CGHS Beneficiaries permitted for OPD Consultation at Private Hospitals

Clarification / modification of the guidelines issued regarding simplification of referral system under CGHS vide OM dated Z 15025/117/2017/DIR/CGHS dated 15/01/2018

OPD Consultation at Private Hospitals

Z 15025/64/2018/DIR/CGHS
Government of India
Ministry of Health & Family Welfare Department of Health & Family Welfare
545-A Nirman Bhawan, New Delhi

Dated the 31st July, 2018.

OFFICE MEMORANDUM

Sub: Clarification / modification of the guidelines issued regarding simplification of referral system under CGHS vide OM dated Z 15025/117/2017/DIR/CGHS dated 15/01/2018

With reference to the above mentioned subject the undersigned is directed to draw attention to the guidelines issued vide OM No. Z 15025/117/2017/DIR/CGHS dt. 15/01/2018 under para no (i) and to state that the matter has been reviewed by Competent Authority and it is now decided to modify para (i) in supercession of the earlier guidelines of the above referred to OM as under

(i) All CGHS beneficiaries (in all CGHS Cities) shall be permitted for seeking OPD Consultation  from Specialists at Private hospitals empanelled under CGHS after being referred by any Medical Officer of CGHS Wellness Centre. The referral may be mentioned on the computer generated Prescription slip. After consultation at empanelled hospital, beneficiary shall report back to concerned Wellness Centre, where MO/ CMO would endorse listed investigation / listed treatment procedure and issue medicines as per the guidelines mentioned in the OM dated 15.01.2018.

For unlisted investigations/unlisted treatment procedures CMO Incharge shall submit the prescription to Competent Authority for consideration in case of pensioner beneficiaries. Serving employees shall seek permission for unlisted investigation/unlisted treatment procedure from their department as per prevailing guidelines.

The other terms and conditions of OM No. Z 15025/117/2017/DIR/CGHS Dated 15/01/2018 shall remain unchanged.

[Dr. Atul Prakash ]
Director, CGHS

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