CGHS card is valid for Referral to empanelled HCOs of pensioner beneficiaries: MOHFW

CGHS card is valid for Referral to empanelled HCOs of pensioner beneficiaries through Referral Module, irrespective of City / WC where the card is registered: MOHFW

File No.44/60/MCTC/CGHS2021
F No. 44/60/MCTC/CGHS2021 /DIR/CGHS/
Government of India
Ministry of Health & Family Welfare
Department of Health & Family Welfare

Nirman Bhawan, New Delhi
Dated the January , 2022.

OFFICE ORDER

Sub: CGHS card is valid for Referral to empanelled HCOs of pensioner beneficiaries through Referral Module, irrespective of City / WC where the card is registered.

With reference to the above mentioned subject the undersigned is directed to state that this Ministry is in receipt of representations from CGHS pensioner beneficiaries in availing treatment facilitates on a visit to another CGHS covered city IWC. The matter has been reviewed and it is decided to issue the following clarifications in this regard:

1. CGHS card is valid at any Wellness Centers in India for availing CGHS facilities, irrespective of the WC/ City, where it is registered.
2. Empanelled HCQOs shall provide treatment on credit basis to CGHS pensioner beneficiaries on referral or in medical emergency to all CGHS pensioner beneficiaries , ex-MPs , etc., irrespective of the City / Wellness Centre where the CGHS Card is registered and the credit bill shall be sent to the CGHS of the City where the treatment is taken. Online referrals issued by Wellness Centres through the CGHS Referral Module can be accessed by any CGHS empanelled HCO, located pan India. Suitable action shall be taken against erring, HCOs in case of violation of these guidelines. HCOs shall suitably brief their staff at the reception counters.
3. Medical Officers of CGHS shall refer the CGHS pensioner beneficiaries, etc., through the referral module regardless of the WC/ CGHS City, where the CGHS Card is registered. There is provision in the online referral module used by GDMOs, to view all referrals issued to a beneficiary by CGHS Wellness Centres across the country, in the last 06 months, thereby avoiding duplication of referrals. GDMOs also have access to the NHA dashboard to search all the referrals issued to a beneficiary by any CGHS Wellness Centre in India.
4. However, in case of availing treatment / investigations in Mumbai City , the referral for any CGHS beneficiary is to be made from any CGHS Wellness Centre in Mumbai only as on date. Similarly , for treatment outside Mumbai, CGHS pensioner beneficiaries of Mumbai shall be referred by Medical Officers of other cities.
5. Additional Directors, CGHS of all Cities / Zones shall circulate a copy of this Order to all CGHS Wellness Centres for strict compliance by Medical Officers.
6. Similarly, Additional Directors, CGHS of all Cities shall circulate a copy of this Order to all the HCOs empanelled in the city concerned and ensure that these orders are complied with.
7. A copy of this Order shall be displayed on the Notice Board of CGHS Wellness Centre.

Digitally Signed by
Nikhilesh Chandra
Date: 18-01-2022 14:33:25
Reason: Approved
[Dr Nikhilesh Chandra]
Director, CGHSP
Tel 011-2306 2800

To:

1. CMOs -in-charge and other Medical Officers of all CGHS Wellness Centres in India through the Addl. Director of city ‘Zone

2. Addl.DDG(HQ) / Addl. Director(HQ) / Addl. Director(MSD)/ Addl. Directors of all CGHS Cities / Zones / Joint Director(HQ)/ Joint Director(R&H)/ Joint Director(Gr. Cell)/ Sr CMO (HEC)/ CMO (Hosp. Cell)

Copy to

1. PPS to AS&DG,CGHS, MoHFW
2. PS to JS (A), MoHFW
3. PA to Director, CGHS

Copy for information to
PS to Hon’ble HFM
PS to MoS, Health

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