Simplification of procedure for investigations and treatment related to COVID-19: CGHS

Simplification of procedure for investigations and treatment related to COVID-19 for CGHS Beneficiaries & Staff : CGHS OM dated 20.05.2021

Misc.1-55/2021/CGHS(HQ)/R&H/DIR/CGHS
Govt. of India
Min. of Health & Family Welfare
Department of Health & Family Welfare
Directorate General of CGHS

545-A Nirman Bhawan, New Delhi.
Dated the 20th May , 2021

OFFICE MEMORANDM

Subject : Simplification of procedure for investigations and treatment related to COVID-19-Infection

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With reference to the above subject the undersigned is directed to state that this Ministry is taking several measures to contain the resurgence of COVID-19 cases. In this regard this Ministry is in respect of the difficulties faced by CGHS beneficiaries in availing treatment / investigation facilities for COVID-19 patients under Homecare treatment. There is also need to minimize the exposure of normal CGHS beneficiaries / CGHS Staff to COVID-19 +ve / suspected COVID-19 cases . The matter has been reviewed in the Ministry and the undersigned is directed to state that it is now decided to take the following measures to simplify the procedures for investigations and treatment related to COVID-19:

i) The CGHS beneficiaries, both Primary Card Holders or their dependent family members, who are suffering from symptoms suggestive of COVID-19 illness shall not visit the CGHS Wellness Center for permission of RT-PCR/ RAT. They are advised to send the request by e-mail to CMO i/c of CGHS Wellness Centre, who shall recommend and refer the beneficiary to any empanelled HCO for the test by e-mail to beneficiary on the same day of receipt of request. All the diagnostic labs and other HCOs shall provide the facility of testing for RT-PCR/ RAT on credit basis to the pensioner beneficiaries and the other eligible category serving employees of the CGHS/ DGHS/ MoHFW. The other serving employees shall pay for the test as per the rates notified by the State Government and claim reimbursement from their respective offices subsequently.

The beneficiaries also have the option to undergo RT-PCR/ RAT test done directly at any of the Central Govt./state Government COVID Test Centres, where no prescription is required

ii) CGHS beneficiaries who are tested positive and have been permitted for Home Quarantine by local authorities / DISO have the option to avail Tele-medicine services with Government specialists under CGHS through the e-Sanjeevani portal. They can also avail tele-consultation services with Govt. Specialists on e-Sanjeevani portal, run by different State Governments.

iii) In case, any beneficiary further investigations for inflammatory markers like CRP, D-Dimer, IL-6, or any other routine or specialized investigation like HRCT etc, no permission is necessary for investigations having a CGHS rate. If there is no CGHS rate for any investigations, the beneficiary shall apply for approval from concerned Additional Director, enclosing a copy of advice on Tele-consultation and CGHS Card. Permission shall be granted by CGHS, preferably on the same day by e-mail to the beneficiary (in respect of all CGHS beneficiaries).

iv) Essential medicines advised for Home isolation treatment can be purchased from Market during the period of isolation and the bills may be preferred to the respective Ministry / Departments / concerned Autonomous body in case of serving employee and CGHS beneficiaries of Autonomous Bodies and to CGHS in case of Pensioners, ex-MPs, etc., as the case may be for reimbursement. Medicines like Remdesivir, Tocilizumab are reserved only for patients who are hospitalized and therefore, no reimbursement shall be permitted for such medicines which are not to be administered to patients in Home isolation. Food supplements and such other inadmissible items shall however, not be considered for reimbursement.

The contact numbers and e-mail of CGHS WCs and Additional Directors are available on CGHS Website at cghs.gov.in at the following link-

https://cghs.gov.in/index4.php?lang=1&level=0&linkid=320&lid=615

(Dr. Sanjay Jain)
Director, CG

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