Post-operative Follow-up treatment from Hospitals empanelled under CGHS in respect of critically ill CGHS beneficiaries
Z.15025/35/2019/DIR/CGHS/ CGHS(P)
Government of India
Ministry of Health & Family Welfare
Department of Health & Family Welfare
Nirman Bhawan, New Delhi
Dated the 29th May , 2019.
OFFICE MEMORANDUM
Sub: Post-operative Follow-up treatment from Hospitals empanelled under CGHS in respect of critically ill CGHS beneficiaries-regarding
With reference to the above mentioned subject the undersigned is
directed to state that in view of the difficulties being faced by
critically ill CGHS beneficiaries in getting post-operative follow-up
treatment at CGHS empanelled hospitals, the matter was reviewed and it
has now been decided that critically ill CGHS beneficiaries shall be
permitted for follow up treatment in CGHS empanelled hospitals as per
the details given under:
i. Permission for post-operative follow-up treatment in respect of the
following post – operative conditions requiring frequent Consultations
from Specialists at private hospitals empanelled under CGHS, need not be
re validated from time to time and follow-up treatment may be under
taken at CGHS rates without time limit.
ii. The consultation /investigations are permitted under these follow-up cases. The conditions covered are:
a. Post Cardiac Surgery Cases including Coronary Angioplasty
b. Post Organ Transplant Cases (Liver, Kidney, Heart, etc.,)
c.Post Neuro Surgery Cases/Post Brain Stroke cases requiring regular follow-up treatment
d. End Stage Renal Disease/follow up cases of Liver Failure
e. Cancer treatment
f. Auto-immune disorders like Rheumatoid Arthritis requiring regular follow-up
g. Neurological disorders like Dementia, Alzheimer’s disease, Parkinsonism, etc.,
Medicines prescribed are to be procured from CGHS Wellness Centre.
iii. The beneficiaries shall have to submit a self-attested photo copy
of the permission letter to the hospital to enable the hospitals to
provide credit facility in respect of pensioners and other categories of
CGHS beneficiaries entitled for credit facility. Serving employees (and
their dependents) who may not be entitled for cashless facilities shall
enclose a self-attested photo copy of permission letter to claim
reimbursement from the concerned Ministry /Department. Permission in
respect of Pensioner CGHS beneficiaries, Ex-MPs (and other categories of
CGHS beneficiaries, whose medical expenditure is borne by CGHS) etc.,
shall be granted by CGHS. Permission in respect of Hon’ble Members of
Parliament shall be granted by Rajya Sabha Secretariat/Lok Sabha
Secretariat as the case may and by concerned Ministry /Department in
respect of serving beneficiaries and by concerned Autonomous Body /
Statutory Body in respect of serving /pensioner beneficiaries
iv. However, if any non-listed investigations / procedures are advised
permission from competent Authority shall be required, except in
emergency.
These orders are in supersession of the earlier guidelines on the subject.
Sd/-
(Dr. Manai Jain)
Addl. DDG(HQ), CGHS