Clarification regarding Fresh empanelment of private hospitals and revision of package rates applicable under CGHS

No: S.11O11/23/2009-CGHS D.II/Hospital Cell (Part I)
Government of India
Ministry of Health & Family Welfare
Department of Health & Family Welfare

Maulana Azad Road, Nirman Bhawan
New Delhi 110 108 dated the 11th April, 2011.

OFFICE MEMORANDUM

Subject:- Clarification regarding Fresh empanelment of private hospitals and revision of package rates applicable under CGHS.

The undersigned is directed to invite reference to this Ministry’s various Office Memoranda issued for empanelling hospitals under CGHS at new rates in various CGHS covered cities, vide which revised package rates payable to private hospitals for treating CGHS beneficiaries were notified and hospitals and Diagnostic Laboratories and imaging centres were empanelled and to state that in response to the representations received from various quarters, it has now been decided to clarify as below:-

(1). A consolidated and updated list of hospitals, which are empanelled under CGHS through tender process initiated in 2009-10, is enclosed specifying the procedures, for which they were empanelled. Clarification is issued in respect of the hospitals, which were already empanelled under CGHS prior to their empanelment in 2010-11 and are approved for the same specialties for which they were empanelled earlier under the precious tender / continuous empanelment scheme,

(2) List of hospitals, which have acquired NABH status has been updated. The term, – Endoscopic procedures – under which category Hospitals are empanelled shall include endoscopic surgery as well as laparoscopy and laparoscopic surgery for the purpose of providing treatment facilities.

(3) Treatment in Casualty OPD shall be treated as treatment under emergency and credit facility shall be extended to the CGHS beneficiaries. However, routine OPD consultation shall not be considered a medical emergency.

(4) NABL Accreditation is not prescribed for imaging centres and therefore, list of Rates prescribed NABL centres shall be applicable for Imaging Centres.

(5) Empanelled hospitals, Diagnostic Labs and Imaging Centres shall send hospital bills (Credit bills) in respect of Pensioners, ex-MPs, Freedom Fighters, etc., to CGHS through UTI-TSL, where as hospital bills (credit bills) in respect of serving employees of Ministry of Health & Family Welfare shall be sent manually to the officer in the Ministry of Health & Family Welfare or Dte.GHS, CGHS or other organisations under the Ministry of Health & Family Welfare, who referred the beneficiary for treatment, as the case may be.

5. All other terms and conditions as mentioned in the earlier Office Memoranda pertaining to new empanelment remain unchanged.

s/d
[R Ravi]
Director