Cashless treatment facilities to CGHS beneficiaries in AIIMS and PGIMER – Guidelines: Rajya Sabha QA

Cashless treatment facilities to CGHS beneficiaries in AIIMS and PGIMER – Guidelines related to treatment: Rajya Sabha QA dated 05.12.2023

GOVERNMENT OF INDIA
MINISTRY OF HEALTH AND FAMILY WELFARE
DEPARTMENT OF HEALTH AND FAMILY WELFARE

RAJYA SABHA
UNSTARRED QUESTION NO. 268

TO BE ANSWERED ON 05 TH DECEMBER, 2023

CASHLESS TREATMENT FACILITIES TO CGHS BENEFICIARIES

268. SHRI RAVICHANDRA VADDIRAJU:
Will the Minister of HEALTH AND FAMILY WELFARE be pleased to state:

(a) Whether Government is planning to expand cashless treatment facilities for the Central Government Health Scheme (CGHS) beneficiaries as is being done in AIIMS Delhi, PGIMER Chandigarh and JIPMER Puducherry bringing under the ambit of CGHS and proposes to include all AIIMS across the country; and

(b) If so, the details thereof and present status of its implementation of the scheme?

ANSWER

THE MINISTER OF STATE IN THE MINISTRY OF HEALTH AND FAMILY WELFARE (DR. BHARATI PRAVIN PAWAR)

(a) & (b) As per the decision taken by the Government, Memorandums of Agreement (MoAs) have been signed by CGHS with AIIMS, New Delhi; PGIMER, Chandigarh; JIPMER, Puducherry and AIIMS located at Bhopal, Bhubaneswar, Jodhpur, Patna, Raipur, Rishikesh, Bilaspur, Rajkot, Kalyani, Bhatinda, Bibinagar, Guwahati, Deoghar and Mangalagiri; to facilitate cashless treatment/ investigation facilities to Pensioner beneficiaries and other eligible categories of CGHS beneficiaries at these premier institutions. The guidelines related to treatment of CGHS pensioner beneficiaries and other entitled class of beneficiaries at these Institutes are given at Annexure.

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Annexure

The guidelines related to treatment of CGHS Pensioner beneficiaries and other entitled class of beneficiaries are as under:

• CGHS Pensioners and other beneficiaries entitled for cashless treatment like ex-MPs, ex- Governors, former Judges of Supreme Court of India , former Judges of High Courts, Freedom Fighters, etc., holding a Valid CGHS Card are eligible for cashless treatment at AIIMS.
• The validity of the CGHS card and the ward entitlement are printed on CGHS Card.
• AIIMS shall create a Special desk for CGHS beneficiaries.
• Entitled CGHS beneficiaries shall present their CGHS Card for verification at CGHS Desk.
• CGHS shall facilitate verification of card details on line from CGHS Data base in consultation with NIC.
• Entitled CGHS beneficiaries shall submit a self attested copy of CGHS Card of self. In case of treatment of a dependant family member copy of the CGHS card of self and family member shall be submitted.
• CGHS Desk at AIIMS refers the beneficiaries to OPD / Investigations / Indoor treatment as the case may be.
• Bills in physical form along with copy of CGHS card shall be submitted by AIIMS in the last week of month to the office of Addl. Director, CGHS of concerned City.
• AIIMS shall send bill to CGHS as per AIIMS rates, except in case of Room rent for Indoor treatment. Bills for room rent shall be sent to CGHS as per prescribed rates for empanelled Hospitals. The beneficiaries are eligible for indoor treatment as per their ward entitlement, as indicated on their CGHS Card.
• AIIMS shall create a separate Bank Account for CGHS beneficiaries to reimburse the bills by CGHS.
• Additional Director, CGHS of concerned City shall process the bills expeditiously and payment shall be credited into the Bank Account created by AIIMS for CGHS.
• CGHS pensioners and others eligible for cashless treatment can avail treatment without any mandatory referral from CGHS.

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