1.The under signed is directed to say that a number of representations from various hospitals, Central Government Employees Welfare Co- ordination Committees were received in the Ministry of Health and Family Welfare for recognition of Private Hospitals at Thrissur (Kerala) for treatment of Central Government Employees and their family members under CS (MA) Rules, 1944
2.In view of the hardships faced by CS(MA) beneficiaries for their own treatment and the treatment of their family members at Thrissur (Kerala), the matter has been examined in Ministry and it has been decided to empanel the Westfort Hi – Tech. Hospital Limited, Thrissur (Kerala) under Central Services (Medical Attendance) Rules, 1944.
3.The Schedule of charges for the treatment of Central Government Employees and the member of their family under the CS (MA) Rules, 1944, will be the rates fixed for CGHS, Thiruvananthapuram. The approved rates are available on the website of CGHS (www.mohfw.nic.in//cghs.html) and may be downloaded / printed.
4.The undersigned is further directed to clarify as under:-
5.Package rates envisage duration of indoor treatment as follows:-
|Up to 12 days||:||for specialized (Super Specialities) treatment|
|Up to 7 days||:||for other Major Surgeries|
|Up to 3 days||:||for Laparoscopic surgeries / normal deliveries.|
|1 day||:||for day care/ Minor (OPD) surgeries.|
No additional charge on account of extended period of stay shall 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.
In case, there are no CGHS prescribed rates for any test/ procedure then AIIMS rates are applicable, If there are no AIMS rates, then reimbursement is to be arrived at by calculating admissible amount item –wise(e.g. room rent investigations, cost of medicine , procedure charges, etc) as per approved rates/ actually, in case of investigations.
|S.No||Pay drawn in pay band||Ward Entitlement|
|1||Up to Rs. 13,950||General Ward|
|2||Rs. 13960to 19,530||Semi- Private Ward|
|3||Rs. 19, 540 and above||Private ward|
7.A hospital/ diagnostic centre empanelled under CS(MA) Rules, 1944, whose rates for treatment procedure / test are lower than the CGHS prescribed rates shall charge as per actual.
|General ward||Rs. 1,000 per day|
|Semi- private ward||Rs. 2,000 per day|
|Private Ward||Rs. 3,000 per day|
|Day care (6 to 8 Hrs)||Rs. 500 (Same for all categories)|
9.In case of non emergencies, the beneficiaries, the beneficiary shall have the option of availing specific treatment / investigation from any of the recognized hospitals of his / her choice (provided the hospital is recognized for that treatment procedure / test), after the specific treatment / investigation has been advised by Authorized Medical Attendant and on production of valid ID card and permission letter from his / her concerned Ministry / Department
10.The recognized hospitals shall honour permission letter issued by competent Authority and provide treatment / investigation facilities as specified in the permission letter.
11.The recognized hospital shall also provide treatment / investigation facilities to the Pensioner CGHS beneficiaries and their dependent and eligible family members at their own rates approved under CS (MA) Rules, whichever is lower. The hospitals shall provide treatment for such pensioner CGHS beneficiaries after authentication through verification of valid CGHS cards.
12.However, pensioner CGHS beneficiaries would make payment for the medical treatment at approved rates as mentioned above and submit the medical reimbursement claim to the Addl. Director, CGHS through the CMO i/c of the CGHS wellness Centre, where the CGHS Card of the beneficiary is registered.
13.In case of emergencies, the beneficiary shall have the option of availing specific treatment/investigation from any of the recognized hospitals of his/ her choice (provided the hospital is recognized for that treatment procedure/ test), on production of valid ID card, issued by Competent Authority.
14.During the in – patient treatment of the CS(MA) beneficiary, the Hospital will not ask the beneficiary or his attendant to purchase separately the medicines/ sundries/ equipment pr accessories from outside and will provide the treatment within the package rate, fixed by the CGHS Which includes the cost of all the items.
15.In case of treatment taken in emergency in any non – recognized private hospitals, reimbursement shall be considered by Competent Authority at CGHS prescribed package/ rates only.
16.If one or more minor procedures form part of a major treatment procedure then package charges would be permissible for major procedure and only 50% of charges for minor procedure
17.Any legal liability arising out of such services shall be the sole responsibility and shall be dealt with by the concerned empanelled hospital. Service will be provided by the Hospital as per the terms given above.
18.Ministry of Health and Family Welfare reserves the right to withdraw / cancel the above O.M. without assigning any reason.
19.The order takes effect from the date of issue of O.M