Guidelines for CGHS Facilities to ensure Efficient Healthcare Services
Ensuring Efficient Healthcare Services: Guidelines for CGHS Facilities
In a recent notification issued by the Government of India's Ministry of Health & Family Welfare, several crucial instructions have been emphasized to streamline the operations of Healthcare Organizations (HCOs) under the Central Government Health Scheme (CGHS) in Mumbai.
Numerous grievances have been reported regarding the functioning of various HCOs, necessitating strict adherence to the following directives outlined in the memorandum. Any deviation from these specified actions will result in immediate consequences in accordance with the Memorandum of Understanding (MoU).
Cashless Facility: CGHS facility must be provided without any advance deposit for Pensioners & CGHS staff.
Documentation: CGHS card photocopies should not be demanded, and hospitalized beneficiaries or emergencies do not require separate permission letters.
Referral Memo: Stamps are not mandatory on referral memos, and prescriptions must be provided in printed form.
Prescription Guidelines: Prescriptions should strictly adhere to the government's policy by being in a generic format, excluding dietary supplements.
CGHS Kiosk: Establish a dedicated CGHS Kiosk (Help desk) for beneficiary assistance.
Billing Practices: Double billing is strictly prohibited, and the name of the nodal officer and contact number must be prominently displayed. Immediate communication of any changes in the nodal officer's details to the CGHS office is required.
Direct OPD Consultation: CGHS beneficiaries aged 75 years and above can seek direct OPD consultation from Specialists of CGHS empaneled hospitals without referral from CGHS Wellness Centre.
Documentation Retention: HCOs must retain a scanned copy of the referral printout and return the original to the beneficiary.
Cashless Treatment: Retired Air India employees with valid CGHS cards are eligible for cashless treatment at all CGHS empaneled HCOs.
Treatment for CS(MA) Beneficiaries: CS(MA) beneficiaries and their dependent family members can receive treatment at CGHS rates from any recognized HCO under CGHS.
Billing Verification: Bills should be verified and signed by pensioner beneficiaries at the time of discharge, and the same shall be uploaded on the National Health Authority (NHA) portal.
These instructions are mandated to be prominently displayed at the CGHS counter within 15 working days. Additionally, surprise visits by the CGHS hospital inspection squad will ensure strict compliance. Failure to adhere to these guidelines may result in severe consequences, including de-empanelment.
Ensuring adherence to these directives will not only enhance the efficiency of healthcare services but also foster trust and reliability within the CGHS framework, ultimately benefiting both beneficiaries and healthcare providers.
