Critically ill CGHS beneficiaries : Post-operative Follow-up treatment from Hospitals empanelled under CGHS

Critically ill CGHS beneficiaries : Post-operative Follow-up treatment from Hospitals empanelled under CGHS

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.

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.
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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. 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
g. Neurological disorders like Dementia, Alzheimer’s disease, Parkinsonism,
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
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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.
(Dr. Manai Jain)

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