The Ministry of Health and Family Welfare, along with the CGHS and Directorate General of Health Services, recently reinforced their guidelines for hospitals and diagnostic centers under the Central Government Health Scheme (CGHS). These guidelines ensure beneficiaries receive top-notch care without unnecessary complications. Below are the key points:
Cashless Treatment for Eligible Groups
Hospitals must offer cashless treatment to pensioners, Members of Parliament (MPs), and retired Air India employees with valid CGHS cards. Employees of CGHS, DGHS, and the Ministry of Health are also entitled to this benefit. Importantly, hospitals should not request advance payments when admitting eligible beneficiaries.
CGHS Rates for Other Beneficiaries
Individuals under CSMA, Central Autonomous Bodies, and Public Sector Undertakings qualify for treatment at CGHS rates. This applies even if they pay for services. Since CGHS cards are valid across India, beneficiaries and their dependents can use them at any empanelled hospital. Hospitals should offer credit to those eligible.
No Extra Charges for Essential Items
Hospitals cannot charge separately for surgical supplies such as gauze, catheters, and gloves. These are included in the treatment package. Likewise, fees for infection control or medical records should not be added to the bill. Investigation reports, including films or CDs, are also part of the service.
Simplified Digital Verification
Hospitals must verify CGHS cards through the CGHS app or DigiLocker. There’s no need for photocopies, simplifying the process for beneficiaries.
Quick Response in Emergencies
In emergencies, hospitals must provide immediate care without asking for referral endorsements from CGHS. This ensures that critical patients receive timely treatment.
Direct Consultations for Seniors
Beneficiaries aged 70 and older can directly consult specialists at empanelled hospitals. They no longer need a referral from CGHS Wellness Centers, streamlining access to specialized care.
Clear and Transparent Billing
At discharge, pensioner beneficiaries should review and sign their bills, which will then be uploaded to the NHA portal. If a beneficiary feels overcharged or harassed, they can report the issue. Hospitals will face consequences based on the Memorandum of Agreement (MoA).
By following these guidelines, hospitals ensure CGHS beneficiaries receive efficient and fair treatment. These measures also promote transparency and reduce the administrative burden for patients.
Below is the OM issued by CGHS bengaluru.
