Central Government Health Scheme formalities have been modernized

“Investigations advised by Specialist of Private Empanelled Hospitals may be undertaken if they are required in emergency as certified by Specialist without endorsement by CGHS”.

Simplification of the Procedure in CGHS

CGHS Wellness Centres provide primary health care facilities and, if required, refer the beneficiaries to the Specialists at Government Hospitals/ Private Hospitals empanelled under CGHS.

In emergency conditions, no endorsement for any treatment/ investigation is required from CGHS Wellness Centre.

However, in non-emergency conditions or unlisted treatment/ tests, endorsement from concerned CGHS Wellness Centre is required.

With a view to facilitate ease of availing consultations from Specialists at empanelled hospitals, Government has permitted elderly CGHS beneficiaries aged 75 years and above to seek consultations from Specialists without any referral and undergo treatment/ investigations without endorsement.

Permission is required only for unlisted treatment procedure/ tests in non-emergency conditions.

The guidelines for referral issued vide Office Memorandum No. Z.15025/117/2017/DIR/CGHS/EHS, dated the 15th January, 2018 have been modified vide Office Memorandum No. Z.15025/117/2017/DIR/CGHS/EHS, dated the 10th December, 2018 and the following modifications have been made in the interest of sick people, pensioners and serving employees:-

The referral shall be valid for consultations upto 3 times in the same hospital within 30 days.

CGHS beneficiaries have been permitted to consult upto 3 Specialists, if required during a single visit.

Investigations advised by Specialist of Private Empanelled Hospitals may be undertaken if they are required in emergency as certified by Specialist without endorsement by CGHS.

The Minister of State (Health and Family Welfare), Sh Ashwini Kumar Choubey stated this in a written reply in the Lok Sabha, here today.