CGHS – Interim Arrangement for Mumbai and Thiruvananthapuram

It has been brought to the notice of the Ministry of Health & Family Welfare that hospitals and diagnostic centres empanelled under CGHS, Mumbai and Thiruvananthapuram have been showing lack of interest in continuing with CGHS due to their perceived grievance of high amount of performance bank guarantee and the rates that were being offered. This has resulted in the ailing CGHS beneficiaries not being able to get treatment in private hospitals and diagnostic centres.

The matter has been examined in the Ministry of Health & Family Welfare and, as an interim arrangement, it has been decided that CGHS beneficiaries in Mumbai and Thiruvananthapuram may be allowed to get their treatment / tests, etc., in any private hospital / diagnostic centre in their respective cities and claim reimbursement from their respective Departments / Ministries / CGHS, as the case may be, subject to the condition that the reimbursement would be limited to the CGHS rates that have been fixed for the city.

There will be no change in the procedure for claiming of reimbursement of expenses.

The hospitals, not being in the list empanelled hospitals under the CGHS, may not provide treatment under CGHS package rates for the city and may charge their own prevailing rates. The hospitals will also not be extending credit facilities to pensioner CGHS beneficiaries. Hence the beneficiaries may have to spend for their treatment from their own resources and claim reimbursement from their respective Ministries / Departments / CGHS. Before they proceed to get treatment in a hospital, the beneficiaries are requested to get the permission from the concerned authorities.

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