Simplification of referral system under CGHS

Ministry of Health and family welfare has Vide its OM No. Z 15025/117/ 2017/DIR/CGHS/EHSc Dated the 10th December, 2018 revised the guidelines for simplification of referral system under CGHS

With reference to the above mentioned subject the undersigned is directed to state that this Ministry has been receiving representations for simplification of procedure for undergoing treatment/investigations at private hospitals empanelled under CGHS_ In this regard attention is drawn to the guidelines issued under Office Memoranda No. Z.15025/117/2017/ DIR/CGHS/EHS, dated 15_01.2018 and S. 1045/40/2012/CGHS/HEC/CGHS (P), dated 22.02.2013 and to state that the matter has been reviewed by this Ministry and it has now been decided to revise the guidelines for consultation and treatment at CGHS empanelled private hospitals as per the details given under:-

i) Referral from CGHS Medical Officer/CGHS Specialist for consultation with Specialists at Private Hospitals empanelled under CGHS shall be valid for 30 days in the same hospital.

ii) Referral shall be valid for consultations upto 3 times in the same hospital within 30 days.

iii) Similarly referral shall be valid for consultation with a maximum of 3 different Specialists, if required during a single visit.

iv) Advice of the CGHS Medical Officer/CGHS Specialist for listed investigations shall be valid for a period of 30 days.

v) Advice of the CGHS Medical Officer/CGHS Specialist for listed treatment procedure shall be valid for a period of 3 months.

vi) if any listed investigation advised by Specialist of empanelled hospital is required urgently as a medical emergency and certified as such, may be undertaken at the same hospital.

vii) Hospitals are empanelled under CGHS for the Specialists available and not by the mime of Specialists.

viii) The Referral of CGHS Medical Officer/Specialists may be issued through Computers or even manually with proper stamp of referring doctor.

The other terms and conditions as prescribed on the above referred OMs shall remain unchanged.

[Rajeev Attri]
Under Secretary to Government of India
Tel- 011-2306 1883

Click here to view the signed copy