CGHS: Now, no referral letter for treatment at private hospitals

New Delhi: In a significant relief to the beneficiaries of Central Government Health Scheme (CGHS), the Centre has relaxed the norm that mandates a CGHS cardholder to take prior approval to undergo treatment in any empanelled private hospital.

According to the revised procedure for treatment, the CGHS beneficiaries are now allowed to undergo treatment at private hospitals empanelled under the CGHS of specific treatment procedure listed under CGHS rate list without any permission letter.

The beneficiary would have just to produce prescription of a Central government/state government specialist or a CGHS medical officer to avail the cashless treatment in empanelled hospital.

The decision in this regard has been taken after the Health Ministry received several representations for simplification of procedures for undergoing treatment at private hospitals empanelled under the scheme.

Earlier, Central government employees and their dependents could undergo specific treatment procedures at private hospitals after being prescribed by medical officers under the scheme. The beneficiaries were to take the prior approval from their dispensary for availing the cashless benefits at empanelled hospitals or claiming the reimbursement of their medical expenses.

According to an office memorandum which has been issued to all the ministries and departments of the central government, private empanelled hospitals shall perform the treatment on a cashless basis in respect of pensioners, former parliamentarians, freedom fighters and regular employees who are at present eligible for the credit facility.

"They shall enclose the prescription issued by government specialist or a CGHS medical officer in original, along with the hospital bill submitted to the competent authorities," the order said.

Previously, one had to consult at a local dispensary, from where the patient had to be referred to a more prominent government hospital where, with the permission of a specialist, the paperwork had to be done to avail the treatment at a CGHS-empanelled private hospital or refer the beneficiaries to any particular hospital, according to the new order.