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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Cancer Treatment under CGHS/CS(MA) Rules, 1944. - CGHS Order 2015.

No. 1-1/13/Hospital Cell/R&H/CGHS (Pt.l)/CGHS (P)

Government of lndia

Ministry of Health & Family Welfare

Department of Health & Family Welfare

Nirman Bhavan, Maulana Azad Road

New Delhi- 110 108

Dated : the 23rd February, 2015

OFFICE MEMORANDUM

Subject:- Cancer Treatment under CGHS/CS(MA) Rules, 1944

With reference to the above mentioned subject the undersigned is directed to draw attention to the Office Memorandum of even number dated 2nd September, 2008 and to state that in view of empanelment of several Cancer hospitals under CGHS the matter was re-examined, and it has now been decided to modify the Office Memorandum as follows:

i) CGHS beneficiaries and beneficiaries covered under CS(MA)Rules, 1944 shall be permitted to get themselves treated from any of the under mentioned 27 (Twenty seven) hospitals recognized by the Ministry of Health & Family Welfare under the National Cancer Control Programmes that are funded by the Government of India, subject to the condition that the reimbursement will be as per the rates fixed in the Regional Cancer Centers under Central Government, if any or as per actual, whichever may be less.

1. Andhra Pradesh – M.N.J. institute of Oncology & Regional Cancer Centre, Hyderabad.

2. Assam – Dr. B. Borooah Cancer institute, Guwahati.

3. Bihar – Indira Gandhi institute of Medical Sciences, Patna

4. Chandigarh – Post Graduate institute Medical Education Research, Chandigarh.

5. Chhattisgarh – Pt. ,i.J.N Medical College & Dr. BR. Ambedkar Memorial Hospital, Raipur.

6. Delhi – Dr. B.R. Ambedkar Institute Rotary Cancer Hospital, AIIMS, New Delhi.

7. Gujarat- Gujarat Cancer Research Institute, Ah medabad, Gujarat.

8. Haryana – Post Graduate Institute of Medical Sciences, Rohtak.

9. Himachal Pradesh- Indira Gandhi Medical College, Shimla.

10. Jammu & Kashmir- Sher-i- Kashmir Institute of Medical Sciences, Srinagar.

11. Jammu & Kashmir- Government Medical College -Jammu.

12. Karnataka – Kidwai Memorial Institute of Oncology, Bangalore.

13. Kerala – Regional Cancer Centre, Thiruvananthapuram.

14. Madhya Pradesh – Cancer Hospital & Research Institute, Gwalior.

15. Maharashtra – Rashtrasant Tukdoji Regional Cancer Hospital Research Centre, Nagpur.

16. Maharashtra -Tata Memorial Hospital, Mumbai.

17. Manipur- Regional Institute of Medical Sciences, Imphal.

18. Mizoram – Civil Hospital, Aizwal.

19. Odisha – Acharya Harihar Regional Cancer Centre, Cuttack.

20. Puducherry – Jawaharlal Institute of Postgraduate Medical Education & Research.

21. Rajasthan – Acharya Tulsi Regional Cancer Treatment & Research Institute, Bikaner.

22. Tamil Nadu – Govt. Arignar Anna Memorial Cancer Research Institute & Hospital, Kancheepuram.

23. Tamil Nadu – Cancer Institute (WIA), Adyar, Chennai.

24. Tripura – Civil Hospital, Agartala.

25. Uttar Pradesh – Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow.

26. Uttar Pradesh – Kamla Nehru Memorial Hospital, Allahabad.

27. West Bengal – Chittaranjan National Cancer Institute, Kolkata.

ii) In cities where there are no facilities for cancer treatment in any of the empanelled private hospitals powers are hereby delegated to the Addl. Directors of CGHS of the concerned cities in respect of CGHS and to HOD/ Head of Office in respect of serving employees covered under CS(MA) Rules, 1944 for grant of permission for undergoing treatment at any hospital that provides treatment to cancer patients, subject to the condition that the reimbursement shall be limited to the prevalent CGHS rates or actual expenditure – whichever may be lower. Permission shall however be granted for the specific treatment procedures as advised by a Government specialist.

iii) Powers are also hereby delegated to the Additional Directors of CGHS of the concerned cities in respect of CGHS and to HOD/ Head of Office in respect of serving employees covered under CS(I\/IA) Rules, 1944 for grant of permission for post-operative follow up treatment from the same centre, where permission has been granted earlier for cancer treatment as per the terms and conditions of OM dated 10.04.2001 regarding Post-operative follow up treatment.

2. These orders shall be in force till further orders.

3. This issues with the concurrence of Integrated Finance Division vide CD No. 115650 /2015 dated 15-01-2015.

Sd/-

(RAVI KANT)

UNDER SECRETARY TO THE GOVT. OF INDIA

Source: http://msotransparent.nic.in/writereaddata/cghsdata/mainlinkfile/File963.pdf

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Reimbursement of medical claim pertaining to in-patient treatment to the Defencc Civilians who are getting Fixed Medical Allowance (FMA).

BHARATIYA PRATIRAKSHA MAZDOOR SANGH

Most Immediate

Ministry of Defence

D(Civ-II) Section

Subject: Reimbursement of medical claim pertaining to in-patient treatment to the Defencc Civilians who are getting Fixed Medical Allowance (FMA).

The proposal for (Reimbursement of medical claim pertaining to in-patient treatment to the Defence Civilians who are getting Fixed Medical Allowance) was taken up by the Ministry of Defence with Ministry of Health & Family Welfare.

2. Ministry of Health & Family Welfare vide their ID No 14025/9/2011-MS dated 14th August, 2014 has proposed that ‘FMA being granted to CS(MA) beneficiaries be stopped and they should be governed by the provisions of CS(MA) Rules, 1944 under which medical reimbursement for outdoor treatment as well as indoor treatment is permissible as per the rules”.

3. It has been stated by the M/o H&FW that stopping of FMA for serving employees in question, will facilitate their family in getting comprehensive medical care under CS(MA) Rules, 1944 including outdoor and indoor treatment, even in emergency conditions. Accordingly, Ministry of Health & Family Welfare has sought comments of this Ministry so that the anomaly in the matter can be removed at the earliest.

4. All lower formations/Employees Federations/Associations are therefore requested to furnish their comments to this Ministry within 15 days i.e. by 24.09.2014 for processing the matter further by this Ministry with the M/o H&FW.

Sd/-

(Gurdeep Singh)

Under Secretary

Source:http://bpms.org.in/documents/fma-4ovd.pdf

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CGHS FAQ : FREQUENTLY ASKED QUESTIONS WITH ANSWERS ABOUT CGHS.

FAQ on Central Government Health Scheme : More questions clarified as FAQ

   Ministry of Health and Family Welfare issued recently some clarifications as in the form of Questions and Answers, now further the Department has once again issued with more details of the scheme on its portal. Lot of questions and answers is given with detailed references, certainly it could be very useful for the both sides of employees and Department authorities.

1. Who are entitled for CGHS facilities
   a. All Central Govt. employees and their dependant family members residing in CGHS covered areas.
   b. Central Govt Pensioners and their eligible family members getting pension from Central Civil Estimates
   c. Sitting and Ex-Members of Parliament
   d. Ex-Governors & Lt. Governors
   e. Freedom Fighters
   f. Ex-Vice Presidents
   g. Sitting and Ex-Judges of Supreme Court & High Courts
   h. Employees and pensioners of certain autonomous organizations in Delhi
   i. Journalists (in Delhi )Accredited with PIB
   j. ( for OPD & at RML Hospital)
   k. Delhi Police Personnel in Delhi only
   l. Railway Board employees

2. In how many cities CGHS is presently operative?
CGHS facilities are available in 25 cities in India
   1. Ahmedabad 2 Allahabad 3 Bengaluru 4 Bhopal 5 Bhubaneshwar 6. Kolkata 7. Chandigarh 8 Chennai 9.Dehradun 10.Delhi & NCR 11.Guwahati 12. Hyderabad 13. Jabalpur, 14. Jaipur 15 Jammu 16. Kanpur 17. Lucknow 18. Meerut 19. Mumbai 20. Nagpur 21 Patna 22.Pune 23. Ranchi 24. Shillong 25. Thirruvananthapuram

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Revision of Ceiling Rates and guidelines for various Coronary Stents for CGHS/CS(MA) beneficiaries.

F. No. Misc. 1002/2006/CGHS(R&H)/ 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 21st February, 2013.

OFFICE MEMORANDUM

Subject:- Revision of Ceiling Rates and guidelines for various Coronary Stents 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 number dated 31.10.2011 and to state that ceiling rates for all DCGI approved Coronary Stents have been revised in super cession of the Office Memorandum of even No. dated 31.10.2011 of the Ministry of Health & Family Welfare as per the ceiling rates mentioned below:-

S.No	Type of Coronary Stents		Ceiling Rate
1.	DRUG ELUTING  CORONARY STENTS	All DCGI and FDA approved Drug Eluting Stents All DCGI and CE approved Drug Eluting Stents All DCGI approved Drug Eluting Stents	Rs.25,000/-
2.	BARE METAL CORONARY STENTS	COBALT STENTS (including Coated and other Stents) All DCGI and FDA approved All DCGI and CE approved All DCGI approved	Rs.12000/-
3.	BARE METAL  STAINLESS STELL   STENTS	Rs.10,000/- the rates were already notified vide OM of even number dated 7th February 2013

   Reimbursement to beneficiaries /empanelled hospitals shall be allowed subject to the ceiling rates or actuals, whichever are lower.

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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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Revision of Ceiling Rates and guidelines for various Coronary /Vascular Stents for CGHS/CS(MA) beneficiaries.

F. No. Misc.1002/2006/CGHS(R&H)/ 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 31st October 2011.

OFFICE MEMORANDUM

Subject:- Revision of Ceiling Rates and guidelines for various Coronary /Vascular Stents for CGHS/CS(MA) beneficiaries.

   In supersession of the Office Memorandum of even No dated 12.09.2007 of the Ministry of Health & Family Welfare for the revised rates and guidelines for Coronary / Vascular Stents for reimbursement of CGHS/CS(MA) beneficiaries, all DCGI approved Coronary / Vascular Stents are approved for reimbursement to CGHS/CS(MA) beneficiaries as per the ceiling rates mentioned below:

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