SIMPLIFICATION OF PROCEDURE
FOR TREATMENT AT PRIVATE HOSPITALS EMPANELLED UNDER CGHS/CS (MA) RULES: ORDER
DATED 27.09.2018
मिसिल संख्या -Misc -69/केसस्वयों) मु(./शिकायत प्रकोष्ठ/2018/981
भारत सरकार / GOVT. OF INDIA
अपर निदेशक का कार्यालय/ OFFICE OF THE ADDITIONAL DIRECTOR
के.स.स्वा.यो (मुख्यालय)/ C.G.H.S. (HQ)
सैक्टर 12 -, आर. के.पुरम, नई दिल्ली- 22/ Sector -12, R.K.Puram, New
Delhi-22
Dated: 27/09/2018
OFFICE
MEMORANDUM
Sub:
Directions to Private HCOs empanelled under CGHS regarding simplification of
procedure for treatment at private hospitals empanelled under CGHS/CS (MA)
Rule, 1944.
With reference to the above mentioned subject the undersigned is directed to state that this Ministry has been receiving various complaints regarding difficulties being faced by CGHS beneficiaries in getting the OPD/IPD treatment at Pvt. HCOs after valid referral from the CMO/MO/Govt. Specialist. It has been viewed very seriously by the Competent Authority.
It is observed that the CGHS beneficiaries are
facing a lot of resistance from the staff/OPD manager/Doctors of the private
NCOs empanelled under CGHS. OPD timing are clubbed with General OPD or OPD for
EWS, which is causing inconvenience to the CGHS beneficiaries. OPD Slot for
CGHS beneficiaries is also reduced to half an hour, The CGHS beneficiaries are
not allowed to seek the consultation from the Senior Doctor or their OPD, so
called premium OPD.
It is reiterated that HCOs empanelled under
CGHS shall adhere to the term and conditions while providing
treatment/investigation facilities to the CGHS beneficiaries. The private HCOs
empanelled under CGHS shall provide quality service to CGHS beneficiaries and
care may be taken to avoid inconvenience, especially for the Senior Citizen,
Cancer Patients and terminally ill patients. Pvt. HCOs shall avoid any discrimination
to CGHS beneficiaries.
As per MOA clause No. 18 (9) discrimination
against CGHS beneficiaries’ vis-å-vis general patients — “The amount of
Performance Bank Guarantee will be forfeited and the CGHS shall have the right
to de-recognize the Health Care Organization as the case may be. Such action
could be initiated on the basis of a complaint, medical audit or inspections
carried out by the CGHS teams at random. The decision of the CGHS will be
final.
All the empanelled HCOs under CGHS Delhi/NCR
are hereby warned/directed to follow the specified guidelines laid down in MOA
and OMs issued by the Ministry Of Health & Family Welfare, Govt. of India
from time to time, failing which the Show Cause Notice will be served and
action as deemed fit shall be taken.
This issues with the approval of Competent
Authority.
sd/-
Dr. Sanjay Jain
Addl. Director, CGHS (HQ)
Dr. Sanjay Jain
Addl. Director, CGHS (HQ)
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