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F. No.S.11011/87/2006-CGHS Desk. II
Government of India,
Ministry of Health & Family Welfare
Department of Health & Family Welfare
***
Nirman Bhawan, New Delhi
Dated the 19th October, 2007.
OFFICE MEMORANDUM
Subject: Empanelment of Hospitals and Diagnostic Centers under CGHS, Kolkata, for treatment
and diagnostic procedures and fixation of package rates.
The undersigned is directed to state that the question of fresh empanelment of Hospitals and
diagnostic centers under CGHS, Kolkata, and fixation of package rates/ rates has been under
consideration of the Government. The approved rates are available on the website of CGHS
(www.mohfw.nic.in/cghs.html) and may be downloaded / printed. After following the prescribed
procedure, the list of Hospitals and Diagnostic Centers approved by the Ministry for empanelment under
CGHS, Kolkata is enclosed as Annexures A and B. The hospitals mentioned in Annexure C
will continue to be empanelled with CGHS, Kolkata, until further orders.
2.
(a)
Package Rate shall mean and include lump sum cost of in-patient treatment / day care /
diagnostic procedure for which a CGHS beneficiary has been permitted by the competent authority or
for treatment under emergency from the time of admission to the time of discharge, including (but not
limited to) (i) Registration charges, (ii) Admission charges, (iii) Accommodation charges including
patient's diet, (iv) Operation charges, (v) Injection charges, (vi) Dressing charges, (vii) Doctor /
consultant visit charges, (viii) ICU / ICCU charges, (ix) Monitoring charges, (x) Transfusion charges, (xi)
Anesthesia charges, (xii) Operation theatre charges, (xiii) Procedural charges / surgeons fee, (xiv) Cost
of surgical disposables and all sundries used during hospitalization, (xv) Cost of medicines, (xvi)
Related routine and essential investigations, (xvii) Physiotherapy charges etc. (xviii) Nursing care and
charges for its services.
(b)
Cost of Implants is reimbursable in addition to package rates as per CGHS ceiling rates for
implants or as per actual, in case there is no CGHS prescribed ceiling rates.
(c)
Treatment charges for new born baby are separately reimbursable in addition to delivery
charges for mother.
Hospitals / diagnostic centers empanelled under CGHS shall not charge more than the
d)
package rates/ rates.
(e)
Expenses on toiletries, cosmetics, telephone bills etc, are not reimbursable and are not
included in package rates.
3.
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No additional charge on account of extended period of stay shall be allowed if that extension is due to
infection on the consequences of surgical procedure or due to any improper procedure and is not
justified.
In case, there are no CGHS prescribed rates for any test/procedure, then AIIMS rates are applicable. If
there are no AIIMS rates, then reimbursement is to be arrived at by calculating admissible amount itemwise(e.g. room rent, investigations, cost of medicines, procedure charges etc) as per approved rates/
actuals, in case of investigations.
4.
a) CGHS beneficiaries are entitled to facilities of private, semiprivate or general ward depending on their basic pay / pension. The entitlement is as follows:S. No.
1.
2.
3.
(Note: The entitlement in case of pensioners depends upon as to whether the contribution is
being made on the basis of last pay drawn or on the basis of pension drawn.)
b) The package rates given in rate list are for semi-private ward.
It has now been decided that the CGHS pensioner beneficiaries taking treatment in the
c)
empanelled hospitals will be entitled for treatment on credit and serving employees will be entitled for
reimbursement after payment, as per the package rates/ rates given on the web site at
www.mohfw.nic.in/cghs.htm. The package rates prescribed are for semi-private ward. If the beneficiary
is entitled for general ward there will be a decrease of 10% in the rates; for private ward entitlement
there will be an increase of 15%. However, the rates shall be same for investigation irrespective of
entitlement, whether the patient is admitted or not and the test, per-se, does not require admission.
5
A hospital / diagnostic centre empanelled under CGHS, whose rates for treatment procedure /
test are lower than the CGHS prescribed rates shall charge as per actual.
6. a)
b)
Room rent is applicable only for treatment procedures for which there is no CGHS prescribed
package rate.
Room rent will include charges for occupation of Bed, diet for the patient, charges for water and
electricity supply, linen charges, nursing charges and routine up keeping,.
c)
During the treatment in ICCU / ICU, no separate room rent will be admissible.
Private ward is defined as a hospital room where single patient is accommodated and which
d)
has an attached toilet (lavatory and bath). The room should have furnishings like wardrobe, dressing
table, bed-side table, sofa set, etc. as well as a bed for attendant. The room has to be air-conditioned.
e)
Semi Private ward is defined as a hospital room where two to three patients are
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accommodated and which has attached toilet facilities and necessary furnishings.
f)
g)
Normally the treatment in higher category of accommodation than the entitled category is not
permissible. However, in case of an emergency when the entitled category accommodation is not
available, admission in the immediate higher category may be allowed till the entitled category
accommodation becomes available. However, if a particular hospital does not have the ward as per
entitlement of beneficiary, then the hospital can only bill as per entitlement of the beneficiary even
though the treatment was given in higher type of ward.
If, on the request of the beneficiary, treatment is provided in a higher category of ward, then the
expenditure over and above entitlement will have to be borne by the beneficiary.
7.
a)
In case of non-emergencies, the beneficiary shall have the option of availing specific
treatment / investigation from any of the empanelled hospitals/ diagnostic centre of his / her choice
(provided the hospital / diagnostic centre is empanelled for that treatment procedure / test), after the
specific treatment / investigation has been advised by CGHS / other Government Specialist / CMO i/c
and permission is obtained from competent authority.
(Note: Endorsement Referred to CGHS approved Centre by either the Specialist or the CMOin-Charge will not be required for the concerned Ministry / Department to issue permission for
treatment in a private empanelled hospital.)
Permission for treatment / investigations is granted by CMO Incharge / Additional
b)
Director / Joint Director, CGHS in case of pensioners, former Governors, former Vice-Presidents, exMPs, Freedom Fighters, etc., and by Rajya Sabha/ Lok Sabha Secretariat as the case may be in case
of Members of Parliament, by the Registrar General of Supreme Court and by the Registrar, Delhi High
Court in respect of serving and retired judges respectively, by the concerned Ministry /Department/
Organization in case of serving Govt. employees, serving employees and pensioners of autonomous
bodies covered under CGHS.
The empanelled hospitals / diagnostic centers shall honour permission letter issued by
8.
competent authority and provide treatment / investigation facilities as specified in the permission letter.
9.
a)
The hospital / diagnostic centre shall treat / investigate on credit basis to the
following categories of CGHS beneficiaries (incl. dependant family members, whose name is entered in
CGHS Card) on production of valid permission letter:
Members of Parliament
Pensioners of Central Govt. drawing pension from central estimates
former Vice-presidents, Former Governors and former Prime Ministers
Ex-Members of Parliament,
Freedom Fighters,
serving CGHS employees,
such other categories of CGHS cardholders as notified by the Government.
b) Bills should be submitted to the Secretary Generals of Rajya Sabha and Lok Sabha in case
of Members of Parliament and to Additional Director / Joint Director, CGHS, Kolkata, in case of other
beneficiaries enlisted above, once in a month.
c) The hospitals / diagnostic centres shall extend credit facility to the above categories of CGHS
beneficiaries under emergency / with prior permission irrespective of the CGHS city wherefrom CGHS
card is issued and submit the bill, as per prescribed CGHS rates to Additional / Joint Director, CGHS,
Kolkata.
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10.
In case of emergencies, empanelled hospitals shall not refuse admission nor demand
payment from any CGHS beneficiary on production of valid CGHS card, issued by competent
authority and provide treatment on credit basis and submit the bills to the concerned authority.
11.
Reimbursement in case of pensioners, former Governors, former Vice-Presidents, ex-MPs ,
Freedom Fighters , etc., is made by CGHS and by Rajya Sabha Secretariat / Lok Sabha Secretariat in
case of Members of Parliament and by concerned Ministry / Department / Organization in case of
serving Govt. employees, serving employees and pensioners of autonomous bodies covered under
CGHS.
12.
During the In-patient treatment of the CGHS beneficiary, the Hospital will not ask the
beneficiary or his attendant to purchase separately the medicines / sundries / equipment or accessories
from outside and will provide the treatment within the package rate, fixed by the CGHS which includes
the cost of all the items.
13.
In case of treatment taken in emergency in any non-empanelled private hospitals,
reimbursement shall be considered by competent authority at CGHS prescribed Package / rates only.
14.
If one or more minor procedures form part of a major treatment procedure, then package
charges would be permissible for major procedure and only 50% of charges for minor procedure.
15.
Any legal liability arising out of such services shall be the sole responsibility and shall be
dealt with by the concerned empanelled hospital / diagnostic centre. Services will be provided by the
Hospitals/Diagnostic centers as per the terms of Agreement.
16.
The hospitals / diagnostic centres will not refuse permission to Central Government
employees or their dependent family members who are not CGHS beneficiaries if they produce
certified / attested copies of identity cards issued by the Government of India and have been referred to
the hospital / diagnostic centre by the organisation in which they are working.
17.
The hospitals / diagnostic centres will give a discount of 5% on every cash payment charged
directly from the beneficiaries.
18.
This Office Memorandum supercedes all earlier orders relating to empanelment of Hospitals
and diagnostic centers for specialized and general purpose treatment and investigations for Kolkata.
A copy of this Office Memorandum along with copy of MOA is placed on the internet at
19.
www.mohfw.nic.in/cghs.htm.
(R.RAVI)
DEPUTY SECRETARY TO THE GOVERNMENT OF INDIA
[Tel: 2306 3483]
To
1.
All Ministries / Departments of Government of India
Director, CGHS, Nirman Bhawan, New Delhi
2.
3.
All Pay & Accounts Officers under CGHS
4.
Additional Directors / Joint Directors of all CGHS Cities
5.
JD(Gr.) / JD(R&H), CGHS, Delhi
6.
CGHS Desk-I / DeskII / CGHS-I / CGHS-II, Directorate General of
Nirman Bhawan, New Delhi
7.
Estt. I / Estt. II / Estt. III / Estt. IV Sections, Ministry of Health & Family
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8.
Admn. I / Admn. II Sections of Directorate General Health Services
9.
M. S. Section, Ministry of Health & Family Welfare
Rajya Sabha / Lok Sabha Secretariat
10.
11.
Registrar, Supreme Court of India / Delhi High Court, Sher Shah Road,
New Delhi
U.P.S.C.
12.
Finance Division, Ministry of Health & Family Welfare
13.
14.
Deputy Secretary (Civil Service News), Department of Personnel &
Training, 5th Floor,
Sardar Patel Bhawan, New Delhi
PPS to Secretary (H&FW), Min. of Health & Family Welfare
15.
16.
PPS to DGHS / AS&FA / AS(DG) / AS & DG, NACO
MS of all hospitals being empanelled under CGHS, Kolkata
17.
18.
Swamy Publishers (P) Ltd., P. B. No.2468, R. A. Puram, Chennai
600028.
Swamy Publishers (P) Ltd., 4855, 24, Ansari Road, Near Sanjeevan
19.
Hospital, Daryaganj, New Delhi 110002.
21
M/s Bahri Brothers, 742 Lajpat Rai Market, Delhi 110 006
New Delhi
22.
Shri. Umraomal Purohit, Secretary, Staff Side, 13-C, Ferozshah Road,
110001.
23.
All staff side members of National Council (JCM).
24.
Office of the Comptroller & Auditor General of India, 10 Bahadur Shah
Zafar Marg,
New Delhi.
25.
All Officers / Sections / Desks in the Ministry.
26.
Office order folder
Guard file
27.
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ANNEXURE -
The following hospitals are empanelled under CGHS, Kolkata, with effect from the date of issue of Office
Memorandum, No: S.11011/87/2006-CGHS Desk. II
S.
No.
1.
2.
3.
4.
5.
6.
Rabindranath
Tagore
International
Institute of Cardiac Sciences, 124
Mukundapur, E. M. Bypass, Kolkata
700099
[Tel: 033 2436 4000 / 3001 4000]
Empanelled for
Specialised purpose [Cardiology and
Cardio-thoracic surgery] and diagnostic
services [Laboratory].
Specialised purpose [Cancer treatment
including radiotherapy] and diagnostic
service
[laboratory,
USG,
CT,
Mammography and X Ray].
General,
Specialised
purpose
[Haemodialysis,
TURP,
Laparoscopic
surgery, IOL implant, Joint replacement]
and diagnostic services [Laboratory, CT,
USG / Colour Doppler and X Ray].
General,
Specialised
purpose
[Haemodialysis,
TURP,
Laproscopic
surgery, IOL Implant, Joint replacement]
and diagnostic services [Laboratory, MRI,
CT, USG / Colour Doppler and X Ray].
Specialised purpose [Cardiology and
Cardio-thoracic
surgery,
Laproscopic
Surgery,
IOL
Implant
and
Joint
replacement] and diagnostic services
[Laboratory, USG / Colour Doppler and X
Rays].
Cardiology and Cardio-thoracic surgery
ANNEXURE -
The following diagnostic centres are empanelled under CGHS, Kolkata, with effect from the date of issue
of Office Memorandum, No: S.11011/87/2006-CGHS Desk. II
S.
No.
Empanelled for
1.
2.
3.
4.
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5.
6.
7.
700020
[Tel: 033 2281 1138 / 2281 1139]
Medinova Diagnostic Services Limited,
1 Sarat Chatterjee Avenue, Kolkata
700029
[Tel: 033 2466 3651 / 2466 1780]
N. G. Medicare & Calcutta Hope
Infertility Clinic, 123A Rashbehari
Avenue, Kolkata 700 029
Reliance Diagnostics, AE 337, Salt
Lake City, Kolkata 700 064
[Tel: 033 2359 2472 / 3332 57 2019]
USG
Colour
Note:
The empanelment of the hospitals and diagnostic centres is subject to the condition that they
submit the Memorandum of Agreement and the appropriate bank guarantee to the Director, CGHS, within
45 days of the issue of the Office Memorandum No: S.11011/87/2006-CGHS Desk. II dated the 18
October, 2007,
ANNEXURE The following hospitals will continue to be empanelled under CGHS, Kolkata until further orders
S.
No.
1.
2.
Empanelled for
General purpose treatment and diagnostic
procedures.
Specialised
treatment
(Haemodialysis) only.
for
dialysis
(R.RAVI)
DEPUTY SECRETARY TO THE GOVERNMENT OF INDIA
[Tel: 2306 3483]
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