Fresh empanelment of private hospitals applicable under the Central Government Health Scheme (CGHS),
Delhi is being done. This will cover areas in Delhi, Faridabad, Gurgaon, Ghaziabad and NOIDA. Along with this, package rates to be paid to the hospitals that were fixed in 2006, are also being revised. CGHS has also explained some of the aspects of its package rates for the beneficiaries. Package rates envisage up to a maximum duration of indoor treatment as: (i) twelve days for Specialised (Super Specialised) treatment; (ii) seven days for other Major surgeries; (iii) three days for Laparoscopic surgeries / normal deliveries, and (iv) one day for day / Minor (OPD) surgeries.
However, if the beneficiary has to stay in the hospital for a period more than the period covered in the package, in exceptional cases, supported by relevant medical records and certified as such by the hospital, the additional reimbursement is to be limited to accommodation charges as per entitlement, investigation charges at approved rates and doctor visit charges and cost of medicines. No additional charge on account of extended period of stay is to be allowed if that extension is due to infection on the consequences of surgical procedure or due to any improper procedure and is not justified. CGHS beneficiaries desirous of getting treated in super-speciality hospitals, in non emergency conditions, prior approval of the concerned Additional Director, CGHS would have to be obtained.
The category `super speciality hospitals' has also been defined. The entitlement of hospitals to be super-speciality rates will not be because they perceive themselves to be such but subject to their fulfilling the eligibility conditions in the tender document for being classified as such.
Empanelled hospitals are to provide credit facility to – Members of Parliament, pensioners of Central Government drawing pension from central estimates, former Vice-Presidents, former Governors and former Prime Ministers, ex-Members of Parliament, freedom fighters, serving CGHS employees, serving employees of Ministry of Health and Family Welfare and such other categories of CGHS cardholders as notified by the Government. In case of treatment taken in emergency in any non empanelled private hospitals , reimbursement is to be considered by competent authority at CGHS prescribed packages / rates only.
This OM supercedes all earlier instructions relating to empanelment of hospitals for specialized and general
purpose treatment and investigations for Delhi, Faridabad, Ghaziabad, Gurgaon and NOIDA areas.
The revised rates were to be effective from September 1, 2010 but it has been deferred till all the short listed hospitals sign the Memorandum ofAgreement with the CGHS, Delhi. They are to sign the MoU on or before September 25, 2010 failing which they will be taken off the empanelment list.
This OM supercedes all earlier instructions relating to empanelment of hospitals for specialized and general
purpose treatment and investigations for Delhi, Faridabad, Ghaziabad, Gurgaon and NOIDA areas.
The revised rates were to be effective from September 1, 2010 but it has been deferred till all the short listed hospitals sign the Memorandum ofAgreement with the CGHS, Delhi. They are to sign the MoU on or before September 25, 2010 failing which they will be taken off the empanelment list.
