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.