Clarification for CGHS beneficiaries
Regarding CGHS rates applicable in the empanelled hospitals in various cities, the Department of Health and Family Welfare has issued an Office Memorandum [No.S.11011/23/2009-CGHS D.II/Hospital Cell (Part IX)] on 30th September, 2011. The order has been published on its website of http://msotransparent.nic.in/cghsnew/index.asp
The earlier order was clarified that the treatment of casualty OPD shall be treated as treatment under emergency and credit facility shall be extended to the CGHS beneficiaries. However, routine OPD consultation shall not be considered a medical emergency.
Similarly, one of the main clairfication of the order is that for any day care procedure requiring short admission – a few hours to one day – accommodation charge for one day as per entitlement shall be applicable.
Moreover “If CGHS rate is not available for any procedure / investigation / category (say super-speciality) in any CGHS covered city, the CGHS rate notified for such procedure / investigation / category for the nearest CGHS city or the rate notified under CGHS, Delhi, whichever is lower shall be applicable as CGHS rate for such procedure / investigation / category for that city”.
And also clarified that “Since NABL Accreditation for in-house laboratories of hospitals has been made optional, rates prescribed for NABL Accredited laboratories shall be applicable for the in-house laboratories of hospitals, for the investigations under taken for in-patients”.