No cashless CGHS treatment from February 1, 2014

The 800 hospitals in the country empaneled under the Central Government Health Scheme will stop cashless transactions from February 1, 2014, because, they claim, the government has not cleared arrears of Rs 600 crore.

The aggrieved hospitals have come together under the umbrella of the Association of Healthcare Providers India and had served notice to the CGHS office in New Delhi on December 13, 2013.

A meeting with the Union health secretary K.N. Desiraju on January 9 yielded no results.

A senior officer of AHPI said, “The amount has been budgeted in the health budget and it must be released. But it is not being done. Hence, the question is, where is it going?”

Since 2010, the hospitals have been complaining of 40 per cent unauthorised deductions in the payments. Now they have come together to put across their point to the government.

AHPI general secretary for AP Govind Hari says, “The problem started in 2002 when they started inviting tenders. In doing so, they reduced the cost of surgeries drastically. Also, orthopaedic treatment costs Rs 3,200 in Karnataka and Rs 10,000 in AP. These errors in terms of determining the cost put the hospitals in a spot.”

A senior member of the APHI said, “We want to quit as it has become more of a burden than a service as the clearance promise of 180 days is hardly followed.”

Additional director, CGHS, Dr Prasad, says, “We have not received any communication from the hospitals.” But senior officers in the Begumpet office of the department say there has been an assessment of the pending amount, and deliberations have started to sort out that matter.

Source: http://www.deccanchronicle.com
[http://www.deccanchronicle.com/140116/news-current-affairs/article/no-cashless-cghs-treatment]

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Government to revise rates for CGHS empanelled hospitals

 In a good news for lakhs of beneficiaries under the Central Government Health Scheme (CGHS), the Government is in the process of revising the rates of medical procedures offered by empanelled hospitals and diagnostic centres and giving them early payment assurance to encourage more medical institutions join the scheme.

The Ministry of Health and Family Welfare has floated e-tenders for empanelment of hospitals and decided that the rates of various medical procedures would be fixed by an average of rates quoted in e-tenders instead of the old system where the lowest quotation became the rate.

Rates of all medical procedure centres under CGHS would be revised by April next year.

Not just that, the Government is also revising its policy by providing empanelled hospitals assured upfront payment of 70 per cent of the total bill within five days of its presentation and balance admissible amount within a maximum period of 30 days.

The direction for a 10 per cent deduction in case of early/cash payment to hospitals under CGHS has also been done away with, highly-placed sources in the Ministry told PTI.

"These measures will put an end to the problems of delayed payments which discourage hospitals from getting empanelled under the scheme," a Health Ministry official said.

Under the new policy finalised by the Ministry, the category of super specialty hospitals empanelled under the CGHS has also been done away with.

"Now, hospitals, exclusive eye hospitals/centres, exclusive dental clinics and diagnostic centres shall be empanelled for all facilities available in the health care organisation as approved by National Accreditation Board for Hospitals/National Accreditation Board for Labs and the Quality Council of India and shall not be empanelled for selected specialities/facilities," the new policy says.

The changes will help rope in more hospitals, clinics and diagnostic centres under the CGHS as many renowned and big hospitals were shying away from being empanelled under the scheme due to pending payments and low rates for medical procedures.

Sources said payments of bills amounting to around Rs 100 crore of private hospitals are pending with the government under CGHS alone, even though hospitals are crying hoarse that pending payments are to the tune of over Rs 400 crore.

Officials, however, say this huge amount is not pending under CGHS and it may include payments under ECHS, ESI and health bills of other big departments like Delhi Police and others.

Source : http://www.business-standard.com/article/pti-stories/govt-to-revise-rates-for-cghs-empanelled-hospitals-113122900482_1.html

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CGHS Hospitals Rates

Corporate hospitals across the country have threatened to stop cashless treatment to lakhs of Central Government employees from January 1. This will impact about 45 lakh employees of the Central Government and public sector agencies who are benefiting from the insurance scheme.
Protesting against “unviable” rates being given to them under the Central Government Health Scheme (CGHS), the Association of Healthcare Providers (India) (AHPI) has said that it will give three months’ time to the Government to revise the rates.
“After that we will stop all cashless services at our hospitals. We will, however, continue to provide services on paying cash (at the hospital rates). They can seek reimbursement later,’’ said Alex Thomas, an AHPI leader.

PRICE CORRECTION 

Representatives of about 100 corporate hospitals held a meeting here on Saturday to discuss the challenges they face with regard to CGHS cases. AHPI said the Government should come out with a scientific method to arrive at proper packages for various treatments.
“They have not revised the tariff for various procedures for years, while the cost of operations has gone up significantly,” said Bhaskara Rao, President of the Andhra Pradesh Speciality Hospitals Association and Chief Executive Officer of Krishna Institute of Medical Sciences.
The Association will submit a memorandum to the Centre through CGHS authorities, demanding a hike in tariff for several packages.
Deviprasad Shetty, Chairman of Narayana Hrudayalaya, said hospitals are not being paid on time, and that the payments are below the actual cost (of procedures).
When asked about the alleged malpractices and inflation of bills by corporate hospitals, both Thomas and Rao said that all such violations should be probed into.

Kurmanath.kanchi@thehindu.co.in
Source:http://karnatakacoc.blogspot.in/2013/10/cghs-hospitals-rates.html

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Pvt hospitals threaten to stop CGHS treatment

HYDERABAD, OCT 12:
Corporate hospitals across the country have threatened to stop cashless treatment to lakhs of Central Government employees from January 1. This will impact about 45 lakh employees of the Central Government and public sector agencies who are benefiting from the insurance scheme.

Protesting against “unviable” rates being given to them under the Central Government Health Scheme (CGHS), the Association of Healthcare Providers (India) (AHPI) has said that it will give three months’ time to the Government to revise the rates.

“After that we will stop all cashless services at our hospitals. We will, however, continue to provide services on paying cash (at the hospital rates). They can seek reimbursement later,’’ said Alex Thomas, an AHPI leader.

PRICE CORRECTION

Representatives of about 100 corporate hospitals held a meeting here on Saturday to discuss the challenges they face with regard to CGHS cases. AHPI said the Government should come out with a scientific method to arrive at proper packages for various treatments.

“They have not revised the tariff for various procedures for years, while the cost of operations has gone up significantly,” said Bhaskara Rao, President of the Andhra Pradesh Speciality Hospitals Association and Chief Executive Officer of Krishna Institute of Medical Sciences.

The Association will submit a memorandum to the Centre through CGHS authorities, demanding a hike in tariff for several packages.

Deviprasad Shetty, Chairman of Narayana Hrudayalaya, said hospitals are not being paid on time, and that the payments are below the actual cost (of procedures).

When asked about the alleged malpractices and inflation of bills by corporate hospitals, both Thomas and Rao said that all such violations should be probed into.

Kurmanath.kanchi@thehindu.co.in

Source:http://www.thehindubusinessline.com/news/cashless-treatment-may-be-stopped-for-central-govt-staff/article5228484.ece#comments

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Approval for Photo selective Vaporization of Prostate (PVP) Surgery using Green Light HPS Fibre (Angled Delivery Device) to be used with HPS Laser System 120 watt (AMS) under CGHS/CS(MA) Rules

F.No.25-09/2013-14/CGHS/Hospital Cell/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 8th August, 2013

OFFICE MEMORANDUM

Sub: Approval for Photo selective Vaporization of Prostate (PVP) Surgery using Green Light HPS Fibre (Angled Delivery Device) to be used with HPS Laser System 120 watt (AMS) under CGHS/CS(MA) Rules regarding;

With reference to the above mentioned subject the undersigned is directed to state that this Ministry has been receiving requests for grant of permission for Green light HPS laser fibre for Laser Prostactomy. The matter has been examined in consultation with specialists in the field and it was now been decided to permit Photo selective ‘Vaporization of Prostate (PVP) Surgery using Green Light HPS Fibre (Angled Delivery Device) to be used with HPS Laser System 120 watt (AMS) under CGHS/CS(MA) Rules on the recommendations of a Government Specialist in the following conditions:

a. Patients or anti-coagulants, which cannot be withdrawn even for a short duration

b. Patients suffering from bleeding diathesis.

c. Patients with Iarge prostate gland, weighing more tnan 60-80 gm.

d. Patients wth CCF anc renal failure, were fluid overload is to be avoided. In other BHP cases the standard line of treatment shall be TURP.

2. The ceiling rate of Green Light HPS Fibre (Angled Delivery Device to be used with HPS Laser System 120 watt (AMS) for reimbursement / approval under CGHS / CS(MA) patients shall be Rs.6.000/- (incl. of all taxes) or actual, whichever is lower. The ceiling rate shall be effective for one year or till further order whichever is earlier.

3. CGHS – Package rate for surgery shall be the same as for Holmium Laser prostatectomy and the cost of Green Light HPS Fibre (Angled Delivery Device) shall be permitted in addition, as per the above prescribed ceiling rate or actual, whichever is lower.

4. This issues with the concurrence of Integrated Finance Division, Ministry of Health & Family Welfare vide CD No. 837 dated 06/08/2013.

5. Hindi version will follow.

sd/-

(V. P. SINGH)

DEPUTY SECRETARY TO THE GOVERNMENT OF INDIA

Source: http://msotransparent.nic.in/cghsnew/index.asp
[http://msotransparent.nic.in/writereaddata/cghsdata/mainlinkfile/File639.pdf]

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Extension of CGHS facilities to permanently disabled dependent brother of a CGHS beneficiary

Government of India 

Ministry of Health & Family Welfare 

Department of Health & Family Welfare 

Nirman Bhawan, Maulana Azad Road 

New Delhi 110 108 

No. S 11011/13/2012-CGHS (P)

Dated the 25th July, 2013 

OFFICE MEMORANDUM 

Sub: Extension of CGHS facilities to permanently disabled dependent brother of a CGHS beneficiary - reg.

The undersigned is directed to state that dependent brother of a Central Government employee is presently entitled for CGHS coverage upto the age of becoming a major. Ministry of Health and Family Welfare has been receiving requests from CGHS beneficiaries for removal of the upper age-limit in the case of disabled dependent brother so as to provide them the CGHS facilities without any age limit as has been provided to disabled son of a CGHS beneficiary.

2. Accordingly, with a view to assuage the hardship, it has been decided to extend the CGHS facilities to permanently disabled dependent brother of a CGHS beneficiary, without any age-limit.

3. For availing CGHS facilities under this provision, the permanently disabled dependent brother of a CGHS beneficiary must be suffering from any one or more of the disabilities as defined in Section 2(i) of 'The persons with Disabilities (Equal Opportunities, Protection of Rights and Full Participation) Act, 1995 (No.1 of 19.96)' which includes:-

(i) Blindness
(iii) Leprosy-cuked
(v) Loco motor disability
(vii) Mental illness
(ii) Low-vision
(iv) Hearing impairment
(vi) Mental retardation
and as per Clause (j) of Section 2 of National Trust for Welfare of Persons with Autism, Cerebral Palsy, Mental Retardation and Multiple Disabilities Act, 1999 (No.44 of 1999), which presently covers a person suffering from any of the condition relating to autism, cerebral palsy, mental retardation or a combination of any two or more of such conditions and includes a person suffering from severe multiple disability. It is clarified that 'permanent disability' means a person with 40% or more of one or more disabilities.

4. The eligibility criteria for a permanently disabled dependent brother to avail medical facilities under CGHS will be as under:-
a. He must be wholly dependent on the principal CGHS card holder beneficiary.
b. He should be unmarried and should not have his own family.
c. The income limit for deciding dependency shall be as prescribed by the Ministry of Health and Family Welfare from time to time and as applicable in CGHS for the time being in force.
d. He must be ordinarily residing with the primary CGHS cardholder beneficiary.
e. All the above conditions are required to be fulfilled for availing CGHS facilities. The CGHS facilities will cease to exist with immediate effect if any one of the above conditions is violated.

5. This office memorandum will be effective from the date of issue

sd/-

(V.P.Singh) 

Deputy Secretary to the Government of India 

Source: http://msotransparent.nic.in/writereaddata/cghsdata/mainlinkfile/File640

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FRESH EMPANELMENT OF PRIVATE HOSPITALS UNDER CGHS LUCKNOW, HYDERABAD, CHENNAI, PUNE, CHANDIGARH, JABALPUR AND DELHI

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 5th January, 2012.

OFFICE MEMORANDUM

Subject: Fresh empanelment of private hospitals and diagnostic centres and revision of package rates applicable under CGHS LUCKNOW, HYDERABAD, CHENNAI, PUNE, CHANDIGARH, JABALPUR AND DELHI

The undersigned is directed to invite reference to this Ministry’s Office Memoranda of even number dated the 8th December 2010 and the 19th January 2011 vide which continuous empanelment scheme has been initiated under CGHS LUCKNOW, HYDERABAD, CHENNAI, PUNE, CHANDIGARH, JABALPUR AND DELHI for treating CGHS beneficiaries. The CGHS rates applicable have already been notified and are available on CGHS website. Three rates were notified, one for super-speciality hospitals, the second for hospitals that were accredited with the NABH and the third for hospitals not accredited with the NABH.

2. The undersigned is directed to enclose further list of hospitals and diagnostic centres under the categories mentioned in the application for continuous empanelment and tender document that have conveyed their acceptance of the CGHS rates notified under different CGHS Cities and have signed the Memorandum of Agreement with CGHS and have also furnished the appropriate performance bank guarantee. These hospitals and diagnostic centres are now taken as included in the list of approved hospitals for empanelment under CGHS, LUCKNOW, HYDERABAD, CHENNAI, PUNE, CHANDIGARH, JABALPUR AND DELHI.

3. It has now been decided that in the list of hospitals and diagnostic centres enclosed, and have now been approved under tile fresh empanelment procedure and have now signed the fresh Memorandum of Agreement and submitted the appropriate performance guarantee will be eligible to treat CGHS beneficiaries and charge at tile revised rates with effect from the date of issue of this Office Memorandum. The empanelment shall be for a period of one year or till next empanelment, whichever is earlier.

4. This Office Memorandum and the rates applicable under CGHS for hospitals and diagnostic centres can be downloaded from the website of CGHS, http://msotransparent.nic.in/cghsnew/index.asp

sd/- 

[Jai Prakash] 

Under Secretary to Government of India

Source:www.msotranparent.nic.in

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LATEST LIST OF CGHS HOSPITALS AND DIOGNOSTIC CENTRES IN JABALPUR

As on 10th June 2010]

   JABALPUR : Hospitals 

1.	Anant Nursing Home Pvt. Ltd., Madan Mahal Railway Station Road, Wright Town, Jabalpur. [Tel: 0761 – 506 494 / 415 002]	General, specialised purpose (lithotripsy/ TURP, laparoscopic surgery, IOL implant, orthopedic joint replacement) and diagnostic centre (laboratory, USG / Colour Doppler).
2.	Jabalpur Hospital & Research Centre, Russel Crossing, Jabalpur 482 002	General, specialised purpose (Haemodialysis, lithotripsy/ TURP, laparoscopic surgery, IOL implant, Orthopaedic joint replacement) and diagnostic centre (laboratory, CT, USG / Colour Doppler, X – Ray).
3.	Bombay Hospital & Research Centre, Gole Bazar, Jabalpur [Tel: 0761 – 241 2110 / 241 0202]	General, specialised purpose (laparoscopic surgery, IOL implant, orthopedic joint replacement) and diagnostic centre (Clinical Pathology, Biochemistry, USG/ Colour Doppler, X – Ray).
4.	Marble City Hospital & Research Centre, 21 North Civil Lines, Near 2nd Bridge, Jabalpur 482001 [Tel: 0761 – 262 8154 / 2692745]	General, specialised purpose (Lithotripsy / TURP, IOL implant, laparoscopic surgery, Orthopaedic joint replacement) and diagnostic centre (laboratory, mammography, USG / Colour Doppler.
5.	Jan Jyoti Hospital & Zyoptix Laser Centre, 1051 Gole Bazar, Dixitpura, Jabalpur [Tel: 0761 – 240 4608 / 400 7033]	Super specialty eye care [Cataract / Glaucoma, Retinal Medical & Viteroretinal surgery, Strabismus, Occuloplasty and Adnexa and other specialised treatment].
6.	Deshmukh Dental Clinic, Russel Chowk, Napier Town, Jabalpur 482001 [Tel: 0761 / 245 1520 / 403 6580]	General dentistry and special dental procedure [Orthodontistry only].
7.	Department of Dental, Oral & Maxillofacial Surgery, Jabalpur Hospital & Research Centre, Napier Town, Jabalpur	General dentistry and special dental procedure and diagnostic procedures.
8.	Seth Mannulal Jagannath Das Trust Hospital, Dixitpura, Jabalpur	Multispeciality General purpose, specialised purpose [Orthopaedic surgery including joint replacement, endoscopic surgery and ENT including specialised surgery] and diagnostic procedures [TMT, ECHO, Doppler and ECG].
9.	Bombay Hospital & Research Centre, Gole Bazar, Jabalpur	Dialysis, CRRT and CT Scan.
10.	Metro Hospital & Cancer Research Centre [A unit of Satya Sai Cancer Society, Kuchaini Parisar, Near Chtriya Bus Stand, Damoh Naka, Jabalpur 482002	Multispeciality general purpose and specialised purpose in Neurology & Neurosurgery, Urology including Dialysis, Orthopaedic surgery including Joint Replacement & Arthroscopy, Oncology [Medical, Surgical & Radiotherapy], Gastroenterology and G.I. Surgery, Paediatrics and Paediatrics Surgery, Endoscopic / Laparoscopic surgery and ENT.
11.	City Hospital & Research Centre Pvt. Ltd., 21 / 2 Opp. Hero Honda Show Room, Near 2nd Bridge Nagrath Chowk, Jabalpur.	Multispeciality General purpose and Super- speciality [Neurology & Neurosurgery; Urology including dialysis and Lithotripsy; Orthopaedic surgery including Arthroscopic surgery and Joint Replacement, GI Surgery; Medical & Surgical Oncology; Paediatrics and Paediatric surgeries; Endoscopic surgery and ENT including specialised surgeries] General dentistry; Special dental procedures in Oral & Maxillo facial surgery; and Orthodontistry; and Diagnostic procedures Cataract / Glaucoma only. [Not recommended for Occuloplasty & Adnexa and other specialised treatment]. Diagnostic Centre [Laboratories in Clinical Pathology, Biochemistry and Microbiology; CT Scan; USG / Colour Doppler and X – Ray].
12.	Jamdar Hospital Pvt. Ltd., Gole Bazar, Jabalpur	Multi-speciality General Purpose and Super- speciality [Orthopaedic surgery including Arthroscopic surgery and Joint Replacement].
13.	National Hospital, 703 Gole Bazar, Jabalpur	Multi-speciality General purpose and Super- Speciality [IOL implant, Orthopaedic Joint replacement] and Diagnostic Services [Laboratory, USG / Colour Doppler, X – Ray].

The following hospitals will continue to be empanelled under CGHS in terms of the interim order of the High Court of Judicature at Jabalpur, in WP 10401/2007 in National Hospital, Jabalpur Vs UOI and others, and in three other WPs. 

1.	Seth Mannulal Jagannath Trust Hospital & Research Centre, Dixitpura, Jabalpur.	General purpose treatment and specialised diagnostic procedure [Echo, TMT, USG, Endoscopy & Colour Doppler].
2.	Trivedi Dental Clinic, 1553 Ashoka Hotel Road, Wright Town, Jabalpur	Routine Dental treatment.

1.	Charak Diagnostic & Research Centre Pvt. Ltd., Prabhu-Vandana Building (Ground Floor), 1 Civic Centre, Marhatal, Jabalpur 482 002 [Tel: 0761- 240 4889 / 231 5889]	Diagnostic Services (USG/ Colour Doppler, Echo-cardiography, CT Scan).
2.	Heart Care, Opp. Anjuman School, Civic Centre, Jabalpur [Tel: 0761 231 0003 / 403 3117]	Diagnostic Services (Colour Doppler, ECG, TMT, Holter)
3.	SAI Clinic Medical Endoscopic Centre, 1- Kachnar Enclave, South Civil Lines, Near Sai Baba Mandir, Jabalpur 482 001. [Tel: 0761 – 262 9127]	Diagnostic Services(Endoscopy)
4.	The Heart Clinic, 13, Kingsway Camp, Jabalpur 482 001 [Tel: 0761 -262 6383 / 262 7783]	Diagnostic centre (Colour Doppler, ECG, TMT).
5.	Central India Kidney Hospital, 1572, Wright Town, Jabalpur, Madhya Pradesh	Diagnostic Services [USG / Colour Doppler and X – Ray].
6.	Mahakoshal Hospital, Opp. Gali No: 3, Wright Town Stadium, Jabalpur, Madhya Pradesh	Diagnostic Services [USG / Colour Doppler and X – Ray].
7.	Sanjeevan Hospital & Res. Centre, Ram Nagar Adheerlal, Jabalpur, Madhya Pradesh [Tel: 0761 – 236 0140].	Diagnostic Services [USG / Colour Doppler and X – Ray].

SOURCE;www.mohfw.nic.in 

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LATEST LIST OF CGHS HOSPITALS AND DIOGNOSTIC CENTRES IN JAIPUR

[As on 10th June 2010]

   JAIPUR : Hospitals 

1.	Apex Hospitals Pvt. Ltd., SP – 6, Malaviya Industrial Area, Malviya Nagar, Jaipur 302 017 [Tel: 0141 – 275 1871 / 275 1872]	General and specialised purpose (Laproscopic surgery and IOL Implant).
2.	Bhagwan Mahaveer Cancer Hospital & Research Centre, Jawahar Lal Nehru Marg, Jaipur 302 107 [Tel: 0141 – 270 0107 / 270 2899]	Specialised purpose for Oncology.
3.	Bhandari Hospital & Research Centre, 138 – A Vasundhara Colony, Gopalpura By-pass, Tonk Road, Jaipur 302 018 [Tel: 0141 – 270 3851 / 270 5122]	General and Specialised purpose (Lithotripsy / TURP and Laproscopic surgery).
4.	Dhanwantri Life Care Pvt. Ltd., 67 / 56 A, Near Mandra Bus Stand, New Sanganer Road, Jaipur 302 020 [Tel: 0141 – 278 1425 / 278 0760]	General purpose treatment.
5.	Jaipur Hospital, Lal Kothi, Tonk Road, Near SMS Stadium, Jaipur 302015 [Tel: 0141 – 274 2266 / 274 2619]	General and Specialised purpose (Laproscopic surgery, IOL Implant and Orthopaedic joint replacement).
6.	Rungta Hospital, Malviya Nagar, Jaipur 302 017 [Tel: 0141 – 252 2200 / 252 2002]	General and Specialised purpose (Laproscopic surgery and Orthopaedic joint replacement).
7.	Soni Hospital, 38 Kanota Bagh, Jawaharlal Nehru Marg, Jaipur 302004 [Tel: 0141 – 256 2028 / 257 1122]	General and Specialised purpose (TURP, Laproscopic surgery, neurosurgery, IOL implant and Orthopaedic joint replacement).
8.	Manu Hospital & Research Centre, A – 1A, Near Central Academy School, Shyam Nagar, Sodala, Jaipur 302019 [Tel: 0141 – 229 2530 / 229 5567]	General and Specialised purpose [Urology (including dialysis and lithotripsy), Endoscopic surgery and ENT Neurology & Neurosurgery, Gastroenterology & GI Surgery, Oncology (Surgery & Chemotherapy).
9.	Jain ENT Hospital, Satya Vihar, Lal Kothi, Jaipur	Single Super-speciality [ENT with specialised surgeries].
10.	S. K. Soni Hospital, Vidhyadhar Nagar, Jaipur	General purpose and Specialised purpose in Cardiology & CTVS, Neurology & Neurosurgery, Urology including dialysis, Orthopaedic surgery including orthoscopic surgery and joint replacement, Gastroenterology & GI surgery, Paediatric & Paediatric surgery, Endoscopic surgery, ENT including specialised surgeries.
11.	Anand Hospital & Eye Care Centre, 21 Bharat Mata Lane, Jamna Lal Bajaj Marg, Jaipur	Super-speciality Eye Care [Cataract / Glaucoma, Retinal-Medical and Vitreo-retinal surgery, Strabismus, Occuloplasty and Adnexa and other specialised treatment].
12.	Tongia Heart and General Hospital, 7 Vivekananda Marg, C – Scheme, Jaipur 302 001	Super speciality – Cardiology, Cardiovascular and Cardiothoracic surgery and diagnostic centre (Laboratory, CT, USG / Colour Doppler)
13.	Tagore Hospital & Research Institute, Mansarovar, Jaipur	Multi-speciality General purpose.
14.	Jain Eye Clinic & Hospital, K / 4 /A, Fateh Tiba, M. D. Road, Jaipur 302004	Superspeciality Eye Care [Cataract / Glaucoma, Retinal – Medical and Vitreo – Retinal surgery, Strabismus, Occuloplasty & Adnexa].
15.	K. C. Memorial Eye Hospital, Malan Ka Chauraha, Malviya Marg, “C” Scheme, Jaipur 302 001.	Superspeciality Eye Care [Cataract / Glaucoma, Retinal – Medical and Vitreo – Retinal surgery, Strabismus, Occuloplasty & Adnexa except Corneal transplant].
16.	Ganadhipati Purushotam Shekhawati Hospital & Research Centre, A / 2, Opp. Time Square Central Spine, Vidhyadhar Nagar, Jaipur 302 023.	Multi-speciality general purpose and specialised purpose in Urology including Dialysis, Orthopaedic Surgery, including joint replacement and Arthroscopic surgery; Neurology & Neurosurgery, Endoscopic / Laparoscopic surgery & ENT.
17.	S. R. Kalla Memorial Gastro & General Hospital, 7 – 8 Dhuleshwar Garden, Behind HSBC Bank, Sardar Patel Marg, C Scheme, Jaipur 302 001	Super-speciality in Urology including Dialysis, Gastroenterology and G. I. Surgery except Liver Transplant, Endoscopic / Laparascopic Surgery.
18.	Santokba Durlabji Memorial Hospital cum Medical Research Institute, Bhawani Singh Marg, Jaipur 302 015 .	General & specialised purpose [Cardiology and Cardio-thoracic Surgery, Renal Transplant, Haemodialysis, Lithotripsy / TURP, Laparoscopic surgery, IOL Implant, Orthopaedic Joint Replacement] and diagnostic services [Laboratory, USG / Colour Doppler, X – Ray].
19.	Monilek Hospital & Research Centre, Sector 4, Jawahar Nagar, Jaipur 302 004	General & specialised purpose [Renal Transplant; Haemodialysis; Lithotripsy / TURP; Laparoscopic surgery; IOL implant, Orthopaedic Joint Replacement].
20.	Apex Hospital Pvt. Ltd., SP – 6, Malviya Industrial Area, Malviya Nagar, Jaipur 302 017	Super-speciality in Neurology and Neurosurgery; Orthopaedic surgery including Arthroscopic surgery and Joint replacement and Gastro-enterology.
21.	Soni Hospital, 38 Kanota Bagh, Jawahar Lal Nehru Marg, Jaipur	Super-speciality in Cardiology; Cardiovascular and Cardiovascular surgery; Urology including Dialysis; Gastro-enterology and GI surgery; Paediatrics & Paediatrics Surgery; Medical & Surgical Oncology; Endoscopic Surgery and ENT and Diagnostic services [Clinical Pathology; Biochemistry; Microbiology; CT Scan, USG / Colour Doppler and X – Ray].
22.	J. P. Eye Hospital, Behind Times of India, Tonk Road, Jaipur 302 015	Super-speciality Eye Care [Cataract / Glaucoma; Strabismus; Occuloplasty & Adnexa].

JAIPUR : Diagnostic Centres

1.	Dhawal Diagnostic & Research Centre, B – 99, Vidyut Nagar, Near Purani Chungi Naka, Ajmer Road, Jaipur [Tel: 0141 – 235 8762]	Diagnostic services (Clinical pathology and biochemistry).
2.	Dr. Wahi’s Central Diagnostic Clinic, Vaid Bhawan, A – 5, Chandpole – Jhotwara Road, Jaipur 302 016 [Tel: 0141 – 230 5113]	Diagnostic services (Microbiology, USG / Colour Doppler and X – Ray).
3.	SAI Clinic Medical Endoscopic Centre, 1- Kachnar Enclave, South Civil Lines, Near Sai Baba Mandir, Maharashi Raman Diagnostic Centre, B – 5 Shiv Circle, Shiv Marg, Bani Park, Jaipur 302 016 [Tel: 0141 – 220 1589 / 220 1500]	Diagnostic services (Clinical pathology, Biochemistry, USG / Colour Doppler).
4.	Okay Diagnostic Research Centre Ltd., 4 Vivekanand Marg, C Scheme, Opp. S. M. S. Hospital, Jaipur [Tel: 0141 – 236 6494 / 236 7099]	Diagnostic services (Clinical pathology, Biochemistry, Microbiology, MRI, Mammography, USG / Colour Doppler, X – Ray and Bone Densitometry).
5.	Vardhman Scanners & Imagers (P) Ltd., Santokba Durlabhji Memorial Hospital, Bhawani Singh Road, Jaipur 302 015 [Tel: 0141 – 256 2707 / 256 6251]	Diagnostic services (MRI).

SOURCE; www.mohfw.nic.in 

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LATEST LIST OF CGHS HOSPITALS AND DIOGNOSTIC CENTRES IN BHUBANESHWAR

[As on 10th June 2010]

   BHUBANESHWAR : Hospitals 

S.No.	Name of the Hospital	Name of the Hospital
1.	Hi-Tech Medical College and Hospital, Pandara, Rasulgarh, Bhubaneshwar 751 010.	General and specialised purpose (Haemodialysis, laproscopic surgery, IOL Implant) and diagnostic services (laboratory, X- Ray, USG / Colour Doppler).
2.	Kalinga Institutes of Medical Science (KIMS), Patia, Bhubaneshwar (Now renamed as Pradumna Bal Memorial Hospital)	General and specialised purpose (Laproscopic surgery, IOL Implant) and diagnostic services (Laboratory, CT scan, X-Ray, USG / Colour Doppler).
3.	Aditya Care Hospital, Plot No: 329 / 1929 (P), Chandrasekharpur, Bhubaneshwar 751 014	Multi-speciality general purpose and specialised purpose in Cardiology & CTVS, Neurology & Neurosurgery, Urology, Orthopaedic surgery including joint replacement, Gastroenterology and GI surgery, Endoscopic / Laparoscopic surgery and ENT.

BHUBANESHWAR : Diagnostic Centres

1.	Hope Diagnostics, Plot No: 55 Mati House, Unit III, Behind RamMandir, Bhubaneshwar [Tel: 0674 – 653 1554]	Diagnostic Centre [Laboratory in Clinical Pathology, Biochemistry and Microbiology.

SOURCE;www.moh.nic.in

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Review of Functioning of CGHS

The performance of the CGHS is regularly reviewed by the Government. The committee of secretaries has also been regularly reviewing the functioning of the CGHS since December 2008 and has been giving directions to the Ministry of Health & Family Welfare for making it beneficiary friendly. Some of the recent initiatives are listed below:



1. Computerisation: To keep pace with the modern times, a massive computerisation work has been taken up under CGHS in collaboration with the National Informatics Centre. Computerisation of the CGHS will result in lesser waiting period for beneficiaries at the dispensaries; online placement indents on local chemists, availability of patients profiles; availability of medicine, drugs usage pattern, which enable the CGHS to prepare a realistic of formulary drugs; reduction in use of paper; removal of jurisdictional restriction (as regard the dispensaries) for the beneficiaries, etc.



2. Introduction of Plastic cards: As part of the computerisation process, it has been decided to plastics cards individually to each beneficiary of the CGHS. This will enable beneficiaries to avail CGHS facility in any city should they happen to be in that city either on official work or on leave. Inter city treatment will be possible after all cities are computerised and networked.



3. Accreditation of hospitals with National Accreditation Board for hospitals and health care providers (NABH) and lapse with National Accreditation Board for Testing and Caliberation Laboratories (NABL): With a view to providing better quality treatment to CGHS beneficiaries, it was decided that only those private hospitals and diagnostic centres would be empanelled under the CGHS, as have been cleared by the quality Council of India after it carried out inspection of the facilities available at these hospitals and diagnostic centres. It may been decided all the hospitals and laboratories on the panel of CGHS have to get certificates issued by the NABH / NADL under the quality council of India.



4. Medical Audit of Hospital Bills is an important exercise to assess the quality of services offered and expenditure incurred. In order to be sure that the bills raised by private empanelled hospitals are genuine and that the beneficiaries were required to undergo only that treatment as was required and that the hospital has not forced the beneficiary to undergo unnecessary tests / treatment at the hospital. The job of the medical audit of Hospital bills has been outsourced to TPAs.



5. Holding of Claims Adalats: Complaints were received in the CGHS and in the Ministry that old cases of reimbursement of medical expenses incurred by pensioners were pending for settlement for long time. It was decided that claims adalats be held in each Zonal office of CGHS, Delhi under the chairmanship of the Additional Directors of the respective zones. Claims adalats were held annually, in each zone (East, Central, South and North Zones) in Delhi, during 2007 and 2008 and over 95% of the claims were settled in those adalats. Encorporated by the success in Delhi, all CGHS cities have been directed to hold claim adalats on annual basis.



6. Local Advisory Committees Local Advisory Committee meetings are held in each CGHS dispensary on second Saturday on the month attended by the Welfare Officer appointed by the Chief Welfare Officer, Department of Personnel & Training, representatives from pensioners associations, local chemists to resolve problems at dispensary level.



7. Decentralisation and delegation of powers: Ministries / departments have been delegated powers to handle all cases of reimbursement claims if no relaxation of rules was involved. Either they had powers to handle requests upto Rs. 2 Lakh and beyond that amount, the cases were referred to CGHS.



8. Rate contract for purchase of drugs: Dispensaries in Delhi have been permitted to place indent directly on the manufacturers on rate contract basis. The benefit of this arrangement is that dispensaries / CGHS do not have to carry huge inventory of medicines and indents can be placed on a monthly basis depending on the need.



This information was given by Minister for Health and Family Welfare Shri Ghulam Nabi Azad in written reply to a question raised in Rajya Sabha today.

SOURCE;PIB

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WHERE IS CGEPHIS?CENTRAL GOVERNMENT EMPLOYEES WAITING FOR THAT SCHEME TO COME.

We know already that central Government is planning to introduce a New Medical Insurance Scheme to central government employees and Pensioners.(OM No S 11010/6/2009-CGHS-P(Pt). Government notice also published in the newspapers all over the country on 28-01-2010.



In this insurance scheme a family  can claim up to Rs 5 lacs.But the premium amount has been not yet decided.

Demand survey  for the CGEPHIS to find out the beneficiaries for taking further steps to implement.Those employees who are interested in this scheme can join and it is included for the retired employees also.



The scheme is compulsory for the new recruiters and the employee to be retired.The scheme which was introduced  was not been educated to the lower group employees.Computers with internet connection is not common among the employees.So it is difficult  for the employees to know about this scheme..At the mean time the managements  and the trade unions who are responsible  to educate the common employees are not involved  in this matter.



The present scheme(CGHS) has its prescribed rates in the final claim.Lower group employees gets only 60% to 80%  in their final claim.17 lac employees and 7 lac retired employees will be getting benefit by this scheme But the scheme still not implemented in to action.



Central government employees portal interact with some employees regarding the new scheme, most of them interested in this.



The following points may be concentrated by federations



1 Give wide publicity to this scheme(CGEPHIS).That means a lower grade employee also should know about this scheme.

2  Bring down the premium amount as much as possible.

3  Initial premium should be paid by the government

4  Instead of insisting their(federations) views to the employees they must educate and explain them to take a decision in this regard.

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Instructions regarding issue of Medicines to the CGHS Beneficiaries for Chronic Illness, Reiterated

            The Central Government servants/pensioners who are availing of medical facilities under the Central Government Health Scheme and are suffering from chronic illnesses like diabetes, tuberculosis, heart ailment, hypertension, I.H.D., epilepsy, etc., can be issued medicines for a period of three months at a time by the Officer-in-charge of the CGHS dispensary, provided the specialist has prescribed the medicine for a long period.  This Ministry has been receiving complaints from the patients suffering fro long term diseases and the Pensioners Organizations, etc., that the patients are not being issued medicines for a period of three months at a time and they have go to the dispensary every month for issue of the requisite medicines.

 2. In order to alleviate the hardships being faced by such CGHS beneficiaries, CMO-in-charge of the CGHS dispensaries all over the country are requested to issue them medicines for a period of 3 months at a time against the individual valid prescription containing the advice of the Government specialist.  They may, however, satisfy themselves of the circumstances for the period for which the medicines are issued.  

3. The CMO-in-charge may also maintain the records indicating all such cases where medicines are issued to CGHS beneficiaries for a long period along with the name of the beneficiary, diagnosis and justification for issue of medicines.

4. The above-mentioned orders are also being circulated to all the Ministries/Departments of the Government of India for general information of all the CGHS beneficiaries.

SOURCE;CGHS

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ADDITION/DELITION OF EMPANELLED HOSPITALS FROM CGHS LIST

The Directorate General of Health Service,CGHS Desk.ll, Nirman Bhawan, New Delhi,with referance to the order NoS.11011/69/2004-CGHS Desk.Il (Part.4),Dated ,the 30th March, 2010,has directed the CGHS Head Quarters to add/delete the names of empanelled hospitals from the Ministry’s website due to non-submission of MOA / bank guarantee and not interested to continue on the panel of CGHS after expiry of agreement period of two years  TO VIEW THE  HOSPITALS  CLICK HERE--http://mohfw.nic.in/writereaddata/cghsdata/citytender/File146.pdf

 

SOURCE;GEN

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CGHS----MORE DETAILS

The “Central Government Health Scheme” (CGHS) provides comprehensive health care facilities for the Central Govt. employees and pensioners and their dependents residing in CGHS covered cities.

Started in New Delhi in 1954, Central Govt. Health Scheme is now in operation in Allahabad ,Ahemdabad ,Bangalore , Bhubhaneshwar ,Bhopal ,Chandigarh , Chennai ,Delhi , Dehradun ,Guwahati , Hyderabad , Jaipur , Jabalpur , Kanpur , Kolkatta , Lucknow , Meerut , Mumbai , Nagpur , Patna , Pune , Ranchi , Shillong , Trivandrum and Jammu.

The Central Govt. Health Scheme provides comprehensive health care to the CGHS Beneficiaries in India. The medical facilities are provided through Wellness Centres(previously referred to as CGHS Dispensaries) /polyclinics under Allopathic, Ayurveda, Yoga, Unani, Sidha and Homeopathic systems of medicines.

v 248 allopathic dispensaries, 19 polyclinics.78 Ayush dispensary/ units

v 3 Yoga Centres

v 65 Laboratories

v 17 Dental Units

SOURCE;GOVTEMPDIARY.COM

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CGHS to do Preventive Health Check up for beneficiaries

CGHS to do Preventive Health Check up for beneficiaries above forty years of age







Preventive health check up for adults has been introduced in CGHS within primary health care level. The introduction is designed to conduct a periodic examination, which can detect disease early and can help in preventive diseases. Such a preventive check up is a health appraisal specially related to age, risk factors and lifestyle.







The aim of the preventive health check envisages to develop a system to assess the health status through health checks for CGHS beneficiaries above 40 years of age and to provide preventive, referral and follow-up services to the beneficiaries through medical check-ups, health education and counseling of the beneficiaries on various issues.







The Preventive Health Check is envisaged as a Pilot Project which has been started for Central Government employees aged over 40 years at CGHS Wellness Centre RKP-V (Sector-12), R.K. Puram, New Delhi and CGHS Wellness Centre RKP-I (Sector 4), R.K. Puram, New Delhi, with a set of proforma and investigations. It is proposed to have a mass screening of Central Government employees, Serving and Pensioners at CGHS Wellness Centre level by paramedic initially for basic history, clinical examination by Medical Officer/Specialist later reviewing investigations done.







The on line module(software) of the Preventive Health Check Project has been developed with the collaboration of the NIC officials. The Module with the proforma for health checks and investigations is being deployed for use for the CGHS Wellness Centre RKP-V (Sector-12), D-57, where the Preventive Health Check Project has started. All operational formalities are complete and the module is in use.







CGHS has already finalized a package deal with Dr. Bhasin Path Labs for the set of specific investigations (Male/Female) for Health Check.







Operational steps for check up







Within 10 days prior to registration date given, beneficiary goes to CMO I/c of his Wellness Centre for an investigation slip for Health Check up.







Beneficiary goes to the center for investigations. The reports of beneficiary are uploaded by the center in module and are now available to CMO I/c of the Wellness Centre/Health Check Centre.







On the date of registration, beneficiary reports at Health Check Centre where a Paramedic (preferably a Staff Nurse) enters all Preliminary History data and baseline General Physical examination data like Weight, Height, BMI, Pulse, BP, Temp. etc.







The physician now has History, Examination data done by Para-medic and investigations data from Diagnostic Centre, Physician after entering all Clinical examination data and evaluating all details put beneficiary in one of the following four categories and records his advice on in physician column.







1.Apparently healthy: :Follow up after one year for Annual Health Check







2.Needs to be investigated further :Next Health Check after 6 Months







3.At risk for Disease :Advised follow-up after that 3 Months







4.Diagnosed to have Disease :Referred to a Specialist for management





SOURCE;CGSN

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Government introduce a new Medical Scheme for Central Government Employees and Pensioners

Government introduce a new Medical Scheme for Central Government Employees and Pensioners





Government introduce a new Medical Scheme for Central Government Employees and Pensioners as in the name of Central Government Employees and Pensioners Health Insurance Scheme (CGEPHIS). In all over India, pensioners are getting meager amount of Rs.100 as Medical Allowance (except CGHS beneficiaries). It is estimated that approximately 17 lakh serving employees and 7 lakh pensioners shall be offered this Scheme and Government plan to enroll all serving employees and pensioners on compulsory / optional basis.



Some key points regarding the scheme:-



CENTRAL GOVERNMENT EMPLOYEES AND PENSIONERS HEALTH INSURANCE SCHEME (CGEPHIS)



BENEFICIARIES:



CGEPHIS shall be compulsory to new Central Government Employees who would be joining service after the introduction of the Health Insurance Scheme.



CGEPHIS shall be compulsory to new Central Government retirees who would be retiring from the service after the introduction of the Insurance Scheme.



CGEPHIS would be available on voluntary basis for the following:



Existing Central Government Employees and Pensioners who are already CGHS beneficiaries. In this case they have to opt out of CGHS scheme. They will also have the option of choosing both CGHS and Insurance policy. In such case the total insurance premium has to be borne by the member.





Existing Central Government Employees and Pensioners who are not CGHS beneficiaries but are covered under CS (MA)



INSURANCE COVERAGE:



In-patient benefits – The Insurance Scheme shall pay all expenses incurred in course of medical treatment availed of by the beneficiaries in an Empanelled Hospitals/ Nursing Homes (24 hours admission clause) within the country, arising out of either illness/disease/injury and or sickness.



NOTE: In case of organ transplant, the expenses incurred for the Donor are also payable under the scheme.





Pre & Post hospitalization benefit: Benefit up to 30 days Pre Hospitalization & up to 60 days Post Hospitalization respectively which would cover all expenses related to treatment of the sickness for which hospitalization was done.





FAMILY SIZE:





Serving/Retired Employees: Self, Spouse, Two dependent children and up to Two Dependent Parents. New born shall be considered insured from day one till the expiry of the current policy irrespective of the number of members covered subject to eligibility under maternity benefit.



Any additional dependent member in addition to above [Sr. No. 5 (1)] can be covered under the Scheme by paying the fixed amount of premium. This additional full premium shall be borne by the beneficiary.



IDENTIFICATION OF FAMILY:



Beneficiaries shall be identified by a “Photo Smart Card” issued by the insurer to all beneficiaries which would have all personal details, medical history, policy limits etc. of the CGEPHIS members. This card would be used across the country to access Health Insurance Benefits. The photograph embedded in the chip of the Smart Card will be taken as the proof for determining the eligibility of the beneficiaries.





SUM INSURED AND BUFFER / CORPORATE SUM INSURED



SUM INSURED:



The Scheme shall provide coverage for meeting all expenses relating to hospitalization of beneficiary members up to Rs. 5, 00,000/- per family per year in any of the Empanelled Hospital/Nursing Home/Day Care Unit subject to stated limits on cashless basis through smart cards. The benefit shall be available to each and every member of the family on floater basis i.e. the total reimbursement of Rs. 5.00 lakh can be availed by one individual or collectively by all members of the family.



Entitlements for various types of wards: CGHS beneficiaries are entitled to facilities of private, semi-private or general ward depending on their pay drawn in pay band / pension. These entitlements are amended from time to time and the latest order in this regards needs to be followed. The entitlement is as follows:-



Pay drawn in pay band/Basic Pension – Entitlement



Rs. 13,950/-(up to)……………………………… General Ward



Rs. 13,960/- to 19,530/- …………………… Semi-Private Ward



Rs. 19,540/- and above ……………………… Private Ward



CASHLESS ACCESS SERVICE:



The Insurer has to ensure that all CGEPHIS members are provided with adequate facilities so that they do not have to pay any deposits at the commencement of the treatment or at the end of treatment to the extent as the Services are covered under the Scheme. The service provided by the Insurer along with subject to responsibilities of the Insurer as detailed in this clause is collectively referred to as the “Cashless Access Service.”



The services have to be provided by the Empanelled Hospitals/Nursing Homes/Day Care Clinics to the beneficiary based on Photo Smart Card authentication only without any delay. The beneficiaries shall be provided treatment free of cost for all such ailments covered under the Scheme within the limits/sub-limits of defined package rates and sum insured, i.e., not specifically excluded under the scheme.



ENROLMENT PROCESS



The process of enrolment shall be as under:



Serving Employees:



1. Departments and offices will call for options from employees to join voluntary CGEPHIS with or without existing CGHS/CS (MA) benefits.



2. Head of Department of the Administrative Ministry/Department would be the contact point for the Insurance Companies.



3. Enrolment forms giving details about self and family and authorization to the department for recovery of premium on a monthly basis would be consolidated by the Administrative Ministry / Department. The data of the beneficiary and dependent members to be covered along with 2 recent passport size photo and copy of enrolment form will be forwarded to Insurance Company on monthly basis.

4. Insurance Company will issue Smart Cards on the basis of information received of the beneficiaries for enrolment.



5. Such Smart Cards along with the enrollment kit shall be sent by the insurers directly to the insured persons at their respective mailing addresses at insurer’s cost within 7 days.

Insurance Premium:-



The beneficiary will have to pay an annual premium which will be determined after the formal introduction of the Scheme. It will vary according to the grade pay of the officer. The estimated annual premium for a standard family size will be in the range of Rs.8000 to Rs.12000 p.a. It is however proposed to be subsidized by the Government to a considerable extent



SOURCE;CGSN

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