Treatment from CGHS Empanelled Hospitals

Government empanels private hospitals under CGHS for indoor treatment and treatment can be undertaken with prior permission or under emergency. OPD medicines are issued by CGHS Wellness Centres on the prescription by CGHS Medical officers / Government specialists only.

In case of cardiac surgery, cancer treatment, neuro-surgery, renal transplantation and hip/knee joint replacement surgery, there is provision for issue of permission for post-operative follow up treatment from the same empanelled hospitals, where the initial treatment was taken with prior permission. In such cases OPD medicines as per the available brand name / generic name are issued by CGHS Wellness Centres.

In respect of other post-operative cases, where permission was granted, there is provision for issue of OPD medicines on the prescriptions of empanelled hospital for up to one month.

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

Source: PIB

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.

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.