Simplification of CGHS Procedure for treatment in Private Hospitals empanelled by CGHS/CS (MA) Rules, 1944

Simplification of CGHS Procedure for treatment in Private Hospitals – No permission or referrel letter – CGHS OM dated 09.11.2017

Z 15025/105/2017/DIR/CGHS/EHS

Government of India

Ministry of Health & Family Welfare

Department of Health & Family Welfare

EHS Section

***

Nirman Bhawan, New Delhi

Dated the 9th November, 2017

OFFICE MEMORANDUM

Sub:  Simplification  of  procedure  for  treatment  at  private  hospitals empanelled  under CGHS/CS (MA) Rules, 1944

With reference to the above mentioned subject the undersigned is directed to state that this Ministry has been receiving representations for simplification of procedure for undergoing treatment at private hospitals empanelled under CGHS.  The matter has been examined and it has now been decided that CGHS beneficiaries are allowed to undergo treatment at private hospitals empanelled under CGHS of specific treatment procedures listed under CGHS rate list are advised by a Specialist in a Central Government / State Govt. Specialist hospital or a CGHS Medical Officer without any requirement of any other referral (permission) letter.

2. Private empanelled hospitals shall perform the treatment on cashless basis in respect of pensioners, ex-MPs, Freedom Fighters, Regular employees {both CGHS and CS (MA) beneficiaries} of this Ministry & other categories of CGHS beneficiaries, who are presently eligible for credit facility and shall enclose the prescription issued by Government Specialist or a CGHS Medical Officer, in original (or a self-attested photocopy) along with the hospital bill submitted to the competent authorities.

3. Serving  government  employees  shall  enclose  the  prescription  issued  by  a  Government Specialist or a CGHS Medical Officer in original (or a self-attested photocopy), while submitting the medical claim to the concerned Ministry /department/office for reimbursement.

4. CGHS  Medical  Officer  /  Government  Specialist  shall  not  refer  the  beneficiaries  to  any particular empanelled hospital by name but, shall specify the treatment procedure and mention‘referred to any CGHS empanelled centre’.

5.  These orders are applicable only in respect of treatment procedures for which CGHS rates are available.

6.  This issue with the concurrence of IFD vide FTS No. 3130849, dated 09.11.2017.

[Sunil Kumar Gupta]

Under Secretary to Government of India

Tel- 011-2306 1986

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