Revision of time limit for submission of final claims reimbursement of medical expenses under CS(MA) rules, 1944 – regarding.1

No. S. 14025/19/2015-MS

Government of India

Ministry of Health and Family Welfare

Department of Health & Family Welfare

Nirman Bhagavan, New Delhi

Dated, 27th May, 2015.

OFFICE MEMORANDUM

Subject: Revision of time limit for submission of final claims reimbursement of medical expenses under CS(MA) rules, 1944 – regarding.

The undersigned is directed to refer to OM No. F. 29-40/68-MA dated 15.10.1968 in which it was laid down that submission of final claims for reimbursement of medical expenses of Central Government servants in respect of a particular spell of illness should ordinarily be preferred within 3 months from the date of completion of treatment.

2. A representation was received from National Council (Staff Side) to extend the time limit for submission of such medical bills from 3 months to 6 months. The matter was examined in the Ministry and it has been decided that the period of 3 month s for submission of medical claims be revised to 6 months. Henceforth, only the cases in which the bills are submitted after 6 months from the date of completion of medical treatment/discharge of the patient from the hospital are required to be taken up for condonation. The power of condonation of such delays and other terms and conditions woukld be same as enumerated in the OM No.S.14025/8/99/-MS dated 25.05.1999.

3. The issue with the approval of the competent authority.

Sd/-

(Sunil Kumar Gupta)

Under Secretary to the Govt. of India

Source : http://www.mohfw.nic.in/showfile.php?lid=3205

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Clarification of CGHS rates on 2014

F. No. S. 11011/20/2014-CGHS (HEC)

Directorate General of Central Govt. Health Scheme

Ministry of Health & Family Welfare

Nirman Bhavan, New Delhi

Dated, 16th July, 2014

CLARIFICATION                  

It has been brought to the notice of the undersigned that some of the CGHS empanelled Health Care Organizations have started charging new CGHS rates 2014 which have been placed on CGHS website for information and acceptance only. Since these rates have not yet been notified by Ministry of Health and Family Welfare, the empanelled HCOs cannot charge these new rates and CGHS 2010 rates would prevail. Charging these new rates 2014 from CGHS beneficiaries by empanelled health care organizations would amount to overcharging and suitable action including recovery of overcharged amount and forfeiture of performance bank guarantee would be initiated against those HCOs by CGHS.

Sd/-

Dr. (Mrs.) Sharda Verma

Director (CGHS)

Source:http://msotransparent.nic.in/writereaddata/cghsdata/mainlinkfile/File712.pdf

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CGHS ORDER 2014: Revision of Ceiling Rates for various Coronary Stents / Angioplasty & Angioplasty with Balloon for CGHS/CS (MA) beneficiaries.

No. Misc. 1002/2006/CGHS(R&H)/CGHS(P)

Government of India

Ministry of Health & Family Welfare

Department of Health & Family Welfare

CGHS (P)

Nirman Bhavan, New Delhi

Dated: the 29th April, 2014

OFFICE MEMORANDUM

Sub:- Revision of Ceiling Rates for various Coronary Stents / Angioplasty & Angioplasty with Balloon for CGHS/CS (MA) beneficiaries.

With reference to the above mentioned subject, the undersigned is directed to draw attention to the Office Memorandum of even No. dated 7/2/2013, 21/2/2013 and 7/2/2014 and to state that the ceiling rates for reimbursement of drug eluting coronary stents for CGHS beneficiaries / CS(MA) beneficiaries prescribed in the above referred to Office Memorandum are revised w.e.f. the date of issue of this office memorandum as follows:

Revised ceiling rates of Drug Eluting Stents: Rs. 23,625/- (Inclusive of all taxes). Other terms and conditions shall remain the same.

2. This issues with the approval of the competent authority.

Sd/-

(Ravi Kant)

Under Secretary to the Government of India

Source:http://msotransparent.nic.in/writereaddata/cghsdata/mainlinkfile/File677.pdf

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Irregularities in Medical Treatment

Press Information Bureau
Government of India

Irregularities in Medical Treatment

   In a special audit drive undertaken by all the Principal Controllers of Defence Accounts (PCsDA) to examine the bill processing procedures of Ex-servicemen Contributory Health Scheme (ECHS), PCDA, Western Command had raised observations relating to excess payment to ECHS empanelled hospitals amounting to Rs.15 crores. All the observations raised by the PCDA, Western Command were thoroughly analysed by Regional Centre, Chandigarh and it was noticed that most of the observations raised were due to incorrect interpretation of the policies. Wherever observations of the Controller of Defence Accounts were conceded to, the overpayments have been duly deducted from the concerned hospitals and suitable warnings issued to them.

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Regarding empanelment of Kalra Hospital, Kirtinagar, New Delhi under CGHS, Delhi.

No: S. 11031/03/2012-13 / CGHS (HEC)/CGHS(P)
Government of India
Ministry of Health & Family Welfare
Department of Health & Family Welfare

Maulana Azad Road, Nirman Bhawan
New Delhi - 110 108, dated the 9th April 2013

OFFICE MEMORANDUM

Subject: Regarding empanelment of Kalra Hospital, Kirtinagar, New Delhi under CGHS, Delhi

   With reference to the above mentioned matter the undersigned is directed to draw attention to the Office Memorandum of even number dated 18.12.2012 vide which Kalra Hospital, Kirtinagar, New Delhi was removed from the list of empanelled hospitals under CGHS, Delhi till further orders. In response to the representations received, an inspection of Kalra Hospital, Kirtinagar, New Delhi was carried out on 20.03.2013 by a team of officers led by Addi. Director, CGHS(HQ) to ascertain whether the deficiencies pointed out in the earlier inspection were rectified or not.

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New Rates for Undergoing Angioplasty in CGHS.

   New Rates for Undergoing Angioplasty

   The Government has revised the CGHS package rates for coronary angioplasty and angioplasty with balloon w.e.f. 7/2/2013 as per the following details:
 
  Coronary Angioplasty and Angioplasty with Balloon
 
   Coronary Angioplasty                          -      Rs. 50,000/-
   Coronary Angioplasty
   with Balloon                                        -      Rs. 55,000/-
 
   All the empanelled private hospitals have not discontinued to provide angioplasty treatment to CGHS beneficiaries. However, ‘3’ hospitals in Delhi & NCR have  filed Writ Petitions in Hon’ble High Court of Delhi against the revised rates.

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Revision of Ceiling Rates for Coronary Angioplasty and Coronary Angioplasty with Balloon for CGHS beneficiaries.

 

F.No. Misc. 1002/2006/CGHS(R&H)/ CGHS(P)
Government of India
Ministry of Health & Family Welfare
Department of Health & Family Welfare

Latest CGHS Orders

Maulana Azad Road, Nirman Bhawan
New Delhi 110 108 dated the 7th February, 2013.

OFFICE MEMORANDUM

Subject: Revision of Ceiling Rates for Coronary Angioplasty and Coronary Angioplasty with Balloon for CGHS beneficiaries.

   With reference to the above mentioned subject the undersigned is directed to draw attention to the Office Memorandum No. S.11011/23/2009 /Hospital Cell dated 17.08.2010 and other Office Memoranda issued subsequently whereby the CGHS package rates for Coronary Angioplasty were fixed by the Government for empanelled hospitals under CGHS in Delhi and NCR and other CGHS cities and to state that in supersession of the earlier CGHS rates ceiling rates the following ceiling rates are approved for reimbursement to CGHS beneficiaries/CGHS empanelled hospitals as per the details given below:-

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Guidelines & Ceiling Rates for Liver Transplant Surgery in respect of CGHS / CS(MA) beneficiaries

F.No.S-14025/3/2010-MS/CGHS (P) 
Government of India 
Ministry of Health & Family Welfare 
Department of Health & Family Welfare

Nirman Bhawan, New Delhi 
Dated the 16th January, 2013

OFFICE MEMORANDUM

Subject :- Guidelines & Ceiling Rates for Liver Transplant Surgery in respect of CGHS / CS(MA) beneficiaries

   With reference to the above mentioned matter the undersigned is directed to state that the Ministry of Health and Family Welfare has been receiving requests from the Central Government employees and pensioners covered under CGHS / CS(MA) Rules, 1944 seeking approvals for Liver Transplantation surgery in respect of themselves and their eligible family members under CGHS / CS(MA) Rules. The Ministry has been examining these proposals on case to case basis for allowing the medical treatment to the beneficiaries on merits. In view of the increasing number of cases, the matter has been reviewed by this Ministry and it has now been decided to issue guidelines and ceiling rates for permission / reimbursement for Liver Transplant Surgery in respect of CGHS / CS (MA) beneficiaries as per the details mentioned below: -

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Recognition of Curie Manavata Cancer Centre, Nashik (Maharashtra) for treatment of Central Goverment employees under CS(MA) Rules, 1944.

No. S. 14021/9/2011-MS
Goverment of India
Ministry of Health & Family Welfare

Nirman Bhavan, New Delhi
Dated 17th October, 2012

OFFICE MEMORANDUM

Subject:- Recognition of Curie Manavata Cancer Centre, Nashik (Maharashtra) for treatment of Central Goverment employees under CS(MA) Rules, 1944.

   The undersigned is directed to say that a number of representations have been received in the Ministry of Health & Family Welfare for recognition of Curie Manavata Cancer Centre, Nashik (Maharashtra) for treatment of Central Government Employees and their family members under CS(MA) Rules, 1944.

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Continuation of empanelment of private hospitals, diagnostic laboratories and imaging centres under CGHS and revalidation of CGHS package rates - regarding.

Government of India
Ministry of Health & Family Welfare
Department of Health & Family Welfare,
Nirman Bhawan, Maulana Azad Road,
New Delhi 110 001

No. S 11041/23/2009/-CGHS (Hosp. Cell)/ CGHS (P)/Pt-IX

Dated the 15th October, 2012.

OFFICE MEMORANDUM

Sub:- Continuation of empanelment of private hospitals, diagnostic laboratories and imaging centres under CGHS and revalidation of CGHS package rates - regarding.

   The undersigned is directed to refer to the various office memoranda issued by this office from time to time vide which private hospitals, diagnostic laboratories and imaging centres were empanelled under CGHS in Delhi & NCR and other CGHS covered cities from 7th October 2010 onwards which would be completing empanelment period of 2’ years before 31st March 2013 and to state that it has been decided to extend the validity of empanelment of such empanelled hospitals, diagnostic laboratories and imaging centers on the same terms and conditions under which they were empanelled, till 31st March 2013 or till next empanelment, whichever is earlier.

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Clarification regarding admissible / non-admissible items under CGHS.

Latest CGHS Orders

F.No. 2-1/2012/CGHS/VC/CGHS (P)
Government of India
Ministry of Health & Family Welfare
Department of Health & Family Welfare

Nirman Bhawan, New Delhi
Dated the 1st October, 2012.

OFFICE MEMORANDUM

Subject: Clarification regarding admissible / non-admissible items under CGHS.

   The undersigned is directed to refer to the directions given by Hon’ble High Court of Delhi in the case of Sh. Kanhiya Singh Vs UOI and others [W.P.(C) 9044/2011], regarding admissibility and non-admissibility of certain items under CGHS, the following clarifications are issued:-

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Empanelment of private hospitals and Diagnostic Laboratories and Imaging Centres under CGHS- Clarification — regarding rates

No: S.11011/23/2009-CGHS D. II/Hospital Cell (Part IX)

Government of India

Ministry of Health & Family Welfare

Department of Health&Family Welfare

Maulana Azad Road, Nirman Bhawan

New Delhi 110 108 dated the September 30, 2011

OFFICE MEMORANDUM

Subject:- Empanelment of private hospitals and Diagnostic Laboratories and Imaging Centres under CGHS- Clarification — regarding rates

   With reference to the above mentioned subject the undersigned is directed to draw attention to the CGHS rates notified in 2010 / 2011 applicable to empanelled hospitals and Diagnostic Laboratories and Imaging Centres in Various CGHS cities and to state that in response to the several representations received by this Ministry seeking clarifications regarding CGHS rates applicable, it has now been decided to clarify as under:-

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