Showing posts with label CGHS. Show all posts
Showing posts with label CGHS. Show all posts

Wednesday, 1 April 2020

Reimbursement of OPD Medicines Special Sanction in view of COVID-19



Reimbursement of OPD Medicines Special Sanction in view of COVID-19

Z 15025/12/2020/ DIR/CGHS
Government of India
Ministry of Health & Family Welfare
Directorate General of CGHS

Nirman Bhawan, New Delhi
Dated the 27th March, 2020.

OFFICE MEMORANDUM

Sub: Reimbursement of OPD Medicines Special Sanction in view of COVID-19

In view of the Corona Virus Disease (COVID-19) , all out efforts are made by the Government to contain its impact by instituting measures at community as well as at individual level.

Guidelines for maintaining social distancing between individuals have already been issued by the Government. In the spirit of above guidelines the undersigned is directed to state that CGHS beneficiaries getting medicines for chronic diseases may purchase medicines based on the prescription held (prescribed by CGHS Medical Officers / CGHS Specialists /other Govt. Specialists/ Specialist of empanelled hospital) till 30th April 2020 irrespective of Non-Availability certificate from CGHS or otherwise . The idea behind the measures is that CGHS beneficiaries need not visit CGHS Wellness Centres to collect medicines till 30th April 2020.

The medical claim shall be submitted to CGHS by pensioners, ex-MPs etc., through CGHS Wellness Centre , where the card is registered , to concerned Ministry /Department in case of serving employees , to the Rajya Sabha Secretariat / Lok Sabha Secretariat ,as the case may be in respect of Hon’ble Members of Parliament and to the concerned Autonomous Body in case beneficiaries of Autonomous Bodies.

These orders shall come into force with immediate effect.

(Dr. Sanjay Jain)
Director, CGHS

Monday, 20 January 2020

CGHS- Extension of validity period of empanelment of Contacare Eye Hospital

CGHS- Extension of validity period of empanelment of Contacare Eye Hospital

GOVERNMENT OF INDIA
OFFICE OF THE ADDITIONAL DIRECTOR
CENTRAL GOVERNMENT HEALTH SCHEME
NEW A.G.Colony, DORANDA, RANCHI-834002
TELEPHONE & FAX NO. -0651 -2480147

No CGHS /Continuous/2019-2020/67

Date- 18/12/2019

Office Order

Sub: Extension of validity period of empanelment of already empanelled Health Care Organization under CGHS Ranchi as interim measure.

With reference to the above mentioned subject the competent authority has decided to extend the empanelment of Contacare Eye Hospital for a further period of 02 (two) years w.e.f. 20/12/2019 or till next empanelment whichever is earlier on same terms, conditions and rates on which they are presently empanelled

Additional Director
CGHS, Ranchi

Copy to

1.  Addl DDG(HC)/OH & FW, Nirman Bhawan, New Delhi.
2. Nodal Officer, MCTC.
3. Sr. CMO (HEC) 524 A Wing, Nirman Bhawan, New Delhi.
4. UTl-TSL,153/1, First Floor O/c Madras Road, Ulsoor, Bengaluru-560008
5. Secretary, Central Co-orc1notion Committee, O/o Principal Accountant General Ranchi,83 4002

Friday, 17 January 2020

CGHS Package Rates for 15 Investigations under CGHS 2020


CGHS Package Rates for 15 Investigations under CGHS 2020
CGHS Package Rates for 15 Investigations under CGHS 2020

CGHS

S-1101110912019/ Addg.HQ/ CGHS
Government of India
Ministry of Health and Family Welfare
Department of Health & Family Welfare
Directorate General of CGHS

Nirman Bhawan, New Delhi
Dated the 14th January,2020

OFFICE MEMORANDUM

Subject: Notification of CGHS Rates for 15 Investigations under CGHS

With reference to the above mentioned subject the undersigned is directed to draw attention to the Office memorandum No S.11045/ 36/2012-CGHS (HEC) dated 01.10.2014 vide which CGHS package rates for various treatment procedures and investigations were notified by the Government for Health Care Organizations (HCOs) empanelled under CGHS and to state that representations from various stake holders regarding non-availability of CGHS rates for some of the investigations have been received in this Ministry. The matter was reviewed and it is now decided to notify CGHS package rates for the following investigations and their inclusion in CGHS rate list as under:

S. No.Name of Unlisted Investigations/ Unlisted ImplantRecommended Rates (in Rupees)
1.Kappa Lambda Light Chains, Free, Serum3500/-
2Serum IGE level300/-
3NT-Pro BNP1800/-
4CECT Chest2500/-including CD
5MRI-Prostate (Multi-parametric)6000/-including CD
6HCV RNA Quantitative1500/-
7Tarcolimus2300/-
8Protein Creatinine Ratio, Urine120/-
9Fibroscan Liver1000/-
10HLA B27 (PCR)500/-
11Montoux Test175/-
12Procalcitonin1800/-
13TORCH Test1120/
14Lntracoronary OCT (AIIMS Rates)65000/-+GST
15FFR Wire cost (AIIMS Rates)Wire as per AIIMS rates of Rs. 23500 + GST And procedure charges as per existing CGHS rates of Rs. 15000 for NABH and Rs. 12750 for Non NABH hospitals

The rates for investigations from S.No.1 to S.No.13 are for Non-NABL/ Non-NABH accredited HCOs. The rates for NABL/ NABH accredited HCOs shall be 15% more. The rates from S.No.14 &15 shall be common for both NABH-accredited /Non-NABH accredited HCOs.

Also check: CGHS medical facilities reimbursement to Central Government pensioners

These rates shall come in to force from the date of issue of the letter.

This issues with concurrence of Integrated Finance Division of Ministry of Health & Family Welfare vide CD No 3495 dated:13.01.2020.

Sd/-(Dr. Manoj Jain)
Addl. DDG (HQ), CGHS

Read this: CGHS - Medical benefits to dependent parents of Central Government Employees

Tuesday, 17 December 2019

CGHS – Medical benefits to dependent parents of Central Government Employees

CGHS – Medical benefits to dependent parents of Central Government Employees

CGHS

Medical benefits to dependent parents of Central Government Employees

CGHS – Medical benefits to dependent parents of Central Government Employees
 13 DEC 2019

For availing of medical facilities under Central Government Health Scheme (CGHS), parents are deemed to be dependent on the Central Government employee if they are normally residing with the employee and their monthly income from all sources including pension/ family pension does not exceed Rs. 9,000 plus the amount of Dearness Relief thereon. This condition of dependency is applicable to Pensioners of State Government(s) as well.

Also check: CGHS medical facilities reimbursement to Central Government pensioners

Regarding any scheme for providing medical facility to the dependent parents of employees of private sector, The Employees’ State Insurance (ESI) Act, 1948 read with ESI (Central) Rule, 1950 provides for medical benefits to the dependent parents of the Insured person i.e. an employee who works in a factory/ establishment having 10 or more workers & registered under the said Act and drawing salary less than Rs. 21,000 per month (Rs. 25,000 in case of persons with disability). Income limit for dependency of parents from all sources is Rs. 9,000 per month. The ESI Act is not applicable to Central Government employees and their dependents.

The Minister of State (Health and Family Welfare), Sh Ashwini Kumar Choubey stated this in a written reply in the Lok Sabha here today.

PIB

Friday, 6 December 2019

CGHS medical facilities reimbursement to Central Government pensioners

CGHS

CGHS medical facilities reimbursement to Central Government pensioners

CGDA, Ulan Batar Road, Palam, Delhi Cantt.-110010
(Ph.011-25665714,25665560/ Fax-011-25674806/ Email: admin14.cgda@nic.in)

IMPORTANT CIRCULAR

No.AN/XIV/19015/ Govt. Orders/TA /DA/LTC/ Medical

To,
All PCsDA/ CsDA/ PCA (Fys.)
(Through website)

Dated: 29/11/2019

Subject: Reimbursement of medical claims to Pensioners under CS(MA) Rules 1944 - guidelines issued by Ministry of Health & Family

Ministry of Health and Family Welfare vide its OM No. S.14025/23/2013-MS.EHSS dated 29th September 2016 has clarified that CS (MA) Rules 1944 are not applicable to pensioners till date. The Ministry has issued the following guidelines for medical facilities to Central Government pensioners:-

Also check: CGHS - Central Government Health Scheme

a) Pensioners residing in CGHS covered areas:

  1. They can get themselves registered in CGHS dispensary after making requisite contribution and can avail both OPD and IPD facilities.
  2. Pensioners residing in CGHS areas cannot opt out of CGHS and avail any other medical facility (i.e. Fixed Medical Allowance). Such pensioners, if they do not choose to avail CGHS facility by depositing the required contributions, cannot be granted Fixed Medical allowance in lieu of CGHS.

b) Pensioners residing in non-CGHS areas:

  1. They can avail Fixed Medical Allowance (FMA) © Rs. 500/- per month revised to Rs. 10001- from 01.07.2017.
  2. They can also avail benefits of CGHS (OPD and IPD) by registering themselves in the nearest CGHS city after making the required subscription.
  3. They also have the option to avail FMA, for OPD treatment and CGHS for IPD treatments after making the required subscriptions as per CGHS guidelines.
2. All retired/ retiring Officers/ Staff of the Defence Accounts Department may please be advised to adhere to the above provisions and subscribe to CGHS facility by depositing the required contributions for availing medical facilities after retirement.

This issues with the approval of Sr. Jt. CGDA (AN).

(Rajeev Ranjan Kumar) Dy. CGDA (AN)

Friday, 29 November 2019

Extension of CGHS Dispensaries/Hospitals

Ministry of Health and Family Welfare

Extension of CGHS Dispensaries/Hospitals


The   norms   for   establishment   of   new   Wellness   Centre   under   CGHS   are   as   under:-

I. In an existing CGHS City:-

For opening of a new CGHS Wellness Centre in an existing CGHS  City,  there  has  to  be  a  minimum  of  2000  Card  holders  (serving  employees  of Central Government and Central Civil Pensioners).

Also check: NPS covered pensioners allowed to use CGHS facilities without any bar of minimum qualification service

II. Extension of CGHS to a new City:-

For extension of CGHS to a new City, there has to be a minimum of 6000 Card holders.

At present, there is no such proposal. Opening of new CGHS Wellness Centre is considered as per the extant norms in this regard, subject to availability of resources.

The Minister of State (Health and Family Welfare), Sh Ashwini Kumar Choubey stated this in a written reply in the Lok Sabha here today.

Source: PIB

Sunday, 20 October 2019

7th CPC dress allowance for CGHS employees


7th pay commission dress allowance for CGHS employees

7th CPC dress allowance for CGHS employees

7th CPC Dress Allowance

File No.A.27011/1/2019-CGHS.II
Government of India
Ministry of Health & Family Welfare
CGHS-II Section
Nirman Bhawan, New Delhi
Dated 26.09.2019
To
The Additional Directors,
All CGHS cities

Subject: Grant of Dress Allowance for CGHS employees - regarding.

Sir/Madam,
The undersigned is directed to refer to this Ministry’s O.M of even no. dated 23.08.2018 regarding grant of dress allowance in lieu of Uniform Allowance and Washing Allowance to eligible employees of CGHS as per recommendations of 7th CPC. All Additional Directors are requested to issue necessary instructions to all employees concerned under their administrative control to wear uniform while on duty. It may be made sure that guidelines in this regard are strictly be adhered to and instances of employees not adhering to the said instructions may be brought to the notice of this Ministry.

2. This issues with the approval of SS & DG (CGHS).

Also read: 7th CPC Payment of dress allowance
Yours faithfully,
(Dharminder Singh)
Under Secretary to the Government of India

Saturday, 28 September 2019

CGHS facilities to NPS covered Pensioners


NPS covered pensioners allowed to use CGHS facilities without any bar of minimum qualification service

CGHS facilities to NPS covered Pensioners

CGHS facilities to NPS covered Pensioners

 National Council (Staff Side)



The Secretary,
Ministry of Health & Family Welfare,
Nirman Bhawan,
New Delhi-110011
Dated: September 26, 2019
Dear Sir,

Sub: CGHS facilities to NPS covered Pensioners - Req.
Ref.: Ministry of Health & Family Welfare, Government of India’s G.O.No.S.11011/ 10/2012- CGHS(P)/ EHS dated 28.03.2017

Your kind attention is invited towards the above referred to O.M. dated 28th March, 2017, wherein a condition of Minimum Qualifying Service of 10 years has been laid down for availing CGHS facilities for NPS covered pensioners.

Also check: Good news for NPS employees

In this connection, it would not be out of context to mention that, a substantial number of Gramin Dak Sewaks became regular employees of the Postal Department, crossing age of 50 years. All these CDSs, on having been regularised as Postal Employees after 50 years of age, are thus deprived of CGHS facilities on account of above-mentioned condition of minimum 10 years Qualifying Service, as such, the said condition is uncalled for an irrational.

It is, therefore, requested that, the matter may please be looked into in the foregoing, and the same be dispensed with, so that, any regular Government Employee on superannuation, may be NPS covered pensioners, should be allowed to avail CGHS facilities without any bar of Minimum Qualifying Service in the larger interest of justice.

Also check: Guidelines regarding Merger of 33 Postal dispensaries with CGHS
Yours faithfully,
(Shiva Gopal Mishra)
Secretary
CGHS-facilities-to-NPS-covered-Pensioners




Monday, 9 September 2019

Issue of OPD Medicines for CGHS beneficiaries going abroad - CGHS

CGHS

Issue of OPD Medicines for CGHS beneficiaries going abroad
No.1-40/2019-CGHS/C&P/DIR/CGHS
Government of India
Ministry of Health and Family Welfare
Department of Health & Family Welfare
Directorate General of CGHS

Nirman Bhawan, New Delhi 110 011
Dated the 19th August , 2019
OFFICE ORDER

Subject: - Issue of OPD Medicines for CGHS beneficiaries going abroad


With reference to the above subject the undersigned is directed to draw attention to Circular No 4-20/2003 - C&P Section dated the 28th April , 2005 vide which guidelines were issued for supply of OPD Medicines for upto '6' months to CGHS beneficiaries , who are going to stay abroad and to state that the matter has been reviewed by this Ministry and it is now decided in modification of the earlier guidelines that hereinafter, Chief Medical Officer I/C of concerned CGHS Wellness Centre is empowered for issue of OPD medicines for upto six months to the CGHS beneficiaries visiting abroad, subject to submission of the following documents:

(a) Copy of valid CGHS Card.
(b) Valid prescription for six months.
(c) Documentary Proof of going abroad like ticket , visa etc.
(Dr. Atul Prakash)
Director, CGHS
Source: CGHS

Thursday, 5 September 2019

Annual Health Check-up at Hospitals empanelled under CGHS in respect of CGHS Pensioner beneficiaries aged 75 years and above

CGHS

Annual Health Check-up at Hospitals empanelled under CGHS in respect of CGHS Pensioner beneficiaries aged 75 years and above

Z 15025/ 36/2019/ DIR/CGHS/ CGHS(P)pt
Government of India
Ministry of Health & Family Welfare
Department of Health & Family Welfare
Nirman Bhawan, New Delhi
Dated, the 19th August, 2019
OFFICE MEMORANDUM

Subject: Annual Health Check-up at Hospitals empanelled under CGHS in respect of CGHS Pensioner beneficiaries (Primary card holders) aged 75 years and above- regarding

With reference to the above mentioned subject, the undersigned is directed to state that the matter relating to Annual Health Check-up at private hospitals empanelled under CGHS in respect of elderly CGHS beneficiaries was under consideration at this Ministry and it has now bean decided that hereinafter, CGHS Pensioner beneficiaries {Primary Card holders) aged 75 years and above shall be permitted to undergo ‘Annual Health Check-up’ at CGHS empanelled hospitals.

Permission in respect of CGHS Pensioner beneficiaries (Primary Card holders) aged 75 years and above shall be granted by CMO in charge of CGHS Wellness Centre.

The private hospitals empanelled under CGHS shall perform the Annual Health Check-up at CGHS rates and extend cashless facility for the same in respect of CGHS Pensioner beneficiaries (Primary Card holders) aged 75 years and above.

(Rajeev Attri)
Under Secretary to Government of India
Source: CGHS

Tuesday, 3 September 2019

CGHS Clarification regarding issue of Medicines prescribed by Specialists beyond the period for which the medicines had been advised


CGHS

Clarification regarding issue of Medicines prescribed by Specialists beyond the period for which the medicines had been advised
Government of India
Ministry of Health and Family Welfare
Department of Health & Family Welfare
EHS Section
No: Z.15025/23/2018/ DIR/CGHS
Nirman Bhawan, New Delhi 110 11
Dated the 17th June ,2019
OFFICE MEMORANDUM

Subject:- Clarification regarding issue of Medicines prescribed by Specialists beyond the period for which the medicines had been advised

With reference to the above subject the undersigned is directed to state draw attention to the OM Z.15025/33/ 2018/DIR/CGHS dated the 1st May 2018 and to clarify that:
i. In Chronic cases where diagnosis has been made and line of treatment has been decided by the Specialist of CGHS/Govt. /empanelled hospital, there is no need to refer the patients just for extension of validity period of prescription. The prescriptions in such cases may be repeated by the concerned doctor of CGHS Wellness Centre.
ii. Only in such cases, wherein there is a need for modification of the diagnosis and/or modification of the line of treatment, beneficiaries should be referred to the concerned specialist.
iii. However, in case of specific anti-cancer and other immune-suppressant drugs, medicines may be issued only for such periods as advised by the concerned specialists.
These orders are in supersession of all the earlier orders on the subject.
(Dr. Atul Prakash)
Director, CGHS
To
  1. All Ministries/ Departments , Government of India through CGHS Website 2. Addi. DDG(HQ), CGHS, MoHFW, Nirman Bhawan, New Delhi
  2. AD(HQ} , CGHS, R.K.Puram, Sector-12, New Delhi 4. All Addi. Directors/Joint Directors of CGHS
  3. DDG(M) /CMO(SRA} , Dte.GHS, MoHFW, Nirman Bhawan, New Delhi
  4. Rajya Sabha/Lok Sabha Secretariat, New Delhi
  5. Registrar, Supreme Court of India, New Delhi
  6. U.P.S.C. Dholpur House, New Delhi
  7. Office of the Comptroller & Auditor General of India, Bahadur Shah Zafar Marg, New Delhi
  8. Director, Department of Pension & Pensioners Welfare, Lok Nayak Bhawan, Khan Market, New Delhi
  9. PPS to Secretary (H&FW)/Secretary (AYUSH)/ Secretary (HR}, Ministry of Health & Family Welfare
  10. PPS to DGHS/ SS&FA /AS&DG (CGHS)/ AS&MD, NRHM/AS(H), MoHFW, New Delhi
  11. MS Section, MoHFW, Nirman Bhawan, New Delhi
  12. MG-II Section, Dte.GHS, Nirman Bhawan, New Delhi
  13. Hospital Empanelment Cell, CGHS, MoHFW, Nirman Bhawan, New Delhi
  14. CGHS-1/11/111/IV, Dte. Gen of CGHS, MoHFW, Nirman Bhawan, New Delhi
  15. Estt.l/Estt.11/ Estt.111/Estt.IV Section, MoHFW, Nirman Bhawan, New Delhi
  16. Admn./ Admn .11 Section, Dte.GHS, MoHFW, Nirman Bhawan, New Delhi
  17. Integrated Finance Division, MoHFW, Nirman Bhawan, New Delhi
  18. All Officers/ Sections/ Desks in the Ministry
  19. Deputy Secretary (Civil Service News), Department of Personnel & Training, 5th Floor, Sardar Patel Bhawan, New Delhi
  20. Secretary, Staff Side, 13-C, Ferozshah Road, New Delhi
  21. All Staff Side Members of National Council (JCM)
  22. ED(H)/Planning, Railway Board, Ministry of Railways, Rail Bhawan, Rafi Marg, New Delhi - 110001
  23. Central Organization , ECHS, Department of Ex-Servicemen Welfare, Ministry of Defence, New Delhi
  24. Chairman, Employees State Insurance Corporation, Ministry of Labour & Employment, Panchdeep Bhawan, C.l.G. Marg, New Delhi-110002
  25. UTI Infrastructure Technology And Services Limited, UTl-ITSL Tower, Plot No3 Sector -11, CBD Belapur, Navi Mumbai- 400614
  26. Hindi Section, MoHFW, Nirman Bhawan, New Delhi for providing Hindi version of this OM.
  27. Guard file
Source: CGHS

Saturday, 24 August 2019

Issue of OPD Medicines for CGHS beneficiaries going abroad


Issue of OPD Medicines for CGHS beneficiaries going abroad

No.1-40/2019-CGHS/ C&P/DIR/CGHS
Government of India
Ministry of Health and Family Welfare
Department of Health & Family Welfare
Directorate General of CGHS

Nirman Bhawan, New Delhi 110 011
Dated the 19th August , 2019
OFFICE ORDER

Subject: Issue of OPD Medicines for CGHS beneficiaries going abroad

With reference to the above subject the undersigned is directed to draw attention to Circular No 4-20/2003-C&P Section dated the 28th April, 2005 vide which guidelines were issued for supply of OPD Medicines for upto ‘6’ months to CGHS beneficiaries, who are going to stay abroad and to state that the matter has been reviewed by this Ministry and it is now decided in modification of the earlier guidelines that hereinafter, Chief Medical Officer I/C of concerned CGHS Wellness Centre is empowered for issue of OPD medicines for upto six months to the CGHS beneficiaries visiting abroad, subject to submission of the following documents:
(a) Copy of valid CGHS Card.
(b )Valid prescription for six months.
(c) Documentary Proof of going abroad like ticket, visa etc.
sd/-
(Dr. Atul Prakash)
Director, CGHS
Source: Confederation

Saturday, 27 July 2019

CGHS facilities to the retired BSNL / MTNL employees who are in receipt of pension from Central Civil Estimates – Revised mapping for determining CGHS subscription and Ward entitlement

CGHS facilities to the retired BSNL / MTNL employees who are in receipt of pension from Central Civil Estimates – Revised mapping for determining CGHS subscription and Ward entitlement

No. 4-12(12)/ 2018-PAT-Part(1)
Government of India
Ministry of Communications
Department of Telecommunications
(PAT Section)

New Delhi, dated 1st July, 2019

OFFICE MEMORANDUM

Subject: CGHS facilities to the retired BSNL / MTNL employees who are in receipt of pension from Central Civil Estimates – Revised mapping for determining CGHS subscription and Ward entitlement.

The undersigned is directed to refer to this Office Memorandum No. 4-12(11)/2012- PAT(Part) dated 31.08.2016 vide which CGHS facilities were extended to retired BSNL / MTNL employees who receive pension from Central Civil Estimates.

The rates of monthly CGHS subscription and entitlement of Wards in Private hospitals empanelled under CGHS have been revised with effect from 01-01-2017 by Ministry of Health and Family Welfare vide OM No. S.11011/11/2016-CGHS(P)/EHS dated 09.01.2017. This has necessitated corresponding revision in mapping of Pay & scales from IDA to CDA as circulated vide O.M. dated 31.08.2016.

Accordingly, Annexures to the said O.M. dated 31.8.2016 stand revised as enclosed w.e.f. 1.1.2017 to enable CGHS in deciding the rate of CGHS contribution and ward entitlement in respect of retired BSNL/MTNL employees who receive pension from Central Civil Estimates and avail CGHS facilities.

This issues with the approval of Member (Services).

Enclosures: As above

(Bulley Mishra)
Assistant Director General (PAT)
Phone 011 2303 6245

Annexure-A

CDA/IDA correspondence for deciding Monthly Contributions for availing CGHS facility
(A1) Case of BSNL retirees:

7th CPC Pay Matrix LevelMonthly Contribution
Level 1 to Level 5Rs. 250/-
Level 6Rs. 450/-
Level 7 to Level 11Rs. 650/-
Level 12 and aboveRs. 1000/-

(A2) Case of MTNL retirees:

7th CPC Pay Matrix LevelMonthly Contribution
Level 1 to Level 5Rs. 250/-
Level 6Rs. 450/-
Level 7 to Level 11Rs. 650/-
Level 12 and aboveRs. 1000/-



Friday, 19 July 2019

Simplification of the Procedure in CGHS


Ministry of Health and Family Welfare
Simplification of the Procedure in CGHS
19 JUL 2019
CGHS Wellness Centres provide primary health care facilities and, if required, refer the beneficiaries to the Specialists at Government Hospitals/ Private Hospitals empanelled under CGHS. In emergency conditions, no endorsement for any treatment/ investigation is required from CGHS Wellness Centre. However, in non-emergency conditions or unlisted treatment/ tests, endorsement from concerned CGHS Wellness Centre is required.

With a view to facilitate ease of availing consultations from Specialists at empanelled hospitals, Government has permitted elderly CGHS beneficiaries aged 75 years and above to seek consultations from Specialists without any referral and undergo treatment/ investigations without endorsement. Permission is required only for unlisted treatment procedure/ tests in non-emergency conditions.
The guidelines for referral issued vide Office Memorandum No. Z.15025/117/2017/DIR/ CGHS/EHS, dated the 15th January, 2018 have been modified vide Office Memorandum No. Z.15025/117/2017/ DIR/CGHS/EHS, dated the 10th December, 2018 and the following modifications have been made in the interest of sick people, pensioners and serving employees:-

The referral shall be valid for consultations upto 3 times in the same hospital within 30 days.
CGHS beneficiaries have been permitted to consult upto 3 Specialists, if required during a single visit.

III. Investigations advised by Specialist of Private Empanelled Hospitals may be undertaken if they are required in emergency as certified by Specialist without endorsement by CGHS.

The Minister of State (Health and Family Welfare), Sh Ashwini Kumar Choubey stated this in a written reply in the Lok Sabha, here today.

PIB

Saturday, 13 July 2019

Health Insurance Scheme for CGHS Beneficiaries

Ministry of Health and Family Welfare
Health Insurance Scheme for CGHS Beneficiaries

12 JUL 2019

The Sixth Central Pay Commission in its report had recommended the introduction of a Health Insurance Scheme for central government employees and pensioners and their dependent family members on pan India basis. Ministry of Health & Family Welfare has framed the draft health Insurance Scheme. OPD facilities are not covered under the proposed scheme. The draft scheme has been sent to the Department of Expenditure, Government of India, for appraisal and approval of the financial feasibility of the scheme.

The Minister of State (Health and Family Welfare), Sh Ashwini Kumar Choubey stated this in a written reply in the Lok Sabha here today.

PIB

Friday, 3 May 2019

KVS - Extension of CGHS facilities to the retired employees of Kendriya Vidyalaya Sangathan

KVS - Extension of CGHS facilities to the retired employees of Kendriya Vidyalaya Sangathan

KENDRIYA VIDYALAY SANGATHAN
18 Industrial Area, Shaheed Jeet Singh Marg,
New Delhi – 110 016
The Deputy Commissioner/Director
Kendriya Vidyalaya Sangathan
All Regional Offices / ZIETs

Subject:- Guidelines to implement O.M. dated 13.03.2019 for extension of CGHS facilities to the retired employees of Kendriya Vidyalaya Sangathan – regarding.

Sir/Madam,
In continuation of KVS Office Memorandum of even no. dated 13.03.2019 vide which the approval of the Competent Authority of KVS for extension of CGHS facility to the retired employees of KVS who were having CGHS card while in service and residing in CGHS covered cities was conveyed. In this connection, the following guidelines may be kept in mind while processing the requests made for making of new CGHS card by the retired employees:-

A. A retired employee of KVS who was having CGHS card while in service and is residing in CGHS covered areas can opt for CGHS facility by submitting his / her application along with relevant documents and CGHS contribution to the concerned Pension Sanctioning Authority (PSA) which has released his / her pensionary benefits. As per 7th CPC, the revised monthly subscriptions, as decided by Ministry of Health & Family Welfare vide their O.M .No. 5.11011/11/2016-CGHS(P)/EHS dated 09.01.2017, to be made by employees/ pensioners for availing CGHS facilities are as under:-

S. No.Corresponding levels in the Pay Matrix as per 7th CPCContribution (Rs. Per month)
1Level: 1 to 5250
2Level: 6450
3Level: 7 to 11650
4Level: 12 & above1000

B. On receipt of application from the retired official, the concerned Pension Sanctioning Authority i.e. Regional Office (R.O)/ZIETs/ Kendriya Vidyalaya Sangathan (HQ) will verify the particulars filled in the application form and enclosed documents as required by CGHS Authority i.e. self-attested photocopy of the LPC, PPO, Aadhar Card, CGHS card while in service, employee contribution as per 7th CPC as applicable to the concerned employee in accordance to his / her pay level at the time of retirement. Thereafter, PSA will write a letter for discontinuation of payment of fixed medical allowance (FMA) to the Pension Disbursing Authority (PDA) i.e. State Bank of India, Parliament Street, New Delhi. The PSA will forward the application form along with Cheque / draft for the amount as per the CGHS rate applicable with reference to residential address of the official concerned to the Deputy Commissioner concerned of the Regional Office having jurisdiction over the CGHS city wherein the official is residing.

Illustration
A Deputy Commissioner or Assistant Commissioner or Administrative Officer is retired from Mumbai Region having CGHS card while in service & residing in Lucknow i.e. CGHS covered area. He / she will submit his / her application (along with his employee-contribution as per 7th CPC in favour of, KVS, HQ and documents stated in para B) to the PSA (KVS, HQ). The PSA will verify the application form and forwarded the same to KVS, RO Lucknow along with the Cheque/DD (amount as applicable for CGHS Centre at Lucknow). Since the Deputy Commissioner, KVS RO Lucknow is having jurisdiction over CGHS Centre at Lucknow the application form will be countersigned by the Deputy Commissioner, RO Lucknow and submitted to CGHS Centre at Lucknow along with Cheque/DD and other necessary documents for preparation of CGHS card. The Deputy Commissioner RO Lucknow will also maintain a register depicting the name of the employee and family members, CGHS card no., validity of the card and the details of the pension sanction authority along with particular of Kendriya Vidyalaya or Regional office from where the official is retired. Further, Deputy Commissioner, KVS RO Lucknow, will also keep a copy of CGHS card (Index Card) issued by CGHS. All medical claims in respect of the Deputy Commissioner/ Assistant Commissioner/ Administrative Officer retired from Mumbai, will be reimbursed by Regional Office Lucknow.
C. The concerned Deputy Commissioner will forward the application to the CGHS center, along with all necessary documents including Cheque or Demand Draft after countersigning the application form, for issue of CGHS card. If the retired official is residing in the city having CGHS Centre which falls under the jurisdiction of Pension Sanctioning Authority, then the Pension Sanctioning Authority will forward the application to the concerned CGHS Centre. The Deputy Commissioner concerned will countersign the form and send it to the CGHS authority for preparation of CGHS card under intimation to the retired official as well as the Pension Sanctioning Authority.

D. The Deputy Commissioner of the RO, who has forwarded the application form to the CGHS Centre for issue of card, will maintainthe proper records and make necessary entries in CGHS card issuing register which will carry the details of Name of the employee and family members, CGHS card, validity of the card and the details of the Pension Sanctioning Authority along with particulars of Kendriya Vidyalaya/Regional Office/ZIETs from where the official retired.

E. Existing Rates of CGHS yearly contributions payable by KVS, as circulated by Directorate General of Health Services (DGHS), Nirman Bhawan, New delhi vide their Circular No. Z.22025/4/2007-CGHS (Stats. Cell) dated 02.03.2010 are given below. The concerned PSA will calculate KVS share by deducting the employee contribution as mentioned in para ‘A’ from yearly contribution as indicated below. The PSA will then forward the total amount (KVS share & employee contribution) to the respective Deputy Commissioner where the retired official is residing.

(Figures in Rs.)
S. No.CityTotal cost per card 2009- 10*
1Ahmedabad8667
2Allahabad 6292
3Bengaluru5736
4Bhopal3060
5Bhubaneswar8943
6Chandigarh11449
7Chennai5236
8Dehradun8947
9Guwahati4296
10Hyderabad6097
11Jabalpur2925
12Jaipur18464
13Kanpur8447
14Kolkata5397
15Lucknow6033
16Meerut14535
17Mumbai7372
18Nagpur8046
19Patna7765
20Pune3593
21Ranchi7068
22Shillong5553
23Thiruvanthapuram6762
24Delhi15368

*(These rates have not been revised after 2009-10 by DGHS, Nirman Bhawan, New Delhi)
F. Medical claims, if any, will be reimbursed by the Kendriya Vidyalaya/ Regional Office/ ZIETs where the official is residing. The copy of CGHS card (Index Card) issued by CGHS has to be kept for record.

Yours faithfully,
sd/-
(Dr. Shachi Kant)
Joint Commissioner (Pers.)

Friday, 26 April 2019

Frequently Asked Questions on Authorised Medical Attendant (AMA)

Frequently Asked Questions on Authorised Medical Attendant (AMA)

Who are covered by CS (MA) Rules?
They shall apply to all Government servants other than (i) these in railway
service and (ii) those of non-Gazetted rank stationed in or passing through Calcutta, whose conditions of service are prescribed by Rules made or demand to be made by the Central Government, when they are on duty, leave or Foreign Service in India or which under suspension.

Who is an AMA?
Authorised Medical Attendant (AMA) is Medical Officer in the employee of Central Government or Private Medical Practitioner appointed/ nominated by the Ministry/Department for providing medical attendance to its employees.

What is the Reimbursement in case of treatment taken under emergency at private hospital?
CS(MA) beneficiaries are being reimbursed as per the prevailing non NABH CGHS as applicable to a CGHS covered city and non-NABH rates applicable
to the nearest CGHS covered city in case of non-CGHS city, as the case may be, or the actual, whichever is less, for treatment undertaken at private hospitals under emergent condition.

What are the hospitals in which CS(MA) beneficiary are entitle for treatment under normal conditions?
CS(MA) beneficiaries and their dependent family members can get treatment from any of the Central Government hospitals/ State Government hospitals/ private hospitals and diagnostic centers recognized under CGHS/ CS(MA) Rules as per provisions.

Can a Central Government Employee gets reimbursement is treatment
undertaken aboard?

Treatment abroad is considered under CS (MA) Rules, 1944, on receipt of application in the prescribed format through the employee’s Ministry/ Department. However, approval depends on the opinion of the standing Committee constituted under these rules.

Tuesday, 19 March 2019

Extension of CGHS facilities to Kendriya Vidyalaya Sangathan retired employees


KVS: Extension of CGHS facilities to Kendriya Vidyalaya Sangathan retired employees

CGHS Facilities to Retired Employees of KVS
CGHS-facilities-Kendriya-Vidyalaya-Sangathan-retired-employees

Kendriya Vidyalaya Sangathan
18, Institutional Area, Shaheed Jeet Singh Marg
New Delhi 110 016

F.11086/01/2012-KVS(HQ)/Admn.II/291-338
Dated: 13-03-2019
OFFICE MEMORANDUM

Subject: Extension of CGHS facilities to the retired employees of Kendriya Vidyalaya Sangathan (KVS) - matter regarding.

Ministry of HRD, vide letter No.F3-5/2011-UT-2 dated:13-03-2019 has conveyed the approval of the Ministry of Health & Family Welfare O.M.No.S.11016/8/2015-CGHS (P) dated 06.03.2019 vide which Ministry of Health & Family Welfare has extended the implementation of CGHS facilities to all the retired employees of KVS, who were having CGHS cards while in service, in all CGHS covered Cities, on the same terms and conditions on which retired employees of KVS were extended CGHS facilities in Delhi/NCR vide Ministry of Health & Family Welfare OM dated 29.05.2015.

Other terms and conditions of MoH&FW OM dated 29.05.2015 circulated vide KVS (HQ) OM No.11086/01/2012-KVS HQ (Admn.II) 793/805 dated 21.08.2015 will remain unchanged.
sd/-
(Dr. Shashi Kant)
Joint Commissioner (Pers.)

Tuesday, 5 March 2019

Advisory to HCOs empanelled under CGHS regarding treatment of critically ill CGHS beneficiaries /CGHS beneficiaries undergoing treatment for Cancer

Government of India
Ministry of Health and Family Welfare
Department of Health & Family Welfare
Directorate General of CGHS
Nirman Bhawan, New Delhi 110 011
Dated the 30th January, 2019
No Z 1502511012019/DIR/CGHS
OFFICE MEMORANDUM
Subject: - Advisory to HCOs empanelled under CGHS regarding treatment of critically ill CGHS beneficiaries /CGHS beneficiaries undergoing treatment for Cancer.

With reference to the above mentioned subject all the HCOs empanelled under CGHS are hereby advised to take special care of critically ill CGHS beneficiaries /CGHS beneficiaries undergoing treatment for Cancer seeking healthcare facilities in your institution as they require special attention. All possible assistance and care may be provided to them.

You are also advised to keep track of the new guidelines issued by CGHS from time to time and comply with the guidelines.
(Dr. Atul Prakash)
Director, CGHS
Source: cghs

Government of India
Ministry of Health and Family Welfare
Department of Health & Family Welfare
Directorate General of CGHS
Nirman Bhawan, New Delhi 110 011
Dated the 30th January , 2019
No Z 15025/10/2019/DIR/CGHS
OFFICE MEMORANDUM
Subject: - Feedback from CGHS beneficiaries about HCOs empanelled under CGHS

With reference to the above mentioned subject the undersigned is directed to state that Critically ill and CGHS beneficiaries undergoing treatment for Cancer need special care and any permissions required for treatment ( including Post-Operative follow up treatment ) may be provided on priority basis by the CMOs i/c/ Addl.Director,CGHS .

A feedback proforma may also be taken from such CGHS beneficiaries about the facilities provided by HCOs empanelled under CGHS. The information so collected may be sent to the Addi. Directors on Monthly basis.

This may be treated as most important.
(Dr. Atul Prakash)
Director, CGHS
Feedback Performa
Name of the CGHS beneficiary Ben ID No
Name of the Hospital Facility
Score ( 1-5)
(1) Poor (2) Fair (3) Good (4) Very Good (5) Excellent

Behavior of Staff at Reception

Ease of Admission

Treatment of the Specialists

Behavior of para-medical staff

Billing related issues if any

Any overcharging
If , no bed was available has the beneficiary tried any other hospital

Signature of CGHS beneficiary/representative

Source: Cghs

Saturday, 23 February 2019

CGHS: Opening of CGHS Wellness Centre at Varanasi


CGHS: Opening of CGHS Wellness Centre at Varanasi

A Central Government Health Scheme (CGHS) Wellness Centre has startedfunctioning at Type -III Govt. Quarters 98-100 at Kendriya Colony Bada Lapur, Sindhoura Road , Chandmari , Varanasi from 19th February, 2019
Government of India
Ministry of Health and Family Welfare
Department of Health & Family Welfare
Directorate General of CGHS
No S. 11012/15/2015-CGHS-l/I
Nirman Bhawan, New Delhi 110011
Dated the 19th February, 2019
OFFICE ORDER

Subject: Opening of CGHS Wellness Centre (Allopathic) at Varanasi

This is for information of all eligible Central Govt. employees/ Central Govt. Pensioners, ex-MPs and other eligible stakeholders that a Central Government Health Scheme (CGHS) Wellness Centre has started functioning at Type -III Govt. Quarters 98-100 at Kendriya Colony , Bada Lapur, Sindhoura Road , Chandmari , Varanasi from 19th February, 2019 to provide comprehensive medical facilities.
The CGHS Wellness Centre (1) at Varanasi shall cover all eligible Central Govt. Employees residing within 5 km radius of the Wellness Centre and eligible pensioners and ex-MPs , etc., living in and around Varanasi as per CGHS guidelines.

The CGHS beneficiaries shall be able to avail the CGHS facilities through the Wellness Centre from 0730 a.m. to 02.00 p.m. on all days, except Sundays and Gazzetted holidays.

The CGHS wellness Centre shall be under the administrative control of Addl Director, CGHS, Allahabad (Tel No 0532-256 0578).
(Dr. Atul Prakash)
Director, CGHS

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