp. EMP/2013/1328

Date:- 29.08.2013

OFFICE MEMORANDUM

Subject:- Empanelment of private hospitals (including dental clinics and eye care centres and diagnostic centres under CGHS, Nagpur.

   I. The undersigned is directed to invite reference to this Office Memorandum No: CGHS/NP/Admn/HEMP/20l3/943 dated 22.07.2013 vide which the list of private hospitals (including dental clinics and eye care centres) and diagnostic centres empanelled under CGHS Nagpur have been notified under different categories.

Empanelment of private hospitals (including dental clinics and eye centres) and diagnostic centres under CGHS Delhi & NCR.

No: S. 1 1045/23/2013-CGHS D.II/HEC
Government of India
Directorate General of Central Government Health Scheme
Department of Health & Family Welfare

Bikaner House Hutments, Shahjahan Road
New Delhi 110 108 dated the 27th, August, 2013

OFFICE ORDER

Subject: Empanelment of private hospitals (including dental clinics and eye centres) and diagnostic centres under CGHS Delhi & NCR.

   In continuation of this Directorate’s Office Order of even no. dated 01.08.2013 on the above mentioned subject, the undersigned is directed to convey that in addition to the list of the hospitals (including dental clinics), diagnostic laboratories and Imaging Centres already empanelled, the hospitals (including dental clinics), diagnostic laboratories and Imaging Centres as per the list attached have also been empanelled under the continuous empanelment scheme under CGHS in Delhi & NCR.

CGHS Wellness Centre.

   X-ray machines have been installed in some dispensaries/Poly clinics/ First Aid Posts in the following cities:

Name of City	No. of total machines	No. of machine working
Bangalore	1	1
Chennai	2	1
Jaipur	1	0
Hyderabad	1	1
Mumbai	1	1
Kolkata	1	0
Delhi	4	2
Total	11	6

Funds for Unani under CGHS.

   Like other systems of medicine practiced under CGHS, Unani division has also a set and transparent system of procurement of medicines. Procurement of Unani medicines is done from three Sources:-

   1. IMPCL: for bulk purchase of 94 Unani Medicines. IMPCL is a Public Sector Undertaking (PSU) which supplies medicines at the rates fixed by the Office of Chief Advisor Cost, Department of Expenditure, and Ministry of Finance. There is no requirement of tendering to procure medicines from M/s IMPCL.
 
   2. From Private Manufacturers: through open tendering-both for Generic & branded items.
 
   3. Authorized Local Chemist (ALC):  medicines which are not available in the dispensary or store are procured through Authorized Local Chemist. Local Purchase system is a stop gap method for daily need. Authorized Local Chemist is appointed after following the due codal provisions.

Service Provided by CGHS.

This Ministry has been receiving complaints/grievances in respect of the following major aspects.
 
   1.Administrative:- Misbehavior by medical and paramedical staff, Shortage of staff,  Punctuality etc.
 
   2. Technical:- Delay in settlement of medical reimbursement claims (MRCs),  Supply of substitute medicines instead of the prescribed by the Govt. specialists, Delay in supply of indented medicines, etc.
 
   3. Related to empanelled hospitals:
Denial of credit facility, Misbehavior of hospital doctors/staff, overcharging, etc.
 
   4. Related to Internet accessibility
Disruption in services due to breakdown in internet connectivity,  etc.
 
To redress the grievances/complaints, the following steps have been taken:

Treatment from CGHS Empanelled Hospitals.

   As per the existing guidelines, a CGHS beneficiary is required to obtain permission from his administrative Department / Office or CMO in charge (in case of pensioner beneficiary) to avail medical treatment in a CGHS empanelled private hospital. However, in case of emergency he can go to any hospital whether empanelled or not, to avail medical treatment. This provision is necessary to ensure proper medical treatment of a CGHS beneficiary in consultation with the Government specialists. This is also a measure of ‘checks and balances’ to ensure financial propriety and optimum utilization of public money.

   This Ministry has been receiving representations from the individuals; Pensioners Associations etc. to allow the CGHS beneficiaries to take treatment from the CGHS empanelled private hospitals without obtaining the requisite permission. However, their requests have not been acceded to as the present referral system is considered necessary in the interest of the beneficiaries and it is also necessary as a check and balance measure to ensure financial propriety.

Dental Clinics in CGHS Dispensaries

   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 at Annexure-A.

   The details of payments made to the service provider in respect of these clinics from the starting of the services till July, 2013 are at Annexure-B.


   No specific complaint has been reported about irregularities committed by the dental clinics in connivance of CGHS officials. However, deficiency in services has been reported from the beneficiaries. An Inspection Committee has been constituted for regular inspection of the dental units to ensure proper delivery of services as per the terms and conditions of the agreement. 

Computerization in Central Government Health Scheme (CGHS).

GOVERNMENT OF INDIA
MINISTRY OF HEALTH AND FAMILY WELFARE
LOK SABHA
UNSTARRED  QUESTION NO 1691
ANSWERED ON   16.08.2013
COMPUTERIZATION IN CGHS

1691 . Shri RAJAGOPAL LAGADAPATI

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

(a) whether all the allopathy and AYUSH dispensaries/hospitals under Central Government Health Scheme (CGHS) in the country have been Computerized

(b) if so, the details thereof and if not, the reasons therefor, dispensary/hospital wise;

(c) the time by which the remaining dispensaries/hospitals are likely to be computerized;

(d) whether the beneficiaries can avail the facilities of CGHS from anywhere in the country;

(e) if so, the details thereof and if not, the reasons therefor; and

Latest CGHS Hospitals; Notification of fresh empanelment of Private Hospitals & Diagnostic Centers under continuous empanelment scheme of CGHS, Meerut.

OFFICE OF THE ADDITIONAL DIRECTOR
CENTRAL GOVERNMENT HEALTH SCHEME
SURAJ KUND ROAD, MEERUT.

No. 9-4/13-CGHS/MRT/ESTT

Dated: 05-08-2013

OFFICE MEMORANDUM

Sub: Notification of fresh empanelment of Private Hospitals & Diagnostic Centers under continuous empanelment scheme of CGHS, Meerut.

   In reference to MOHFW OM No. S.11011/23/2009-CGHS D II / Hospital Cell (part-IX) dated 14-02-2013 and this Directorate letter No. S.11045/23/2013/CGHS D-II (HEC)/CGHS (P)/(Pt) dated 15-07-2013 for continuous fresh empanelment of Private Hospitals & Diagnostic Centers under CGHS Meerut, a committee was formed with two senior most CMOs headed by undersigned including Consultant as Special Invitee. Inspection for authentication of documents submitted was carried out by Transparency officer, CGHS Meerut, Office Superintendent CGHS Meerut & Sr. Consultant CGHS Meerut as Special Invitee. The qualified list of Hospitals & Diagnostic Centers is according to category and purpose attached as Annexure “A” with this OM (on the recommendation of Hospital Committee) for One Year or Fresh Empanelment whichever is earlier.