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.

Regarding empanelment of Jain Neurological Centre, Jagriti Enclave, New Delhi under CGHS, Delhi.

No:S.11011 /03/2012-13 / CGHS (HEC)
Government of India
Directorate General Of Central Govt. Health Scheme

Maulana Azad Road, Nirman Bhawan
New Delhi 110 108, dated the 26th July, 2013

OFFICE  MEMORANDUM

Subject: Regarding empanelment of Jain Neurological Centre, Jagriti Enclave, New Delhi under CGHS, Delhi

      With reference to the above mentioned matter the undersigned is directed to draw attention to the Office Memorandum of even number dated 18.12.2012 vide which Jain Neurological Centre, Jagriti Enclave Delhi was removed from the list of empanelled hospitals under CGHS, Delhi till further orders. In response to the representations received an inspection of Jain Neurological Centre, Jagriti Enclave was carried out on 23.5.2013 by a team of CGHS officers to ascertain whether the deficiencies pointed out in the earlier inspection were rectified or not.

Regarding empanelment of Kalra Hospital, Kirtinagar, New Delhi under CGHS, Delhi.

No: S. 11031/03/2012-13 / CGHS (HEC)/CGHS(P)
Government of India
Ministry of Health & Family Welfare
Department of Health & Family Welfare

Maulana Azad Road, Nirman Bhawan
New Delhi - 110 108, dated the 9th April 2013

OFFICE MEMORANDUM

Subject: Regarding empanelment of Kalra Hospital, Kirtinagar, New Delhi under CGHS, Delhi

   With reference to the above mentioned matter the undersigned is directed to draw attention to the Office Memorandum of even number dated 18.12.2012 vide which Kalra Hospital, Kirtinagar, New Delhi was removed from the list of empanelled hospitals under CGHS, Delhi till further orders. In response to the representations received, an inspection of Kalra Hospital, Kirtinagar, New Delhi was carried out on 20.03.2013 by a team of officers led by Addi. Director, CGHS(HQ) to ascertain whether the deficiencies pointed out in the earlier inspection were rectified or not.

   2. Based on the findings of the inspection report, empanelment of the above hospital under CGHS has been restored, initially for a period of six months for all available facilities w.e.f. the date of issue of this Office Memorandum on the same terms and conditions on which the hospital was empanelled under CGHS prior to 18.12.2012,.

Sd/-
[V.P.Singh]
Deputy Secretary to Government of India

Source: http://msotransparent.nic.in/writereaddata/cghsdata/mainlinkfile/File592.pdf

Removal of Sri Balaji Action Medical Institute, FC-34, A-4, Paschim Vihar, New Delhi-110063 — regarding.

No: S.1107824/2013/ CGHS (HEC) /CGHS(P)
Government of India
Ministry of Health & Family Welfare
Department of Health & Family Welfare

Maulana Azad Road, Nirman Bhawan
New Delhi 110 108 dated the April 5, 2013

OFFICE MEMORANDUM

Subject: Removal of Sri Balaji Action Medical Institute, FC-34, A-4, Paschim Vihar, New Delhi-110063 — regarding.

   With reference to the above mentioned subject the undersigned is to draw attention to No S 11011/23/2009/CGHS DII / Hospital Cell (part I) dated 7.10.2010 vide which Sri Balaji Action Medical Institute, FC-34, A-4, Paschim Vihar, New Delhi was empanelled under CGHS,Delhi and to state that Sri Balaji Action Medical Institute, FC-34, A-4, Paschim Vihar, New Delhi has conveyed its unwillingness to continue its empanelment under CGHS. The matter has been examined by this Ministry and it has been decided that Sri Balaji Action Medical Institute, FC-34, A-4, Paschim Vihar, New Delhi shall stand removed from the list of empanelled hospitals under CGHS, Delhi with immediate effect.

  2. It is further stated that Sri Balaji Action Medical Institute, FC-34, A-4, Paschim Vihar, New Delhi shall however, complete the treatment of CGHS beneficiaries already admitted in the hospital for treatment at CGHS rates.

   3. Action Cancer Hospital,H-2/FC-34, A-4, Paschim Vihar, New Delhi shall however,continue to be on CGHS panel.

   This Office Memorandum comes into effect from the date of issue.

Sd/-
[Ravi Kant]
Under Secretary to Government of India

Source:http://msotransparent.nic.in/writereaddata/cghsdata/mainlinkfile/File589.pdf

Regarding tests / investigations at private hospitals / diagnostic laboratories / imaging centres empanelled under CGHS.

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 22nd February, 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 wherein it has been provided under Para 3 that the serving government employees / CGHS beneficiaries shall submit medical prescription in original while claiming reimbursement of expenses incurred on diagnostic tests and investigations, from their office. Keeping in view the inconvenience and difficulties faced by the serving employees / CGHS beneficiaries in submission of prescription in original, it has been decided to relax the above condition and to allow a self attested photocopy of the medical prescription to claim reimbursement of medical expenses incurred on getting diagnostic tests / investigations carried out from a CGHS empanelled hospital / diagnostic laboratory / imaging centre on a valid prescription issued by a CGHS Medical Officer / Govt. Specialist, without a permission letter issued from the Department concerned.

   2. 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. However, the serving employees of Ministry of Health and Family Welfare are eligible for credit facility from the CGHS empanelled private hospitals / diagnostic laboratories and imaging centres in terms of this Ministry’s OM No. Rec. 1-2008/Gr./CGHS/Delhi/CGHS (P) dated 10.06.2008.

   3. 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. However the medical prescription shall remain valid beyond two weeks for undertaking diagnostic tests / investigations if specifically prescribed by the CGHS doctor / Government Specialist about the date or period by which the prescribed tests are to be conducted for a routine check up or 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 or as prescribed by the CGHS doctor / Govt. Specialist, as the case may be.

sd/-
[V.P.Singh]
Deputy Secretary to the Government of India

Source:http://msotransparent.nic.in/writereaddata/cghsdata/mainlinkfile/File578.pdf

Revision of Ceiling Rates and guidelines for various Coronary Stents for CGHS/CS(MA) beneficiaries.

F. No. Misc. 1002/2006/CGHS(R&H)/ CGHS(P)
Government of India
Ministry of Health & Family Welfare
Department of Health & Family Welfare

Maulana Azad Road, Nirman Bhawan
New Delhi 110 108 dated the 21st February, 2013.

OFFICE MEMORANDUM

Subject:- Revision of Ceiling Rates and guidelines for various Coronary Stents for CGHS/CS(MA) beneficiaries.

   With reference to the above mentioned subject the undersigned is directed to draw attention to the Office Memorandum of even number dated 31.10.2011 and to state that ceiling rates for all DCGI approved Coronary Stents have been revised in super cession of the Office Memorandum of even No. dated 31.10.2011 of the Ministry of Health & Family Welfare as per the ceiling rates mentioned below:-

S.No	Type of Coronary Stents		Ceiling Rate
1.	DRUG ELUTING  CORONARY STENTS	All DCGI and FDA approved Drug Eluting Stents All DCGI and CE approved Drug Eluting Stents All DCGI approved Drug Eluting Stents	Rs.25,000/-
2.	BARE METAL CORONARY STENTS	COBALT STENTS (including Coated and other Stents) All DCGI and FDA approved All DCGI and CE approved All DCGI approved	Rs.12000/-
3.	BARE METAL  STAINLESS STELL   STENTS	Rs.10,000/- the rates were already notified vide OM of even number dated 7th February 2013

   Reimbursement to beneficiaries /empanelled hospitals shall be allowed subject to the ceiling rates or actuals, whichever are lower.

   2. Coronary Stents shall be permitted on the advice of Govt. Specialist, of which not more than two shall be of Drug Eluting Sterits( in any of the coronary stents as per the decision of treating specialist). Permission shall be granted as per the laid down procedure. If more than two drug eluting stents are implanted in an empanelled hospital and no written informed consent was obtained from the beneficiary that he/she would bear the difference in cost between the DES and Bare Metal Stent, and the hospital has charged this amount from the beneficiary, the additional amount shall be paid to the beneficiary and shall be deducted from the pending bills of hospitals.

   3. It is essential for the empanelled hospitals to quote the Batch number when a coronary/vascular stent of any type is implanted in the case of a CGHS/CS (MA) beneficiary and also enclose a copy of the relevant invoices pertaining to the procurement of the stents by the hospitals. In addition to this, the outer pouch of the Stent packet along with the sticker on it on which details of the stent are printed shall also be enclosed with the medical bill for claiming reimbursement from the Govt. In case of treatment from a private non-empanelled hospital, where the treatment was taken in an emergency, it is the responsibility of the beneficiary to obtain the batch number , invoice and outer pouches of the stent(s) before the submission of the medical claim to CGHS/ concerned department, as the case may be.

   4. The empanelled hospital shall submit a self certified undertaking that the hospital has not charged the CGHS / CS (MA) beneficiary more than the rate at which the stent has been procured by the hospital and in case of any detection and establishment that the hospital has overcharged, the hospital shall be removed from the list of hospitals empanelled under CGHS without any further notice.

   5. UTI-ITSL, while processing the hospital bills of coronary / vascular stents shall ensure that the hospitals have enclosed copies of the relevant invoices pertaining to the procurement of the stents by the hospitals and the outer pouch of the Stent packet along with the sticker on it on which details of the stent are printed and that the prescribed rates and the guidelines have been followed, before making provisional payments to the hospitals.

   6. The revised rates and guidelines shall come into force from the date of issue and shall be in force till they are revised.

   7. This issues with the concurrence of Integrated Finance Division vide Note dated 20.12.2012 of AS&FA, Min. of H&FW.

sd/-
(RAVI KANT)
UNDER SECRETARY TO GOVERNMENT OF INDIA

Source:http://msotransparent.nic.in/writereaddata/cghsdata/mainlinkfile/File577.pdf

Revival of ‘Continuous Empanelment Scheme’ for private hospitals and diagnostic centres under CGHS.

No: S. 11011/23/2009-CGHS D.II/ Hospital Cell (Part IX)
Government of India
Ministry of Health & Family Welfare
Department of Health & Family Welfare

Maulana Azad Road, Nirman Bhawan
New Delhi 110 108 dated the 14th February 2013.

OFFICE MEMORANDUM

Subject: Revival of ‘Continuous Empanelment Scheme’ for private hospitals and diagnostic centres under CGHS

   With a view to ensuring comprehensive health care to CGHS beneficiaries, CGHS has been, apart from the Government Hospitals, empanelling private hospitals and diagnostic centres by floating tenders periodically. The latest tender process in this context commenced in the second half of 2009. Even the already empanelled hospitals (including dental clinics and eye centres) / diagnostic centres under CGHS were required to submit the bids under this tender process. Through this process, package rates for different treatment procedures and investigations were notified in 2010. As a part of this process, certain hospitals and diagnostic centres which accepted these rates and also signed MOAs with CGHS were notified in CGHS covered cities. Subsequently, with a view to empanel more hospitals and diagnostic centers , continuous empanelment scheme was initiated in December 2010 and was in operation till July 2011 in some cities & till 26th December 2011 in some other cities.

   2. However, it has been noticed that the number of hospitals and diagnostic centres notified as empanelled under CGHS is not adequate to provide a satisfactory level of healthcare to CGHS beneficiaries in all areas of CGHS covered cities.

Removal/Suspension of Escorts Heart Institute & Research Centre, Max Super Specialty Hospital and Max Devki Heart & Vascular Institute, New Delhi — regarding.

No: S. 11031/CGHS(HEC)/2012- 13-CGHS(P)
Government of India
Ministry of Health & Family Welfare
Department of Health & Family Welfare

Maulana Azad Road, Nirman Bhawan
New Delhi 110 108 dated the 13th February 2013

OFFICE MEMORANDUM

Subject:- Removal/Suspension of Escorts Heart Institute & Research Centre, Max Super Specialty Hospital and Max Devki Heart & Vascular Institute, New Delhi — regarding.

   With reference to the above mentioned matter, the undersigned is directed to draw attention to the Office Memorandum No S 11011/23/2009/CGHS DII / Hospital Cell (part I) dated 7.10.2010 vide which Escorts Heart Institute & Research Centre, Max Super Specialty Hospital and Max Devki Heart & Vascular Institute, New Delhi were empanelled under CGHS, Delhi and to state that Escorts Heart Institute & Research Centre and Max Super Specialty Hospital, New Delhi have conveyed their unwillingness to continue their empanelment under CGHS. It is also stated that Max Devki Heart & Vascular Institute, New Delhi informed that the hospital shall not provide credit facility to CGHS beneficiaries. The matter has been examined by this Ministry and it has been decided that Escorts Heart Institute & Research Centre, Max Super Specialty Hospital, New Delhi shall stand removed from the list of empanelled hospitals under CGHS, Delhi with immediate effect.

   2. It is further stated that the empanelment of Max Devki Heart & Vascular Institute, New Delhi is suspended from the list of empanelled hospitals under CGHS with immediate effect till further orders.

sd/-
[V.P.Singh]
Deputy Secretary to Government of India

Source:http://msotransparent.nic.in/writereaddata/cghsdata/mainlinkfile/File572.pdf

Revision of Ceiling Rates for Coronary Angioplasty and Coronary Angioplasty with Balloon for CGHS beneficiaries.

 

F.No. Misc. 1002/2006/CGHS(R&H)/ CGHS(P)
Government of India
Ministry of Health & Family Welfare
Department of Health & Family Welfare

Latest CGHS Orders

Maulana Azad Road, Nirman Bhawan
New Delhi 110 108 dated the 7th February, 2013.

OFFICE MEMORANDUM

Subject: Revision of Ceiling Rates for Coronary Angioplasty and Coronary Angioplasty with Balloon for CGHS beneficiaries.

   With reference to the above mentioned subject the undersigned is directed to draw attention to the Office Memorandum No. S.11011/23/2009 /Hospital Cell dated 17.08.2010 and other Office Memoranda issued subsequently whereby the CGHS package rates for Coronary Angioplasty were fixed by the Government for empanelled hospitals under CGHS in Delhi and NCR and other CGHS cities and to state that in supersession of the earlier CGHS rates ceiling rates the following ceiling rates are approved for reimbursement to CGHS beneficiaries/CGHS empanelled hospitals as per the details given below:-

   Coronary Angioplasty : Rs.50, 000/- (for semi-private ward)

  Coronary Angioplasty with Balloon : Rs.55, 000/- (for semi-private ward)

   Reimbursement to beneficiaries /empanelled hospitals shall be limited to ceiling rate or as per actuals, whichever is lower. The other terms and conditions as regards to CGHS package rates remain unchanged.

   2. The revised rates shall come into force from the date of issue and shall be in force till further orders.

   3. This issues with the concurrence of Integrated Finance Division vide Note dated 20/12/2012 of AS & FA.

sd/-
(RAVI KANT)
UNDER SECRETARY TO GOVERNMENT OF INDIA

Source:http://msotransparent.nic.in/writereaddata/cghsdata/mainlinkfile/File567.pdf

Regarding tests/investigations at private hospitals/diagnostic laboratories/imaging centres empanelled under CGHS.

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.