CGHS-GUIDELINES FOR REFERRING THE CASES TO HEALTH MINISTRY
Department of Health and Family Welfare, Ministry of Health and Family Welfare has observed that issues relating to CGHS Matters are referred by various Ministries and Departments to Department of Health in a routine manner which could have been settled at the CGHS beneficiary’s own Ministry or Department. Hence, it is informed by Department of Health and Family Welfare that cases related to CGHS matters are to be examined thoroughly as per the CGHS guidelines and instructions and clarification on CGHS policy matter or relaxation of rules is required, the administrative Ministry/Department may refer the case to Department of Health and family welfare with specific recommendation of Joint Secretary/Head of Department with justification along with all supporting documents.
The Office Memorandum dated 27.06.2012 issued in this regard is as follows.
Government of India
Ministry of Health & Family Welfare
Department of Health & Family Welfare
Nirman Bhawan, Maulana Azad Road
New Delhi 110 108
No.S.11011/1/2012-CGHS (P)
Dated the 27th June, 2012
OFFICE MEMORANDUM
Sub: Guidelines to be followed by Ministries/Departments while referring cases to Ministry of Health & Family Welfare on CGHS matters — reg.
Central Government Health Scheme (CGHS) was introduced in 1954 to provide comprehensive medical care for serving/retired Central Government employees and their family members. Instructions have been issued from time to time to regulate this medical facility to ensure that Ministries and Departments of Government of India including the CGHS beneficiaries have a clear idea on different aspects of CGHS.
2. Various instructions on eligibility, dependency, CGHS contributions, issue of CGHS cards, medical advance, settlement of medical claims and medical facilities provided under CGHS have been issued. These instructions are by no means exhaustive but an effort has been made to ensure that most cases are settled at the beneficiary’s own Ministry / Department.
3. Despite issuing a number of guidelines on settlement of reimbursement claims and delegation of powers for referral and approval cases, it has been observed that cases are being referred to this Ministry in a routine manner without adequate examination. Instances of cases have come to notice where despite the lack of documentary evidence, cases have been recommended and referred to this Ministry for examination, with or without the approval of the concerned Joint Secretary/Head of Department.
4. In such cases, it becomes difficult to examine the legitimacy of the claims and much time and effort is spent in collating and verifying the facts of the case. Accordingly, it is impressed upon all the Ministries/Departments of the Government of India to ensure that cases are examined thoroughly as per the CGHS guidelines and instructions. If any clarification on CGHS policy matter/relaxation of rules is required, the Administrative Ministry / Department may, if they are satisfied with the justification/merit of the case, refer it to this Ministry with the specific recommendation of the concerned Joint Secretary /Head of Department along with all supporting documents.
5. This issues with the approval of Additional Secretary & Director General (CGHS).
sd/-
(V.P.Singh)
Deputy Secretary to the Government of India
CGHS-DISTRIBUTION OF LIFE SAVING MEDICINES IN WELLNESS CENTRES
Directorate General of CGHS has favourably considered the representations of CGHS beneficiaries residing in NCR towns of Noida, Ghaziabad, Gurgaon and Faridabad to make available the life saving medicines and anti cancer medicines at the CGHS Wellness Center itself. Until now, these medicines are to be obtained only from Medical Store Depot (MSD), Gole Market, New Delhi. The full text of the Office Memorandum F.No: 1-32/2012-13/CGHS/MSD/IMP dated 24.07.2012 issued in this regard is as follows.
GOVERNMENT OF INDIA
MINISTRY OF HEALTH & FAMILY WELFARE
DIRECTORATE GENERAL OF CGHS
No: F.No. 1-32/2012-13/CGHS/MSD/IMP
Dated the 24th July, 2012
OFFICE MEMORANDUM
Subject: Distribution of Life Saving Medicines/Anti Cancer Medicines to CGHS beneficiaries in NCR towns at Wellness Center level.
The undersigned is directed to refer to the subject mentioned above and to state that the Ministry has been receiving requests from CGHS beneficiaries residing in the NCR towns of NOIDA, Ghaziabad, Gurgaon and Faridabad, for providing the delivery of life saving medicines/anti cancer medicines at the CGHS Wellness Centre level as against the present system in which these are provided at the Medical Store Depot (MSD). Gole Market, New Delhi. In view of the hardships faced by the CGHS beneficiaries in collecting the above medicines, it has been considered sympathetically by the Ministry and it has now been decided to arrange delivery of the life saving drugs and anti cancer drugs to the CGHS beneficiaries in the above cities at the CGHS Wellness Centre level.
The life saving medicines and anti cancer medicines will be delivered at the Wellness Centre by the supplier between 11AM to 1 PM on third day of placing the indent. The beneficiaries can collect their indented medicines from the Wellness Centre accordingly. In case of emergency they can also collect medicines from Medical Store Depot (MSD), Gole Market, New Delhi, itself on the next working day after due confirmation from the Medical Store Depot(MSD).
sd/-
(V.P .Singh)
Deputy Secretary to the Government of India
