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Healthcare/CGHS
dCGHS -Empanelled hospitals- JAN,2014
dEmergency treatment under CGHS
dGuidlines fo issue of Medicines- Mar,'14
dCovering ltr to P K Bansal, M P
dCovering Ltr to A D CGHS, Chd
dOPD Trtmnt in Pvt hospitals- 18 Dec,'13
dCGHS -Empanelled hospitals- Oct,13
dAppeal against CGHS orders denying referrals to Private hospitals
dDiiscontinuation of referrals to Pvt hospitals in of Chandigarh
dCGHS -Empanelled hospitals- Sept,13
dAppeal against CGHS orders denying referrals to Private hospitals
dPMF Memo dated 25 Jul,13 to CGHS on Problems faced in diagnostic Labs
dDiscontinuation of referrals to Pvt hospitals in of Chandigarh
dTimings of CGHS Wellness Centers from 01 April,2013
dCGHS meeting 22 Feb,2013
dMEMO TO AS & DG CGHS-11-03-13
dMemo to CGHS , DG, 13-03-13
dGuidlines for Liver Transplant- 16 Jan,13
dcont. empanelment of hospitals for CGHS- govt O M dated 14 feb,13
dInstruction dated 01-01-2013 reg investigations at private hospitals etc
dInstructions dated 15 jan,2013 regarding CGHS
dNew timings for CGHS wellness centers
dIssue of smart Cards to CGHS beneficiaries
dTreatment for Diabetes, Dialyses etc- OM dt; 01-10-12
dCont. of empanelment of hospitals...under CGHS
dCGHS cover to CAPFs
dTreatment for Diabetes, Dialyses etc On Dt:01.Oct.12
dCont. of empanelment of hospitals under CGHS on dt-15 Oct 12
dReimbursement of Hearing Aids - dated 21 March,2012
dClarification regarding admissible / non-admissible items under CGHS - dated 01 Oct,2012
 
CGHS – Revision of rates and guidelines for reimbursement of expenses on purchase of Hearing Aids under CS(MA) Rules, 1944 and CGHS
No: S..14025/10/2002/MS
Government of India
Ministry of Health & Family Welfare
Department of Health & Family Welfare
Nirman Bhawan, New Delhi 110 108
Dated the 21st March, 2012.
OFFICE MEMORANDUM
Subject: Revision of rates and guidelines for reimbursement of expenses on purchase of Hearing Aids under CS(MA) Rules, 1944 and CGHS-regarding
With reference to the above mentioned subject the undersigned is directed to refer to the Office memoranda of even No. dated 17,11.2006 and 28,10.2002 and OM Nos. S.14025/36/93/MS dated 26.03.94 and 17.08.1999 and to state that on the basis of recommendations of an Expert Committee, it has been decided to revise the rates and guidelines for hearing aids to he reimbursed under CS (MA) Rules, 1944 and CGHS.
2. The revised ceiling rates fixed for various types of Hearing Aids (for one can ear) are as under:
Body worn / Pocket type – Rs. 2.500/-
Analogue BTE – Rs. 7,000/-
Digital BTE – Rs. 20,000/-
ITC/CIC - Rs. 25,000/-
The cost of hearing aid shall include all Taxes including VAT and shall carry `3″ year Warranty. The cost of Analogue BTE/Digital BTE / ITC / CIC type hearing aid shall also include the cost of ear mould,
3. Beneficiaries covered under CS(MA) Rules, 1944/CGHS shall be eligible to obtain hearing aid after the same has been recommended by a Government E.N.T. Specialist on the basis of audiometric and audiological assessment, ENT Specialist shall specify the type of hearing aid most suited for the beneficiary.
4. The permission to procure hearing aid shall be granted by Chief Medical Officer in-charge of CGHS Wellness Centre in case of CGGHS pensioner beneficiaries and by the Head of Department /Office in case of serving employees and CGHS beneficiaries of Autonomous Bodies on the basis of recommendation of a Government Specialist and an undertaking that the beneficiary has not been reimbursed the cost of hearing aid in the preceding Five years.
5. Reimbursement claim shall he submitted to CGHS through CMO i/c of concerned dispensary by CGHS Pensioner beneficiary in the prescribed medical reimbursement claim form along with a photo copy of CGHS card, original bill of the Hearing aid and original copy of the permission letter. In case of other beneficiaries, the medical claim shall be submitted to the concerned Ministry / Department / Office. Reimbursement shall be limited to the ceiling rate or actual cost of the hearing aid, whichever is less.
6. Record of permissions granted for procurement of hearing aids shall be maintained by CGHS in respect of pensioner CGHS beneficiaries and by concerned Ministry / Department/ Office in respect of other beneficiaries,
7. Replacement of hearing aid may be permitted after 5 years on the basis of condemnation certificate issued by a technical expert and on approval of a Goverment ENT Surgeon. Maintenance and repair will be the responsibility of the beneficiary.
8. These orders shall supercede all the earlier orders issued on the subject.
9. The revised rates and guidelines shall come into force from the date of issue and shall be valid for a period of two years or till further revision, whichever is earlier.
10. This issues with the concurrence of Integrated Finance Division vide Dy.No. 5894 dated 19.03,2012 of the office of AS&FA, Min. of Health &Family Welfare.
(V.P. Singh)
Deputy Secretary to the Government of India
Clarification regarding admissible / non-admissible items under CGHS
F.No. 2-1 /2012/CGHS/VC/CGHS (P)
Government of India]
Ministry of Health & Family Welfare
Department of Health & Family Welfare
Nirman Bhawan, New Delhi
Dated the 1st October, 2012
OFFICE MEMORANDUM
Subject: Clarification regarding admissible / non-admissible items under CGHS.
The undersigned is directed to refer to the directions given by Hon'ble High Court of Delhi in the case of Sh. Kanhiya Singh Vs UOI and others [W.P.(C) 9044/2011], regarding admissibility and non-admissibility of certain items under CGHS,the following clarifications are issued:-
2. "CGHS Package Rate" means and includes lump sum cost of inpatient treatment / day care / diagnostic procedures for which a CGHS beneficiary has been permitted by the competent authority or for treatment under emergency from the time of admission to the time of discharge including (but not limited to) Registration charges, (ii) Admission charges, (iii) Accommodation charges including patients diet,(iv) Operation charges, (v) Injection charges, (vi) Dressing charges, (vii) Doctor /consultant visit charges, (viii) ICU / ICCU charges, (ix) Monitoring charges, (x) Transfusion charges, (xi) Anesthesia charges, (xii) Operation theatre charges, (xiii) procedural charges / surgeon's fee, (xiv) Cost of surgical disposables and all sundries used during hospitalization, (xv) Cost of medicines, (xvi) Related routine and essential investigations, (xvii) Physiotherapy charges etc. (xviii) Nursing care and charges for its services.
3. Cost of Implants / stents / grafts is reimbursable in addition to package rates as per CGHS ceiling rates for Implants / stents / grafts or as per actual, in case there is no CGHS prescribed ceiling rate
4. During In-patient treatment of the CGHS beneficiary, the hospital will not ask the beneficiary or his / her attendant to purchase separately the medicines / sundries /equipment's or accessories from outside and will provide the treatment within the package rate, fixed by the CGHS, which includes the cost of all the items.
5. In cases of conservative treatment, where there is no CGHS package rate, the above mentioned items are admissible – items wise at CGHS rates or as per AIIMS rates( if there is no CGHS rate) or as per actual if there is no CGHS / AIIMS rate for any item.
6. 6. Package rates envisage up to a maximum duration of indoor treatment as follows:
12 days for Specialized (Super Specialties) treatment;
7 days for other Major Surgeries;
3 days for Laparoscopic surgeries /normal deliveries; and
1 day for day care / Minor (OPD) surgeries.
7. However, if the beneficiary is required to stay in the hospital for his / her recovery for a period more than the period covered in the prescribed package rate, in exceptional cases, supported by relevant medical records and certified as such by the hospital, the additional reimbursement shall be limited to accommodation charges as per entitlement, investigations charges at approved rates, and doctors visit charges (not more than 2 visits per day per visit by specialists / consultants) and cost of medicines for additional stay). 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 proceed.
8. The above list is however not exhaustive. Some patients may require additional facilities/ procedures, which are admissible depending upon the medical requirements as advised by the treating doctors/specialists, with proper justification. Therefore, it is not possible to indicate a comprehensive list of items, which are not admissible.However, the following items are not admissible for the purpose of reimbursement under CGHS: Telephone charges Toiletries Sanitary napkins Talcum powder Mouth fresheners
(V.P. Singh)
Deputy Secretary to the Government of India
 

COORDINATION COMMITTEE OF CENTRAL GOVERNMENT PENSIONERS ASSOCIATIONS, CHANDIGARH

(Regd. No. 2234 – Under Registration of Societies Act-1860)

Rajpal Sharma, Chairman, CCCGPA 799 Sector 4, Panchkula (Ph: 2567891, 9316122214) Email:rajpalsharma83@yahoo.in P. S. Bedi, DIG (Retd) BSF Sr. Vice Chairman, CCCGPA, 2186, Sector 35, Chandigarh-160022 (Ph: 2604002 & 2615048) Email:psbedi03@yahoo.co.in Harchandan Singh, Secretary General, CCCGPA H.O.32, Phase-6, Mohali-160055 (Ph. 2228306, 09316131599569631598) Email: cccgpa@yahoo.in
 
No: CCCGPA –CHD / 2012/ 14                                                                                 Dated 17 June,2012

GIST OF DISCUSSIONS HELD AT THE MEETING WTH ADD DIRECTOR CGHS
ON 15 JUNE, 2012

Dr S C Anand, Addl Director, CGHS, Chandigarh called a meeting of representatives of pensioners associations on 15 June, 2012 at his office, 4th Floor, Kendriya Sadan, Sector 9 A, Chandigarh. Represetatives from CCCGPA, I A & A D, Customs & Central Excise, Paramilitary Forces, Civil Defence Accounts, CGPWS, MES civil employee, Senior Citizens Society, Zirakpur and others attended the meeting.
 
Dr S C Anand, Addl Director, welcomed the delegates and distributed the latest List of Empanelled hospitals and Diagnostic centers under CGHS Chandigarh, as also some other Circulars /Guidelines issued by CGHS HQs affecting the CGHS beneficiaries.
 
Gist of points discussed is enumerated below:
 
(a)Overcrowding and rush of patients at CGHS Wellness Center, Sector 45, Chandigarh
The representative of pensioners, while appreciating the functioning of the CGHS Wellness Center, under Dr Ashwani Kumar, CMO I/C, expressed their concern about large no of beneficiaries'dependant on this lone CGHS Wellness Center, leading to overcrowding and rush of patients in the OPD waiting hall. The medical officers (doctors) are also overburdened, which results in long waiting time for the elderly patients. A request for opening new dispensaries in Panchkula and Mohali was made to the Add Director.Notwithstanding the statement of Hon'ble Health minister, Sh Ghulam Nabi Azad, in the Parliament regarding constraints for opening new CGHS Wellness Centers, Shri P S Bedi drew the attention to a mail from CGHS, New Delhi, dated 10 May,2012, for opening of THREE new CGHS Wellness centers in South Delhi region, one each in Gurgaon, Vasant Kunj and Sarita Vihar. The members felt that in view of this letter, a fresh request may be sent to the Health Ministry for urgent opening of a new wellness center in chandigarh. Mr. P.S. Bedi suggested that a copy of the same letter should also be sent to Shri Pawan Kumar Bansal, Hon'ble Minister of Parliamentary Affairs & Water Resources for his appraisal on this issue so that he can take up the matter with the Health Minister.A copy of the letter from Shri Pawan Kumar Bansal, Hon'ble Minister of Parliamentary Affairs & Water Resources ( M P from Chandigarh) recommending opening of CGHS Wellness centers in Panchkula and Mohali was also given to the Addl Director. The Addl Director, also expressed concern at the large number of beneficiaries dependant on this lone Wellness center, and indicated that almost 60 new beneficiaries Cards are added very month, as the scheme is open to all central Govt pensioners settled in the adjoining areas of Haryana, Himachal Pradesh and Punjab. He indicated the possibility of starting an Extension Counter for the CGHS dispensary in sector 46. Regarding the earmarked plot for CGHS in Sector 42, there are some differences on the rates for acquisition with the Chandigarh Administration, which is causing delay. He requested the representatives of I A & A D Pensioners Association to forward a copy of the Memorandum on CGHS, given by them to Shri Pawan Kumar Bansal on 19 May,2012.
 
(b)Non availability of empanelled diagnostic Centres for ECG, TMT, Echo and Holter
The pensioners expressed their serious concern about non availability of empanelled Diagnostic centre for such important diagnostic tests as ECG, Echo, TMT and Holter, for which the CGHS patients have to resort to paid alternative and thereafter claim reimbursement. The Addl Director intimated that reimbursement for these test at CGHS rates is being entertained. The Prime Diagnostic centre, Sector 8, Chandigarh has been providing these tests to CGHS beneficiaries at discounted rates, which are based on CGHS rates. However, this Diagnostic Center is shortly shifting to a new location, after which it will have to apply afresh for re-empanelment. He also assured that case will be taken up with this diagnostic Centre for providing facilities for various test to CGHS beneficiaries at concessional rates till its re-empanelment.
 
(c)Continuous Empanelment of Hospitals and Diagnostic Centre's / Laboratories
There is need to empanel more private reputed hospitals for the CGHS in the Tricity, especially in and around Panchkula. Case may be taken up with CGHS HQs, New Delhi for opening the process of empanelment of Hospitals and Diagnostic centers on a continuous basis. Addl Director indicated that he would take up case with the higher CGHS authorities in this respect.
 
(d)Medical Reimbursement Claims
Addl Director intimated that MRC in respect of individual CGHS beneficiaries have been cleared upto April, 2012 and the MRCs received in May,2012 are under process. He clarified that within the budget allotment first preference is given to the clearance of MRCs of individual claimants vis-à-vis Local Chemist. He indicated that in case of disallowed amount in individual claims, the copy of calculation sheet would be provided on demand. It is not feasible to prepare Calculation Sheet in all MRCs due to shortage of staff in his office. In the case of empanelled hospitals / diagnostic centres, their bills are cleared through the third party, UTI-TSL.
 
(e)Treatment by the CGHS empanelled hospitals
Sh D C Gupta, President, Defence Accounts, indicated that some CGHS empanelled hospitals were charging amount from the CGHS patients and not issuing any receipt, against all norms / instructions by the competent authorities. He requested the Addl Director to look into such unfair means by the empanelled hospitals. Add Director intimated that empanelled hospitals are bound to provide cashless treatment to the CGHS beneficiaries and provide accommodation in the wards as per the entitlement of the CGHS beneficiary. In case they charge any amount they have to justify the same and issue receipt.
 
(f)Regular holding of meetings at Add Director CGHS level
Shri Rajpal Sharma, Chairman CCCGPA, enjoined upon the Addl Director to hold these periodic meetings regularly as per directions from higher CGHS authorities for fruitful exchange of views with the beneficiaries and to enable the elderly CGHS beneficiaries to put across their problems/suggestions directly to the Addl Director CGHS. He also expressed his great satisfaction on the working of CGHS wellness center under the leadership of Dr.Ashwani Kumar CMO (NFSG) in charge and his team, on the basis of feedback received from the members of CCGPA. The list of various pensioners associations in Chandigarh with their main office bearers can be made available to the office of Add Director CGHS, Chandigarh by CCCGPA to have a roaster as ready reference for all such meetings.
 
 
Reimbursement of medical expenses
 

REIMBURSEMENT OF MEDICAL EXPENSES

             IN THE HIGH COURT OF DELHI AT NEW DELHI - W.P.(C) No. 889/2007
                         (Judgment delivered on: 12.3.2010)
                 Kishan Chand -Petitioner. Through: Mr. Manohar Singh, Adv.
                                                             versus
       Govt. of N.C.T. & Others.  -Respondents. Through: Ms. Sonia Sharma and Ms.Amita Arora, Adv.
CORAM:              HON'BLE MR. JUSTICE KAILASH GAMBHIR

1. By the present petition filed under Article 226 of the Constitution of India, the petitioner seeks directions to direct the respondents for reimbursement of the medical expenses incurred by the petitioner.
2.  The petitioner was serving as District Employment Officer, North-West, Kirby Place, Delhi Cantt and retired on 30th April, 2001. On 2.4.2005, the petitioner got a heart attack and was admitted in Amar Leela Hospital, Janak Puri, New Delhi and was discharged on 7.4.2005. The petitioner had paid Rs. 18,000/- to the said Hospital on his discharge and had also spent Rs. 1274/- for the purchase of medicines. But, yet again on 8.4.2005 the petitioner suffered severe chest pain and breathlessness and was admitted to Sir Ganga Ram Hospital, New Delhi and underwent a by pass surgery on 9.4.2005 and paid an amount of Rs. 1,25,032/- towards the bill raised by the said hospital. On 2.5.2005, the petitioner filed an application with the respondent no.2 requesting them to issue medical facility card and an amount of Rs. 9000/- was deposited by the petitioner towards subscription money. Thereafter, the medical facility card was issued to the petitioner and on 5.7.2005, the petitioner moved an application to the District Employment Officer (NW) for reimbursement of his medical bills which vide order dated 29.8.2005 was rejected. Again, on 17.3.2006 the petitioner moved an application which was disallowed vide letter dated 28.7.2006, and yet again on 22.8.2006, the petitioner moved an application which was dismissed vide letter dated 9.11.2006. Hence feeling aggrieved by the aforesaid circumstances, the petitioner has now approached this court for relief by way of filing W.P.(C) No.889/2007
3. on the last date of hearing, Ms. Sonia Sharma, counsel appearing for Govt. of NCT of Delhi took an adjournment on the ground that the respondent shall pay the necessary amount towards the medical reimbursement of the petitioner before the next date. However, Mr. Umrao Singh, Employment Officer and Mr. A.K. Sharma, Superintendent with respondent No. 1 submit that under the relevant rules, the respondents are not obliged to grant the medical reimbursement to the petitioner. Ms. Sonia Sharma, counsel further submitted that under the revised scheme announced by the Delhi Government vide O M dated 25th October, 2007 it was for the petitioner to have opted for the scheme and once having not become a member of the said scheme, the petitioner was not entitled to the medical reimbursement. Counsel further submitted that the scheme was prospective in nature and the same would be effective once an employee became a member of the scheme and not otherwise. The contention of counsel for the respondent was that since the petitioner on his retirement failed to opt for the said scheme, therefore, he was not entitled to the benefit of the same.
4. On the other hand, counsel for the petitioner placed reliance on the judgment of this Court in the case of V.K. Jagdhari vs Union of India & Ors. 125(2005) DLT 636. The petitioner also placed reliance on the judgment of the Division Bench of this Court in Government of NCT of Delhi & Ors. Vs Som Dutt Sharma 118 (2005) DLT 144(DB) and S.K. Sharma vs Union of India and Anr. 2002 (64) DRJ 620.
5. The Court heard counsel for the parties.
6. The issue is no more res Integra as in the case of S.K. Sharma (supra), this Court clearly held that the petitioner after getting retired cannot be denied the benefit of the medical reimbursement simply because of the fact that he did not opt for the said scheme. In this case also the claim of the employee was rejected on the ground that he was not covered under the CGHS Rule not being a part of the scheme but still a retired Central Government employee residing in non-CGHS area can make a CGHS card for himself and his dependent family members from the nearest centre where CGHS is functional. Further placing reliance on some authoritative pronouncements of the Apex Court, this Court in the above case took a view that the petitioner cannot be discriminated against, merely because he is not a member of the CGHS scheme as he was staying in a non-CGHS area. In this case also the employee had applied to become a card holder later in the period.
7. In the case of V.K. Jagdhari (supra), which has been relied by the petitioner, a similar question arose before the Court and objection was taken that since the employee had opted for the CGHS card after his surgery, therefore, he was clearly dis-entitled to the claim of reimbursement. Answering the said question in negative, the Court clearly held that the pensioner cannot be discriminated against merely because he has not opted for CGHS scheme or he resides outside a non-CGHS area. Taking into consideration the ratio of the judgments in the S.K Sharma (supra) and Som Dutt Sharma (supra) case, this court consolidated the legal position and held that:
 "The position emerging from various decisions of this Court may be summarised as follows:
1) Even if employee contributes after availing medical facilities, and becoming member after treatment, there is entitlement to reimbursement (DB) Govt. of NCT v. S.S. Sharma : 118(2005)DLT144
2) Even if membership under scheme not processed the retiree entitled to benefits of Scheme - Mohinder Pal v. UOI : 117(2005)DLT204 .
3) Full amounts incurred have to be paid by the employer; reimbursement of entire amount has to be made. It is for the Government and the hospital concerned to settle what is correct amount. Milap Sigh v. UOI : 113(2004)DLT91 ; Ran deep Kumar Rana v. UOI : 111(2004)DLT473
4. The pensioner is entitled to full reimbursement so long the hospital remains in approved list P.N. Chopra v. UOI, (111) 2004 DLT 190
5) Status of retired employee not as card holder: S.K. Sharma v. UOI, : 2002(64)DRJ620 ;
W.P.(C) No.889/2007 Page 5 of 7 6). If medical treatment is availed, whether the employee is a cardholders or not is irrelevant and full reimbursement to be given, B.R. Mehta v. UOI : 79(1999)DLT388 .'
The status of a retired Government Employee was held to be independent of the scheme and rules in so far as the entitlement to medical treatment and/or CGHS benefits were concerned (ref. V.K. Gupta v. Union of India, : 97(2002)DLT337 ). Similarly in Narender Pal Singh v. Union of India, : 79(1999)DLT358 , this Court had held that a Government was obliged to grant ex-post factor sanction in case an employee requires a specialty treatment and there is a nature of emergency involved."
8. It is quite shocking that despite various pronouncements of this Court and of the Apex Court the respondents in utter defiance of the law laid down have taken a position that the pensioner is not entitled to the grant of medical reimbursement since he did not opt to become a member of the said health scheme after his retirement or before the said surgery undergone by him. It is a settled legal position that the Government employee during his life time or after his retirement is entitled to get the benefit of the medical facilities and no fetters can be placed on his rights on the pretext that he has not opted to become a member of the scheme or had paid the requisite subscription after having undergone the operation or any other medical treatment. Under Article 21 of the Constitution of India, the State has a constitutional obligation to bear the medical expenses of Government employees while in service and also after they are retired. Clearly in the present case by taking a very inhuman approach, these officials have denied the grant of medical reimbursement to the W.P.(C) No.889/2007 Page 6 of 7 petitioner forcing him to approach this Court. The respondents did not bother even after the judgment of this Court was brought to their notice and copy of the same was placed by the petitioner along with the present petition.
9. In the light of the aforesaid, the present petition is allowed.
10. The respondents are directed to pay the said medical claim of the petitioner along with 18% interest from the date of submission of his bill. The said payment shall be made by the respondent within one month from the date of this order. Additional costs of Rs. 10,000/- is also imposed on the respondents for causing delay in making the said payment to the petitioner.
                                                                     *****

Memo to Health Minister on CGHS in Chandigarh
 

Coordination committee of central government pensioners associations, CHANDIGARH
(Regd. No. 2234 – Under Registration of Societies Act-1860)

Rajpal Sharma,
Chairman, CCCGPA
799 Sector 4, Panchkula
(Ph: 2567891, 9316122214)
Email:rajpalsharma83@yahoo.in

P. S. Bedi, DIG (Retd) BSF
Sr. Vice Chairman, CCCGPA,
2186, Sector 35, Chandigarh-160022
(Ph: 2604002 & 2615048)
Email:psbedi03@yahoo.co.in

Harchandan Singh,
Secretary General, CCCGPA
H.O.32, Phase-6, Mohali-160055
(Ph. 2228306,  09316131599569631598)
Email: cccgpa@yahoo.in

No: CCCGPA –CHD / 2012/ 07

               Dated 23  May,2012

To,
Shri Ghulam Nabi Azad
Hon’ble Minister of Health & Family Welfare,
Govt of India,
Nirman Bhawan, New Delhi

Sub:   Strengthening of CGHS set-up in Chandigarh

Sir,
          The CGHS cover was extended to Chandigarh in 2002, after concerted efforts by the pensioners of central govt, settled in the tricity (Chandigarh-Mohali- Panchkula). The initial proposal of the govt was to set up two CGHS dispensaries in Chandigarh and one each in Mohali and Panchkula.However, onlyone CGHS dispensary (now called Wellness Center) was established in Chandigarh in the year 2002.
2        Non-the-less, over the years, the CGHS set-up in Chandigarh was strengthened and some reputed private hospitals and Diagnostic centres were empanelled to provide quality medical cover to the CGHS beneficiaries in tune with other CGHS cities in India. With the passage of time, the number of CGHS beneficiaries dependent on the only CGHS Wellness Center in Chandigarh  increased manifold causing considerable problems for the beneficiaries, majority of who are senior and very senior citizens. Some of the grievances / problems faced by the beneficiaries are elaborated below.

  1. Overcrowding in the existing CGHS Wellness center

There is only one CGHS Wellness center in Chandigarh, catering for large number of CGHS beneficiaries, not only from the Tricity, but also from various cities and towns of Punjab, Himachal Pradesh and North Haryana. There are more than 8,000 Card holders (approx 23,000 beneficiaries). The daily OPD attendance ranges between 350  and 400 resulting in overcrowding, and long waiting time for the elderly beneficiaries, leading to considerable stress and strain. Besides, doctors and Medical officers, who themselves are over burdened, cannot devote enough time to the patients, causing frustration amongst the elderly Beneficiaries.                                                                                        
2 The pensioners associations have been repeatedly espousing the demand for opening of new CGHS dispensaries in Panchkula and Mohali, where large numbers of central Govt pensioners have settled, besides existence of various Central Govt offices. There is, however, a set reply that due to financial and manpower constraints as also, govt consideration for an Insurance Cover for the pensioners, it cannot be done. The plan for Insurance Cover to the retired personnel is hanging fire for almost four years, and the pensioners and CGHS beneficiaries are continuing to suffer.
It may kindly be realized that the utmost consideration of any organization is the welfare of its citizens, and action may kindly be taken to mitigate the suffering of the CGHS beneficiaries by opening new CGHS Wellness Centers in Panchkula and Mohali .

  1. Empanelment of Hospitals and Diagnostic Centres

Some Private hospitals and Diagnostic Centers have been empanelled for the CGHS beneficiaries in the Tricity, but these are not enough. Besides, the medical cover offered by these empanelled hospitals, and diagnostic facilities extended by empanelled Diagnostic centres have lately been withdrawn / cancelled, resulting in pensioners facing considerable problems. It is felt that Chandigarh is being given step-motherly treatment vis-à-vis other CGHS covered cities of India.

The cancellation of the empanelment of Grewal Eye Center (Sector 8, Chandigarh), a reputed Eye hospital in Chandigarh is a blow to the elderly CGHS beneficiaries. It offered quality treatment for various Eye ailments, and its re-empanelment may kindly be considered at the earliest.

In respect of diagnostic investigations, the elderly CGHS beneficiaries are continuing to suffer as there is no approved diagnostic centre for such important tests as ECG, Echo Cardiology, TMT and Holter. These tests are very often required by the elderly pensioners for various age related ailments, including heart problem. The Prime Diagnostic centre, which was offering the facilities for these tests, was not re-empanelled for these tests and the elderly CGHS beneficiaries suffering from various age related ailments continue to face acute problem to get the tests on payment. The point for restoring the approval for these tests month after month in the CGHS Grievances Committee meetings has not found any response from the CGHS authorities. The restoration of
the approval for these important diagnostic tests needs urgent attention of the CGHS authorities.                                                               
3        There are some more problems faced by the CGHS beneficiaries, but these are of secondary nature, and once the above points are resolved, these problems would also be mitigated to a considerable extent. It is, therefore earnestly requested to consider our above points with due sympathy and early action to resolve these are taken.

          With regards,

Yours sincerely,
Singnature
(P S BEDI) DIG Retd
Sr Vice Chairman, CCCGPA

 

 

 

                                                            

 

                                                                  

Treatment in non-CGHS areas
 

Coordination committee of central government pensioners associations, CHANDIGARH
(Regd. No. 2234 – Under Registration of Societies Act-1860)

Rajpal Sharma,
Chairman, CCCGPA
799 Sector 4, Panchkula
(Ph: 2567891, 9316122214)
Email:rajpalsharma83@yahoo.in

P. S. Bedi, DIG (Retd) BSF
Sr. Vice Chairman, CCCGPA,
2186, Sector 35, Chandigarh-160022
(Ph: 2604002 & 2615048)
Email:psbedi03@yahoo.co.in

Harchandan Singh,
Secretary General, CCCGPA
H.O.32, Phase-6, Mohali-160055
(Ph. 2228306,  09316131599569631598)
Email: cccgpa@yahoo.in

No: CCCGPA –CHD / 2012/ 06

               Dated  23 May,2012

To,
Sh L C Goyal, IAS
AS & DG CGHS,
Ministry of Health & Family Welfare,
(Dept of H & F W), Nirman Bhawan,
New Delhi

Sub:   Medical facilities for inpatient treatment and Post-operative follow-up treatment to CGHS beneficiaries in Non-CGHS areas

Sir,
            Kindly refer to our letter No CCCGPA-CHD / 2012 / 03 sated 10 March, 2012 on the above subject.

2          It shall be highly appreciated if we are intimated the action taken on our representation and the points raised in our above letter ( copy enclosed) for the information of pensioner CGHS beneficiaries, especially those elderly pensioners residing in areas far from Chandigarh in various cities of Punjab, Himachal Pradesh and Haryana. The senior citizen / pensioner CGHS beneficiaries in the age group of above 80 years often find it difficult to visit Chandigarh for any age related ailments.

3          It is once again humbly requested that clear instructions to mitigate their problems may kindly be issued at the earliest.

            Thanking you,

                                                                                                                        Yours sincerely,
Singnature
                                                                                                             ( P S BEDI ) DIG ( Retd)
           

 

( Enclosure with CCCGPA, Chandigarh letter dated 24May, 2012)

Coordination committee of central government pensioners associations, CHANDIGARH
(Regd. No. 2234 – Under Registration of Societies Act-1860)

Rajpal Sharma,
Chairman, CCCGPA
799 Sector 4, Panchkula
(Ph: 2567891, 9316122214)
Email:rajpalsharma83@yahoo.in

P. S. Bedi, DIG (Retd) BSF
Sr. Vice Chairman, CCCGPA,
2186, Sector 35, Chandigarh-160022
(Ph: 2604002 & 2615048)
Email:psbedi03@yahoo.co.in

Harchandan Singh,
Secretary General, CCCGPA
H.O.32, Phase-6, Mohali-160055
(Ph. 2228306,  09316131599569631598)
Email: cccgpa@yahoo.in

No: CCCGPA –CHD / 2012/ 03

               Dated  10    March,2012

To,
Sh L C Goyal, IAS
AS & DG CGHS,
Ministry of Health & Family Welfare,
(Dept of H & F W), Nirman Bhawan,
New Delhi

Sub:   Medical facilities for inpatient treatment and Post-operative follow-up treatment to CGHS beneficiaries in Non-CGHS areas
Kindly refer to Ministry of Health & Family Welfare ( Dept of H & F W ) O M No S.11011/7/99-CGHS (P) dated 27th April, 2011 under which CGHS beneficiaries residing in non-CGHS areas have been permitted to avail inpatient treatment and post-operative follow-up treatment, subject to the condition that in case of non-emergency treatment in hospitals under CS(MA) rules 1944 and ECHS recognized hospitals, these beneficiaries have to obtain prior approval of CMO IC of concerned Wellness Center, where card is registered ( Para (a-ii) and ( b-i)

2         The retired elderly pensioner CGHS beneficiaries residing in areas far from their ‘Home’ dispensary find it difficult to travel long distances to obtain such prior approval from the CMO in- charge of the Wellness Center where the card is registered. The elderly pensioners residing in various cities/towns/villages in Punjab, Haryana or Himachal Pradesh, whose cards are registered in Chandigarh, have expressed this apprehension. These CGHS beneficiaries may be permitted to undergo the treatment required, as per the local doctor’s advice, and obtain ex-post facto approval later.

3          The CGHS beneficiaries are also not aware of approved / empanelled hospitals under CS (MA) Rules 1944 or ECHS. A consolidated list of all such hospitals may be circulated or website may be indicated. The concerned hospitals may also be issued instructions by the concerned ministry/ dept to entertain the CGHS beneficiaries, so that they do not charge higher rates for the treatment.
 4          The CGHS beneficiaries obtaining treatment from hospitals approved under CS(MA) Rules 1944/ ECHS are required to obtain a certificate from the hospital that they have not charged more than the approved/applicable rates from the CGHS patient.( Para c). In the absence of any govt instructions to the hospitals in this regard, the hospitals may not give such a certificate. Moreover, when a CGHS patient is taken to such hospitals by the kin of the beneficiaries, the main concern is the proper treatment and the financial aspect is secondary. In any case the reimbursement claim of the CGHS beneficiary with the CGHS authorities is limited to the CGHS rates and any expenditure on the treatment over and above this is to be borne by the CGHS beneficiary/ claimant. It is requested that this requirement of obtaining a certificate from the hospital may kindly be reconsidered.           
           
                                                                                                             Yours sincerely
Singnature

 (P S BEDI) DIG (Retd) BSF
                                                                                                Senior Vice- Chairman

Copy to
Addln Director, CGHS,
4th Floor, Kendriya Sadan,
Sector 9 A,
Chandigarh

CMO in-charge
CGHS Wellness Center,
Chandigarh

 

Sh Ghulam Nabi Azad,
Hon’ble Min of H & FW,
5, South Avenue Lane,
New Delhi
Tele ; 011- 23792052 / 23792944
E mail azadg@sansad.nic.in

 

 

                                                                  

Strengthening of CGHS setup in Chandigarh
 

 

Coordination committee of central government pensioners associations, CHANDIGARH
(Regd. No. 2234 – Under Registration of Societies Act-1860)

Rajpal Sharma,
Chairman, CCCGPA
799 Sector 4, Panchkula
(Ph: 2567891, 9316122214)
Email:rajpalsharma83@yahoo.in

P. S. Bedi, DIG (Retd) BSF
Sr. Vice Chairman, CCCGPA,
2186, Sector 35, Chandigarh-160022
(Ph: 2604002 & 2615048)
Email:psbedi03@yahoo.co.in

Harchandan Singh,
Secretary General, CCCGPA
H.O.32, Phase-6, Mohali-160055
(Ph. 2228306,  09316131599569631598)
Email: cccgpa@yahoo.in

No: CCCGPA –CHD / 2012/ 05

               Dated  22 May,2012

To,
Sh L C Goyal, IAS
AS & DG CGHS,
Ministry of Health & Family Welfare,
(Dept of H & F W), Nirman Bhawan,
New Delhi

Sub:   Strengthening of CGHS set-up in Chandigarh

Sir,
          The CGHS cover was extended to Chandigarh in 2002, after concerted efforts by the pensioners of central govt, settled in the tricity (Chandigarh-Mohali- Panchkula). The initial proposal of the govt was to set up two CGHS dispensaries in Chandigarh and one each in Mohali and Panchkula.However, one CGHS dispensary ( now called Wellness Center) was established in Chandigarh.
2        Non-the-less, over the years, the CGHS set-up in Chandigarh was strengthened and some reputed private hospitals and Diagnostic centres were empanelled to provide quality medical cover to the CGHS beneficiaries in tune with other CGHS cities in India. With the passage of time, the number of CGHS beneficiaries dependent on the only CGHS Wellness Center in Chandigarh  increased manifold causing considerable problems for the beneficiaries, majority of who are senior and very senior citizens. Some of the grievances / problems faced by the beneficiaries are elaborated below.

  1. Overcrowding in the existing CGHS Wellness center

There is only one CGHS Wellness center in Chandigarh, catering for large number of CGHS beneficiaries, not only from the Tricity, but also from various cities and towns of Punjab, Himachal Pradesh and North Haryana. There are more than 8,000 Card holders (approx 23,000 beneficiaries). The daily OPD attendance ranges between 350  and 400 resulting in overcrowding, and long waiting time for the elderly beneficiaries, leading to considerable stress and strain. Besides, the
                                                                                              …..2
-2-
doctors and Medical officers, who themselves are over burdened, cannot devote enough time to the patients, causing frustration amongst the elderly beneficiaries.
The pensioners associations have been repeatedly espousing the demand for opening of new CGHS dispensaries in Panchkula and Mohali, where large numbers of central Govt pensioners have settled, besides existence of various Central Govt offices. There is, however, a set reply that due to financial and manpower constraints as also, govt consideration for an Insurance Cover for the pensioners, it cannot be done. The plan for Insurance Cover to the retired personnel is hanging fire for almost four years, and the pensioners and CGHS beneficiaries are continuing to suffer.
It may kindly be realized that the utmost consideration of any organization is the welfare of its citizens, and action may kindly be taken to mitigate the suffering of the CGHS beneficiaries by opening new CGHS Wellness Centers in Panchkula and Mohali .

  1. Empanelment of Hospitals and Diagnostic Centres

Some Private hospitals and Diagnostic Centers have been empanelled for the CGHS beneficiaries in the Tricity, but these are not enough. Besides, the medical cover offered by these empanelled hospitals, and diagnostic facilities extended by empanelled Diagnostic centres have lately been withdrawn / cancelled, resulting in pensioners facing considerable problems. It is felt that Chandigarh is being given step-motherly treatment vis-à-vis other CGHS covered cities of India.

The cancellation of the empanelment of Grewal Eye Center (Sector 8, Chandigarh), a reputed Eye hospital in Chandigarh is a blow to the elderly CGHS beneficiaries. It offered quality treatment for various Eye ailments, and its re-empanelment may kindly be considered at the earliest.

In respect of diagnostic investigations, the elderly CGHS beneficiaries are continuing to suffer as there is no approved diagnostic centre for such important tests as ECG, Echo Cardiology, TMT and Holter. These tests are very often required by the elderly pensioners for various age related ailments, including heart problem. The Prime Diagnostic centre, which was offering the facilities for these tests, was not re-empanelled for these tests and the elderly CGHS beneficiaries suffering from various age related ailments continue to face acute problem to get the tests on payment. The point for restoring the approval for these tests month after month in the CGHS Grievances Committee meetings has not found any response from the CGHS authorities. The restoration of
the approval for these important diagnostic tests needs urgent attention of the CGHS authorities.    -
3        There are some more problems faced by the CGHS beneficiaries, but these are of secondary nature, and once the above points are resolved, these problems would also be mitigated to a considerable extent. It is, therefore earnestly requested to consider our above points with due sympathy and early action to resolve these are taken.

          With regards,

Yours sincerely,
sin
(P S BEDI) DIG Retd
Sr Vice Chairman, CCCGPA,
Chandigarh

 

 

 

 

d CGHS Empanelment order Dated 5 Jan,12
d New Guidlines for issue of CGHS Plastic cards
d New Guidlines for CGHS cards -29 Dec,2011
List of CGHS empanelled Hospitals Chandigarh

LIST OF EMPANELLED HOSPITALS & DIAGNOSTIC CENTRES, CGHS, CHANDIGARH

S.No

NAME OFHOSPITAL/
DIAGNOSTIC CENTRE & ADDRESS

EMPANELLED   FOR

1

Silver Oaks Hospital, Phase 9 ( Sector 63),
SAS Nagar, Mohali
Tel: 5097112, 5094125, 2211303

General Purpose, including Cardiology, cardiothoracic & cardio vascular surgery and Joint Replacement

 

2

Grewal  Eye Institute,
SCO 168-169, Sector 9 C, Chandigarh
Tel: 5056969, 2744843

Super-specialty Eye Care ( Cataract / Glaucoma, Retinal- Medical & Vitriol- Retinal surgery, Strabismus

3

Mukut Hospital & Heart Institute,
SCO 47-49 Sector 34 A, Chandigarh
Tel: 4344444, 4344437

Multi-specialty General purpose and specialized purpose in cardiology, cardiothoracic and cardiovascular surgery, Orthopedic surgery (including arthroscopic surgery and Joint replacement), Oncology (Medical and surgical) & endoscopic surgery.

4

Grover Laser Eye & ENT Hospital,
140 Sector 35 A, Chandigarh
Tel: 22660040, 2603323, 2666726

 

 Eye Care

5

 

Fortis Hospital, Sector 62   (Phase 8),
 SAS Nagar, Mohali
Tel: 4692222, 50212222, 9815196731

Super Specialty
(Cardiology & Cardio-thoracic surgery, Joint Replacement surgery under orthopaedics,Nephrology & urology including renal transplant, Endocrinology, Neurosurgery, Gastro-entrology & surgery including transplant and Oncology )

6

J P Eye Hospital, 35 Phase 7,
SAS Nagar, Mohali
Tel: 2266613, 2227502, 9216066612-13-14

 

Eye Care
-

7

Dr Shamer  Singh Memorial Radio Diagnostic Centre,   SCF-13-14 Sector 16, Chandigarh
Tel: 2541465, 2781496

 

MRI, CT, Memmography,USG,Colour Doppler, X-Ray, Bone Densitory

8

 

Prime Diagnostic Centre, SCO 49.
Sector 8 C, Chandigarh
Tel: 2545111, 2546111, 2546112

 

Colour Doppler & Ultra Sound Center

9

Superb MRI & CT Scan Centre,
SCO 24-25 Sector   8 C, Chandigarh
Tel: 5009005, 5009006

 

BMD & MRI

10

Chandigarh Clinical Laboratories Pvt Ltd,  SCF- 9, Sector 16 D, Chandigarh
Tel: 2277094, 2546267, 5060357, 5085497

 

Laboratory Diagnostics

 

 

Based on the List provided by Adll Dirctor CGHS, Chandigarh during the meeting with Pensioners on 4 Nov, 2011.

 

Procedure for Reference
              CGHS/ Govt Specialist/ CMO  I/C advises specific procedure / test. Permission to undergo the same at the recognized Hospital / Diagnostic Centre is granted by the CMO I/C in the case of pensioner CGHS beneficiaries of the concerned dispensary,If the beneficiary seeks permission from a CGHS recognized hospital in another CGHS city, other than the city where he/she is registered, permission shall be granted by the Adll Director / Joint Director CGHS of the concerned city.
OPD  treatment in Private  recognized hospitals is not permitted except in the case of satellite cities of Delhi viz, NOIDA, Gurgaon, Faridabad, Ghaziabad, where  CMO I/C can directly refer the beneficiary to the recognized hospital and in Post operative  follow-up cases of Cardio surgery, cancer treatment, Kidney transplantation, Hip/knee Joint replacement, Neuro-surgery and Accident cases
OPD medicines are to be collected through the concerned dispensary, except in cases of emergency, in which case reimbursement shall be considered by the Adll Director / Joint Director CGHS in case of pensioners.
In the case of permitted post operated cases for conditions as stated above, the beneficiary may purchase medicines from the chemist and claim reimbursement. However, a utilization certificate from the treating doctor is required to be submitted.
                                                                                                              (Based on the website of CGHS)


Medical reimbursment CGHS letter dated 14 Nov,2011

F. No. S.11024/8/2011/CGHS(P)
Government of India
Ministry of Health and Family Welfare
Department of Health and Family Welfare
Directorate General of C,G.H.S.

Nirman Bhawan, New Delhi
Dated the 14th November, 2011


CIRCULAR


SUBJECT: Streamlining of Procedure for disposal of Medical Reimbursement Claims (MRCs) in CGHS
The pensioner CGHS beneficiaries and their dependent family members are entitled to get cashless medical treatment In CGHS empanelled private hospitals on a referral by a Government medical specialist / CMO in-charge, after obtaining prior permission from the CMO in-charge of the CGHS Wellness Centre/Dispensary they are attached to. They are however, also entitled to obtain the medical services from any un-empanelled hospital in emergency condition and get reimbursement of medical expenses incurred by themselves or any of their dependent family members. They can file Medical Reimbursement Claims (MRCs) with the respective CGHS Wellness Centres they are attached to- The CMO In charge is expected to scrutinize the claim papers with reference to the prescribed Checklist and forward the same to the Office of AD/ JD in charge of the zone/city. The Office of AD/JD processes the claim and arranges reimbursement of the admissible amount to the pensioner beneficiary at the earliest.

2. A number of complaints are being received from the pensioner beneficiaries about the slow and tardy pace of disposal of MRC claims by CGHS, Complaints have also been received about the unnecessary harassment of pensioner beneficiaries who are also senior citizens, affecting them mentally and financially, and thereby creating a bad image for CGHS. CGHS is responsible for taking care of healthcare needs and well being of the central government employees and pensioners. It has therefore been decided to lay down a comprehensive procedure to be followed by all concerned in CGHS to ensure timely and hassle free disposal of the MRC claims by CGHS in order to facilitate prompt reimbursement of medical expenses to the pensioner beneficiaries.

3. The procedure to be followed by CGHS for dealing with MRC cases shall be as follows;

i. The beneficiary will submit the MRC in the prescribed format with all relevant supporting vouchers/documents in original, to the CMO-I/C of the relevant CGHS Wellness Centre. The CGHS  are enclosed as per the prescribed checklist and issue a dated acknowledgement to the claimant in token of receipt of the MRC by CGHS.

ii. The CGHS Wellness Centre shall forward the MRC papers online to the Office of Zonal AD/JD, CGHS for further processing for reimbursement of claims. The physical papers shall be sent to the office of the AD/JD within one / two days of receipt of claim papers.
iii. If there are still any deficiencies / gaps found in MRC documents/papers, the Office of AD/JD, shall retain the papers and communicate the list of deficiencies / observations, preferably online, to the CMO-I/C for removing the shortcomings. The MRC may also be returned in original to the CMO- I/C, if it is absolutely necessary for doing the needful to remove the deficiencies in consultation with the beneficiary.
iv. The CMO-I/C shall contact the beneficiary concerned and inform him about the shortcomings in the MRC papers and request him to submit the requisite information / documents. The CMO I/C shall not return the MRC in original unless it is rejected in total.
v. The MRCs should be scrutinized and processed by the Office of AD/JD as far as possible through computerized software as per the extant policy and instructions issued from time to time about the CGHS rates and admissibility of claims under CGHS.
vi. The amount found admissible as per the CGHS guidelines may be passed for payment and forwarded online / manually to the PAO for making payment. The original documents should also be forwarded simultaneously to the PAO for making payment of the admissible amount to the claimant.
vii. When a bill is sent to the PAO, the details pertaining to the claimant will be entered through computer and the claimant shall be informed of the same along with bill number, amount admissible and details of disallowances clearly indicating the specific reasons / grounds for deductions.
viii. The Office of AD/ID of the zone / city shall submit a weekly report in Form ‘MRC-I’ and Monthly Return in Form  ‘MRC - II’ indicating the details of disposal of MRC cases, to the Office of AD(HQ), CGHS for Delhi & NCR and to the Office of Additional DDG (HQ), CGHS for other than Delhi and NCR CGHS cities.
ix. A separate analytical statement shall be attached with the Monthly Return in Form-’MRC- II’ giving therein, the details of the MRCs pending for 2 months and above, clearly indicating the reasons there for and steps taken to dispose of such cases.
x. The Office of AD (HQ), CGHS, New Delhi and Office of Addl. DDG (HQ), CGHS shall compile the Monthly returns received from the respective zones and cities and submit a consolidated Monthly Return on MRC cases (Zone-wise/City wise) to the Director, CGHS for monitoring of MRC cases on a monthly basis. A copy of this Monthly Return shall also be endorsed by AD (HQ), CGHS and Addl. DDG (HQ), CGHS to Additional Secretary and Director General, CGHS for his information.
4. All the CMO — I/C of the CGHS Wellness Centres and the ADs and JDs of the zone /city are herby directed to follow the above procedure religiously in both letter and spirit to ensure speedy and timely disposal of the Medical Reimbursement Claims (MRCs) filed by the pensioner CGHS beneficiaries.
End: Forms – MRC-I & II

sd/-
(L.C.Goyal)
AS&DG (CGHS)

Source: http://msotransparent.nic.in/cghsnew/index.asp.

d CGHS reimbursement forms
d CGHS Medical Reimbursement Form
d Procedure for referals-CGHS
d The empanelment of Fortis Hospital, mohali vide their O M dated 27 July,2011
Minutes of the meeting held on 14/7/2010 regarding proposed Central Government Employees and Pensioners Health Insurance Scheme

F.No.B.12012/03/2010-CGHS (P)
Government of India,
Ministry of Health & Family Welfare  
Department of Health & Family Welfare

Nirman Bhawan, New Delhi
Dated the 6th June, 2011.


Subject: – Minutes of the meeting held on 14/7/2010 regarding proposed Central Government Employees and Pensioners Health Insurance Scheme – regarding.

The undersigned is directed to enclose a copy of the Minutes of the meeting of Staff Side Members of National Council (JCM) with Joint Secretary (Regulation), Ministry of Health & Family Welfare held on 14/07/2010 regarding proposed Central Government Employees and Pensioners Health Insurance Scheme (CGEPHIS) for information and further necessary action, if any.

sd/-
(JAI PRAKASH)
Under Secretary to the Govt. of India.

Minutes of the meeting of Staff Side Members of National Council (JCM) with Joint Secretary (Regulation) held on 14/07/2010 at 11: 00 AM in the Committee Room of Ministry of Health and Family Welfare, Nirman Bhawan, New Delhi on the proposed Health Insurance Scheme for Central Government employees and pensioners.

Shri Vineet Chawdhry, Joint Secretary (Regulation) M/o Health and Family Welfare held a meeting with staff side members of National Council (JCM) on 14th July. 2010. List of the participants in the meeting is at Annexure. At the outset, Chairman welcomed the Staff Side members of National Council (JCM) to the meeting to discuss the proposed Central Government Employees & Pensioners Health Insurance Scheme (CGEPHIS), to be rolled out in compliance of the recommendation of Sixth Central Pay Commission and to directions of Committee of Secretaries (COS). He informed the members about the salient features of the Scheme which had already been circulated, and said that:

 

• The proposed scheme shall be compulsory for new appointees and new retirees and would be voluntary for existing pensioners and employees.
• Government may bear upto 75% of the insurance premium share as a subsidy depending upon the eligible categories of the employee. The remaining portion of the premium will be borne by the members as is being done for CGHS.
• Scheme will have no age limit, therefore member of any age can join the scheme.
• All pre existing diseases will be covered from day one.
• He further stated that OPD benefit is not available under the Insurance scheme due to various constraints, however, free OPD consultation will be provided by the networked hospitals and also they will charge the discounted CGHS rates for diagnostics procedures if prescribed during OPD consultation. However, cost of medicines will not be covered in such cases.
• The scheme will operate on cashless basis on the lines of existing CGHS packages for the treatment taken in the networked hospitals by pensioners beneficiaries and no money is to be paid by the members to the hospitals.
• The ‘family’ under CGEPHIS has been defined as self, spouse two dependent children and two dependent parents. Dependency criteria will remain same as applicable under CGHS. For including any additional member as a beneficiary under the scheme, the beneficiary would have to bear the entire premium on the additional member without it being subsidized by the Government.
• The Insurance cover for the family will be Rs. 5 lakh and it will operate on family floater basis. In addition to this, a provision has also been made to create a corporate buffer of Rs. 25 Crore to take care of eventualities in cases where the above limited is exhausted fully and the member/ beneficiary is still undergoing treatment. In other words, although a monetary limit of Rs 5 Iakh has been kept as insurance cover for the family but it is only to decide the insurance premium with the Insurer. In fact, the members will enjoy an unlimited cover for their medical treatment under this Health Insurance Scheme too. Anything over and above Rs. 5 lakh will be borne by the Government.
• Pre and post hospitalization benefits would also be available to the members.
• Insurance premium to be paid would be deducted from the salary of the serving employees and pensioners would authorize their banks to deduct the applicable premium.
• There will be a provision in the scheme for the beneficiaries to opt out of the scheme after three years.
Shri V. P. Singh, Deputy Secretary (Medical services) informed the members that the Ministry conducted a ‘Demand Survey’ and gave wide publicity through newspaper advertisements all over India and invited response from the target population i.e., employees and pensioners who are willing to join the Scheme when it becomes operational. It was hosted on the website of the Ministry and CGHS website and willingness was invited through email too. The response have been quite encouraging and around 16,000 responses have been received which are being compiled for analysis. Majority of the response were from Non CGHS area and people have shown their willingness to join the scheme. The staff side requested that the outcome of the ‘Demand Survey’ may also be shared with them on its completion, which was agreed to.
He also informed that as per the information made available by IRDA, 97% of the claims settled by the Insurance companies involved amount of less than Rs 3 lakh annually. Only 0.35 % of the claims were for amount exceeding Rs. 5 lakh annually, the balance falling between the Rs 3 to 5 lakh. Hence the proposed insurance cover of Rs 5 lakh would be adequate for the beneficiaries.
DR. S. P. Goswamy, National Consultant (Health Insurance), Ministry of Health and Family Welfare informed the members that most of the benefits available under CGHS have been made a part of the CGEPHIS. The CGEPHIS is almost a replica of CGHS. Most of the defined day-care procedures which are covered in CGHS under OPD have been made part of the scheme. Further, in such cases where patients require hospitalization, but the condition of the patient is such that he cannot be shifted to hospital or bed is not available, CGEPHIS shall provide for such medical treatment under domiciliary hospitalization. These cases are part of OPD in CGHS
Chairman further informed the Staff Side that all possible efforts have been made to make the Scheme suitable for the employees and pensioners retaining in it all the important features of CGHS and CS(MA)Rules, 1944, so that it attracts the target group and provide a freedom of choice in the hands of employees and pensioners, to select the best suitable scheme for them. He sought the views of the Staff Side members of JCM on the Scheme.
Opening the discussion from the Staff Side, Shri S.K.Vyas Member(Staff side) JCM informed the meeting of their collective view on the scheme and stated that they have been opposing the Health Insurance Scheme all along and they still hold the view that CS(MA) Rules, 1944 is more suitable and it may be extended to all non CGHS areas and should provide cover to the pensioners who have been deprived of this medical facility since long. He further opined that the proposed scheme will also deprive the existing benefits available to the employees and pensioners viz. OPD facilities, coverage to all dependent family members etc. Extension of CS(MA) Rules, 1944, to all pensioners living in Non CGHS areas is their long pending demand. The Staff side unanimously stated that if the Government has already made up its mind to introduce Insurance Scheme, it should be implemented with the following points given due consideration before introduction of the scheme, so that it attracts the prospective members to join the scheme:
• The Scheme should not be made compulsory for the future employees and pensioners. A voluntary option for joining the scheme must be given to all future employees and pensioners. The choice must be left to them. Especially the future retirees should not be deprived of the CGHS benefits that they have been availing during their service period as per the present scheme.
• All eligible dependent members of the family may be allowed to join the scheme without any additional financial burden on members. This is being done in the existing CGHS and no financial burden is being imposed on members. Whatever the liability of premium for additional members is worked out; the same may be borne by the Government.
• As the OPD consultation will be free in networked hospital, the cost of medicines on the prevailing guidelines of the CGHS may be reimbursed to the members. Else, an amount to Rs. 1000 +DA per month as Fixed Medical Allowance (FMA) be paid to them on the analogy of the Transport Allowance. The revised amount of Rs. 300/- per month as FMA is inadequate, considering the ever increasing cost of the medical treatment under the present inflationary conditions.
• The annual contribution to be made by the employee as his share of the Insurance premium for the Health Insurance policy should not in any case be more than the CGHS contribution applicable for him.
• Life time contribution in respect of insurance premium may be taken from the pensioners as per the present CGHS provisions (for ten years for life time benefit) and rest may be borne by the government.
Staff side raised the point about the implementation process of the scheme and enquired about the number of Insurance companies that may be involved in this scheme, as insurers to cover the entire country. Chairman informed the members that it will depend upon the future scenario as it emerges in due course.
Shri S.K. Vyas reiterated his opinion that the extension of CS(MA) Rules, 1944, to the pensioners living in non CGHS areas would be more economical and cost effective way of addressing their health related issues in comparison to the proposed Health Insurance Scheme (CGEPHIS).
Shri C. Srikumar raised the issue of revision of Fixed Medical Allowance (FMA) to those employees who are posted in remote areas where AMA is not available. Since the Government has already issued order for revising the FMA for pensioners, necessary order for serving employees may also be issued.
Chairman assured the Staff Side members of the National Council(JCM) that the Ministry will look into the points raised by them seriously and the concerns expressed by them and suggestions made by them will be given due consideration while finalising the Scheme.
The meeting ended with a vote of thanks to the chair.

MINUTES OF THE MEETING OF ADVISROY COMMITTEE HELD ON 30-06-2011 IN THE CGHS WELLNESS CENTRE NO-1, SECTOR 45, CHANDIGARH

Govt. Of India
MINISTRY OF HEALTH & FAMILY WELFARE
C.G.H.S.WELLNESS CENTRE NO-1. 
SECTOR 45, CHANDIGARH

No: CMO/CGHSWC-I /Advisory Committee/Minutes/196                                Dated: 30-06-2011
MINUTES OF THE MEETING OF ADVISROY COMMITTEE HELD ON 30-06-2011   IN THE CGHS WELLNESS CENTRE NO-1, SECTOR 45, CHANDIGARH
The meeting was attended by the following members:-:-
(1)Sh Raghuvir Singh, IAAS (Retd) formerly Add. Secy, Min of H & F W.
(2)Sh.P.S.Bedi-DIG(Retd)-Sr.ViceChairman,Central Govt.Pensioners Coordination Committee,CHD.
(3)Sh.G.S.Bhogal, Gen.Sec, Senior Citizens Forum, Zirakpur.
(4)Sh.M.C.Arya, Gen.Sec,Defence Accounts Pensioner Welfare Association, Chandigarh
(5)Sh D D Sharma, Survey of India, Sector 32, Chandigarh.
(6)Sh.Raj Kumar, Representative of Goyal medicose, local chemist.
(7)Dr. Ashwani Kumar Seniaray, Chairperson, Advisory Committee, Chief Medical Officer (NFSG) I/C, CGHS WC-1, Sector 45, Chandigarh.

Welcome Address:
Dr. Ashwani Kumar Seniaray, CMO In charge, welcomed the members of the Advisory Committee. He apprised the members regarding the action taken to improve the functioning of the Wellness Center. The CMO intimated that he had attended a meeting in the office of Home Secretary, Union Territory, Chandigarh on 22-06-2011,. He apprised the Home Secretary that this point fell under the jurisdiction of the Additional Director, CGHS, and informed them that action is in hand to shift the office of Additional Director, CGHS, from Sector 34 to Kendriya Sadan in sector 9. However, in the case of CGHS Wellness Center, Sector 45, the process of allotment of land for construction of CGHS Office and Wellness Center, is under active consideration of Chandigarh Administration. The land has been identified and the final decision will be taken soon.

The members of the Advisory Committee expressed concern on this issue and requested the CMO to take up case for early allotment / possession of the earmarked plot for CGHS in Chandigarh, and enjoin upon the Additional Director CGHS, Chandigarh and CGHS authorities in New Delhi for expeditious allotment of funds and approval for early construction of CGHS campus in Chandigarh. MRC status/Pendency of claims::

The members expressed concern as the AD office has not provided the status of pending MRC claims before the meeting of the advisory committee as per the instructions of Ministry of H & F W OM No 4-27/2005-CGHS/C & P/Pt1 dated 27 Feb, 2010 Para 3 (vii).It was suggested that Add Director may again be requested to take necessary action on this issue. It was, however, intimated that reimbursement bills of pensioners up to April, 2011 had been cleared.

Performance of Local Chemist: :  
Performance of local chemist has been satisfactory and drugs are supplied in time and there has been no case of supply of substitute medicines by the local chemist.

Availability of Drugs in the WC:
As per the records, there are 29 Generic items and 63 Proprietary items available in the WC. A problem had occurred due to failure of some computer connectivity, whereby there was some delay in procurement of drugs / medicines. This has been sorted out and regular supply of medicines would be resumed shortly. It was reiterated that Add Director CGHS, Chandigarh be requested to expedite the procurement of drugs/items for the Wellness Center on priority.

Amenities for the beneficiaries::
The Additional Director, CGHS office is taking action for early installment of Token Display System in the Wellness Center to mitigate the patients stress and avoid long queues.
Shri D D Sharma, representative of serving CGHS beneficiaries, point regarding giving preference to serving employees in the morning hours from 07.30 to 9.30 a.m. was implemented w.e.f 30 May, 2011. No problem was experienced in its implementation.

Shri M C Arya point regarding issue of Plastic Cards to the CGHS beneficiaries in Chandigarh is under consideration of CGHS Head Office, New Delhi. It will be started only under the directions from the Headquarters.
On a query regarding empanelment of diagnostic centres in Chandigarh, CMO intimated that notification for empanelment of Chandigarh Clinical Laboratories is awaited from CGHS HQs, New Delhi.
Shri M C Arya wanted to know the position regarding issue of ‘Insulin pens’ and ‘needles’ to the diabatic patients through the CGHS dispensaries. The CMO intimated that these are not authorized items and cannot be issued by CGHS.

Staff Punctuality & Behavior:
The conduct and behavior of the staff of the Wellness Center has been very good. They are courteous and helpful to the senior/aged CGHS beneficiaries. Ms Anupama, Pharmacist of the Wellness Center,was adjudged as the most helpful, efficient and the Best worker for the Quarter ending
30 June,2011. She has successfully handled various medicines and drugs including the ‘un-utilised returned’ drugs dropped in the UNUSED MEDICINES Box kept in the Wellness Center.

Cleanliness & Maintenance of Wellness Centre:
The Wellness Centre was found to be clean and well maintained.

Grievance Redressal:
The complaint box was opened by Sh.M.C.Arya and two letters were found. In the first letter,
Shri J S Sandhu (CGHS Card-P2145) suggested that Minutes of the meeting of the Advisory Committee be displayed on Notice Board in the Wellness Center for the information of beneficiaries visiting the dispensary for consultations. CMO indicated that this would be done.
The second letter, from Sh Madan Singh (CGHS Card- P 810) expressed his appreciation of the CMO and the staff of the dispensary in helping him to shift his acutely ill wife, Smt Charanjit Kaur, from a private hospital to an empanelled hospital, Silver Oaks, for hassle free treatment thereby relieving him of mental and financial stress. The meeting ended with the vote of thanks by the CMO to all the members.

                                                                                                                                                                     

Dr. Ashwani Kumar Seniaray)
CMO (NFSG) I/C
CGHS WELLNESS CENTRE NO-1,
Sector 45, Chandigarh.

Copy forwarded to:-
1.            Dr. S.C. Anand, Addl. Director CGHS Chandigarh for information
2.            All the committee members.

MINUTES OF THE MEETING OF ADVISROY COMMITTEE HELD ON 30-04-2011 IN THE CGHS WELLNESS CENTRE NO-1, SECTOR 45, CHANDIGARH

Govt. Of India
MINISTRY OF HEALTH & FAMILY WELFARE
C.G.H.S.WELLNESS CENTRE NO-1. 
SECTOR 45, CHANDIGARH

No: CMO/CGHSWC-I /Advisory Committee/Minutes                                Dated: 30-04-2011
MINUTES OF THE MEETING OF ADVISROY COMMITTEE HELD ON 30-04-2011   IN THE CGHS WELLNESS CENTRE NO-1, SECTOR 45, CHANDIGARH
The meeting was attended by the following members:-
(1) Sh.P.S.Bedi-DIG(Retd)-Sr.ViceChairman,CentralGovt.Pensioners Coordination Committee, Chandigarh.
(2186, Sector 35 C,Chandigarh- Tele; 2615048)
(2). Sh.G.S.Bhogal, Gen.Sec, Senior Citizens Forum, Zirakpur.
(F-23, Panchsheel Enclave,  Ambala Road, Zirakpur- M- 9872639304)
(3). Sh.M.C.Arya, Gen.Sec,Defence Accounts Pensioner Welfare Association, Chandigarh
(210 Swastik Vihar, Patiala Road, Zirakpur- M- 9417495648)
(4) Sh D D Sharma, Survey of India, Sector 32, Chandigarh (M-94171-84124)
(5). Sh.Raj Kumar, Representative of Goyal medicose, local chemist.
(6). Dr. Ashwani Kumar Seniaray, Chairperson, Advisory Committee,
Chief Medical Officer (NFSG) I/C, CGHS WC-1, Sector 45, Chandigarh.

Welcome Address:
Dr. Ashwani Kumar Seniaray, CMO In charge, welcomed the members of the Advisory Committee. He apprised the members regarding the action taken to improve the functioning of the Wellness Center, by putting up ‘Information Boards’ at appropriate places in the Wellness Center, and upgrading the facilities for the beneficiaries e.g. provision of safe drinking water, clean toilet etc.
Following points were discussed.
MRC status/Pendency of claims:
It was intimated to the members that as per information provided from AD office, the MRC bills of pensioners have been cleared up to February, 2011. The members again reiterated that the AD office may be requested to provide the status of pending MRC claims before the meeting of the advisory committee on regular basis.  In respect of serving employees, as per latest instructions, their re-imbursement bills are being cleared by the respective department. It was also stressed that new modified form for reimbursement claims as per latest instructions should be used.
Performance of Local Chemist:  
Performance of local chemist has been satisfactory and drugs are supplied in time and there has been no case of supply of substitute medicines by the local chemist.. 
Availability of Drugs in the WC:
As per the records, there are 33 Generic items and 115 Proprietary items available in the WC. It was also intimated that six drugs have been banned by the Drug Controller, and had been withdrawn from pharmacy distribution counter.
Amenities for the beneficiaries:
The members again felt the need to have a Token Display System installed at the Wellness center to mitigate the patients stress and avoid long queues. There is urgent need to implement this point at an early date.

Shri D D Sharma, representative of serving CGHS beneficiaries, reiterated that serving employees should be given preference in the morning hours to enable them to reach their office in time. A proposal to attend to the employee beneficiaries in the ratio of 3 employees to 1 pensioner from 07.30 a.m to 09.30 a.m. and there-after the Pensioners will be given preference in the same manner.  However, emergency cases and acutely ill patients will be attended to on top priority as per norms.
A need to have a Ceiling fan at the Local Purchase Dispensing Area was discussed and the feasibility of putting the fan will be looked into, as this area is in the open, possibility of theft cannot be ruled out.
It was pointed out that the performance of the Diagnostic Centre at Silver Oaks Hospital, Mohali has invited criticism from few of the beneficiaries. Besides its distance from Chandigarh/ Panchkula and other areas, there have been cases of anomaly in reporting. It was decided to approach the hospital authorities by a sub-committee of the Advisory Committee consisting of Sarv Shri P S Bedi, M C Arya and D D Sharma to meet the Director, Silver Oaks Hospital and sort out this problem.
Staff Punctuality & Behavior:
The conduct and behavior of the staff of the Wellness Center has been very good. They are courteous and helpful to the senior/aged CGHS beneficiaries. Ms. Minakshi  Tomar, Staff Nurse, who had been selected  as the best and most helpful staff member of the Wellness center No 1, Chandigarh for the Quarter ending 31 March,2011 was felicitated and presented the Certificate of Excellence by the CMO, in the presence of all Medical Officers, Staff and the Advisory Committee members. A suggestion was mooted to give some monetary grant also, if admissible as per govt rules, with the certificate as an additional incentive.
Cleanliness & Maintenance of Wellness Centre:
The Wellness Centre was found to be clean and well maintained. . Air purifier has been placed in the toilet block.
Grievance Redressal:
The complaint box was opened by Sh.M.C.Arya and one letter, in which one of the beneficiaries had requested for installing Token system in the Wellness Center, was found. This point had already been discussed in the meeting.

The meeting ended with the vote of thanks by the CMO to all the members.                                                                                                                                                                     
(Dr. Ashwani Kumar Seniaray)
CMO (NFSG) I/C                                           
 CGHS WELLNESS CENTRE NO-1,
 Sector 45, Chandigarh.
Copy forwarded to:-
1.            Dr. S.C. Anand, Addl. Director CGHS Chandigarh for information
2.            All the committee members.

Note:
The three members of the Advisory Committee visited the Silver Oaks, Hospital, Mohali on 10 May, 2011 and had a fruitful discussion with the Director, Dr Akhil Bhargava and the Pathologist, Dr Bharti Ahuja to sort out the problems. The hospital authorities gave positive indications to address the problems of CGHS beneficiaries to their entire satisfaction.

Medical Facilities for inpatient treatment and post-operative follow-up treatment to CGHS beneficiaries in Non-CGHS areas.
Certificate of Merit awarded to CGHS, Chandigarh
Identification of Stroke / Blood-Clot
How to indentify a Blood Clots / Stroke

STROKE IDENTIFICATION

A neurologist says that if he can get to a stroke victim within 3 hours he can totally reverse the effects of a stroke. The trick was getting a stroke recognized, diagnosed, and then getting the patient medically cared within 3 hours.

RECOGNIZING A STROKE

Sometimes symptoms of a stroke are difficult to identify. Unfortunately, the lack of awareness spells disaster. The stroke victim may suffer severe brain damage when people nearby fail to recognize the symptoms of a stroke.

A bystander can recognize a stroke by asking three questions:
(Remember 1st three letters....S T R  of  STROKE)

S   --   Ask the person to smile.  

T   --   Ask the person to talk and speak a simple sentence (Coherently) i.e. It is sunny out today.  

  --   Ask him or her to raise both arms...

If he or she has trouble with any one of these tasks, call emergency number immediately and describe the symptoms to the doctor.


ANOTHER INDICATOR OF A STROKE --- TONGUE

Ask the person to stick out his tongue. ... If the tongue is 'crooked', or if it goes to one side or the other, that is also an indication of a stroke.
Some questions about bowl movement
Question 1: How long does it take you to have a bowel movement?
Answer: Healthy bowel movements happen within seconds of sitting on the toilet. Stool should easily come out without straining, grunting, or any discomfort. It should have the consistency of toothpaste. If you have time to read a newspaper while sitting on the toilet—you probably have a problem with constipation or poor bowel health.

Question 2: Does your stool sink immediately?
Answer: Fast sinking stool is a sign of a fiber deficiency in your diet. Healthy stool should slowly descend to the bottom of the toilet bowl. If you have a "fast sinker"—add more fiber-rich foods to you diet. These include fruits, vegetables, nuts, and whole grains. If your stool sticks to the sides of the toilet or leaves "streak marks"—that's a sign of excess fat in your stool. This can be caused by a poor diet or a sluggish liver. 

Question 3: What is the shape of your stool? 
Answer: Healthy stool averages about four to six inches long and shaped like a banana or a torpedo. Very narrow, pencil-shaped stool is a sign your colon walls are impacted or you have polyps or growth on the inside of your colon or rectum. This causes the stool to squeeze to get through. Stress can also create narrow stool. Hard, round, or pellet-shaped stool is a possible sign of poor liver function, lack of exercise, dehydration, or constipation. 

Question 4: Is your stool accompanied by foul odor? 
Answer: Gas or odor is a sign of a bacterial imbalance in your intestinal flora. The "bad" bacteria release foul-smelling gases and toxins that can cramp your colon and create embarrassing odors.You can eliminate this odor by removing debris and encrusted feces from the walls of your intestines and restoring the balance in your intestinal flora. 

Question 5: What color is your stool?
Answer: According the Mayo Clinic research, all shades of brown and even green are considered normal stool colors. And the foods you eat can affect the color of your stool. For example, beets, tomato juice, blueberries, popsicles, and green leafy vegetables can affect your stool color. However, a distinct change in stool color can be a warning sign for health problems. Yellow-colored stool indicates your food is moving too quickly through your digestive tract—as in the case of diarrhea. If stool is greasy or foul-smelling, it may indicate excess fat caused by mal-absorption of nutrients. Green-colored stool means your food isn't properly being processed through your intestines. As a result, bile isn't broken down—and gives your stool that green color. Green stool can also mean you're eating too much sugar, and not enough grains or salt. Gray or ashy colored stool indicates undigested fats or heavy use of prescription or over-the-counter drugs that contain aluminum hydroxide. It can also indicate a lack of bile in stool that may be caused by a bile duct obstruction or a liver problem. Black stool is a serious warning sign for bleeding in the upper gastrointestinal tract—possibly the stomach. Bright red stool may indicate bleeding in the lower intestinal tract—possibly the large intestine or rectum. Hemorrhoids are usually the source of the bleeding. 

Question 6: Do you pass gas while you're having a bowel movement or have you noticed air or bubbles in your stool?
Answer: Air or bubbles in stool can indicate an intestinal imbalance. Gas producing bacteria may be overgrowing and competing with the healthier flora in your gut. Please know this: A normal bowel movement happens within 60 seconds of sitting on the toilet. There should be no straining, pain, bleeding or foul odor accompanied with your bowel movements. And wiping afterwards should be easy and simple—using just one or two pieces of toilet paper!

[Courtesy: Jasbir Singh Sandhu, Comdt. (Retd.), CRPF]
Healthcare Schemes of Govt. of India
1.  During the British period, the govt servants were getting medical treatment from the provincial hospitals. In 1944, Central Services (Medical Attendant) Rules were formulated by the govt of India for the serving employees. The retirees were left out and till date this option of CS (MA) Rules is not applicable to retirees. The first govt funded medical scheme with an element of workers contribution was enacted in 1948 in the shape of ESIC Act, 1948. Here the workers earning less than a base line were not to pay any contribution, but others above this base line and up to a certain upper limit were to contribute 1.5% of the wages. Above this upper limit, the employees were to fend for themselves. This upper limit till recently was Rs 10,000/- and has now been increased to Rs 15,000/-.ESIC is controlled by Ministry of Labour.

2.    CGHS was introduced in 1954-55. The employees had to pay a graded monthly subscription to CGHS, based on his Basic Pay. This subscription was minimum 50 Paisa p m and maximum Rs 120/-. This has been revised from time to time with increase in pay etc as per various Pay Commission Reports. For the pensioners, they had to make the payment on six monthly basis or yearly basis. Subsequently the govt introduced the ‘Life Card’ if the pensioner paid a lump sum for ten years contribution.

3.    The Railways, around 1964, introduced free OPD for retirees and subsidized indoor treatment. In 1997, the Railways introduced a contributory health scheme with onetime payment scheme for retirees and their spouse providing same level of treatment at the time of retirement. The lump sum payment was one month pay +D A on LPD. This scheme is known as RELHS. In the Defence services, a medical contributory scheme was introduced in April, 2000, known as ECHS (Ex-servicemen Contributory Health Scheme). For this, the retirees had to make graded payment based on their LPD Equivalent to ten years contribution as in the case of CGHS. The pre-1996 retirees / ex-servicemen are entitled to free treatment for life in military hospitals. Other retiree of Defence services have to make payment as per their rank at the time of retirement. These rates of subscription / contribution are similar to CGHS rates.

4.    The latest rates of contribution to CGHS as per Ministry of Health & Family Welfare O M No S. 11011/2/2008-CGHS (P) dated 20 May, 2008 are as under:

Sr. No. Grade Pay Contribution p.m. Contribution per pear Contribution for 10 years
1. Up to Rs 1650/- p.m. Rs50/- Rs600/- Rs6,000/-
2. Rs 1800, Rs 1900, Rs 2,000 Rs 2,400and Rs 2600 p.m. Rs125/- Rs1,500/- Rs 15,000/-
3. Rs4200 p.m. Rs225/- Rs2,700/- Rs27,000/-
4. Rs 4600, Rs 4800, Rs 5400, and Rs 6600 p.m. Rs 325/- Rs 3,900/- Rs 39,000/-
5. Rs 7600 and above p.m. Rs500/- Rs 6,000/- Rs 60,000/-


5.     Entitlement of Wards in Private Hospitals empanelled under CGHS is as under:
Sr. No. Ward Entitlement Pay drawn in the Pay Band
1. General Ward Up to Rs 13,950/-
2. Semi Private Ward Rs 13,960 to Rs 19,530
3. Private Ward Rs 19,540 and above

6.    The pensioners have an option to get their CGHS Pensioners cards by either making CGHS contribution on an annual basis ( Twelve Months) or making contribution for ten years( 120 Months) for getting a Pensioners Card with Life-Time validity. It is also clarified that:-

(i) Contribution to be made by the pensioner/ family pensioner would be the amount they were subscribing at the time of their retirement or at the time of death of the govt servant.

(ii) Pensioner beneficiaries, who have already obtained CGHS card with lifetime validity by paying a lump sum amount equivalent to 10 years contribution, will not be required to pay any additional amount as a result of revision in the rates of contribution for availing CGHS facility.

(iii) Entitlement of pensioners/ family pensioner, who have deposited their contribution for life-time CGHS facility, will not be changed.

(iv) Pensioners/family pensioners who are contributing to the CGHS on an annual basis and wish to continue to avail CGHS benefits will have to contribute at the revised rates up to the time of contribution needed to cover a period of a total of ten years from the time pensioner CGHS card was issued for the first time to them. The revised rate of contribution for the remaining period would be with reference to the grade pay that he/she would have drawn in the post held by him/her ,( at the time of his/her retirement/death), had he/she continued to be in service now but for his/her retirement/death.

(v) Any pensioner/ family pensioner who is entitled to avail CGHS facility has not so far got his / her pensioner CGHS card made, the rate of contribution in such cases will be with reference to the grade pay that he / she would have drawn in the post held by him / her (at the time of his /her retirement/death), had he/ her continued to be in service, but for his / her retirement / death.
Procedure For Enrolment as Members of CGHS

In Chandigarh, the office of Additional Director CGHS is located in Sector 34 D, Chandigarh. The retirees of Central Govt (Including retired personnel of Paramilitary Forces) have to apply to this office for enrolment as member of CGHS on form ‘Application for CGHS Card for Pensioners of Central Government’. This form can be collected from the office of Additional Director, CGHS, Sector 34 D Chandigarh. As per instructions issued by the office of Additional Director CGHS, pensioners have to come personally between 3.00 p.m.  and 5.00 pm on any working day (Monday to Friday), with following documents:-

  1. Original PPO, issued by CPAO, New Delhi, with Photocopy of the same duly attested, indicating the ‘Grade Pay’ as per 6th CPC, effective w.e.f 01-01-2006.
  2. Salary Slip/LPC duly attested ( if want to opt on Salary basis)
  3. Family Photographs ( Passport size)
  4. Residence Proof (Photocopy of Electricity/ Water/ Telephone/ Mobile bill or Voter Card) duly arrested.
  5. A certificate from the Bank, indicating stoppage of ‘Fixed Medical Allowance’, as also details of ‘Revised Pension details’.
  6. Bank Draft in favour of ‘Additional Director, CGHS, Chandigarh’ payable at Chandigarh from any nationalized Bank.
  7. Surrender Certificate of Service CGHS card from Pensioner’s office
  8. An affidavit indicating that the pensioner, after superannuation/ VRS, has not joined any Govt/ Semi Govt/Autonomous Body of India to avail Medical facility, and my wife is a house wife.

Note 1- In case wife is a pensioner or serving in a govt/ semi govt/ autonomous body of India, a certificate from the Head of the Dept/ Bank regarding ‘ Stoppage of Fixed Medical Allowance/ Reimbursement ‘. This should be enclosed in original with the application form.

Note 2 – In case of Children & Parents, (i) Name & Date of Birth of each dependant (with attested photocopy of proof of age) – (ii) A certificate indicating that the dependants are residing with the pensioner and their monthly income from all sources is Nil and the children are unmarried, (iii) in case of divorcee/ legally separated daughter, certified copies of legal documents. These documents must be enclosed with the application

Note 3- Sons up to the age of 25 years are eligible for medical facilities under CGHS, till they start earning or get married whichever is earlier.

Note 4 – Daughter is eligible for medical facilities under CGHS irrespective of age  till she starts earning or gets married whichever is earlier.

2              The CGHS contact Nos are as under;-
                (i) CGHS Helpline (New Delhi) – 011-66667777, 156224
                (ii) E mail- cghs@nic.in (between 0930 – 1730 hrs on working days)
                (iii) Additional Director CGHS, Chandigarh – 0172-2646050, 2646030
                (iv) E mail; cghs_chd@yahoo.co.in
                (v) Chief Medical Officer, CGHS Wellness Center – 0172- 2630692

Govt. instructions on streamlining the functioning of CGHS Dispensaries

17366.1  o. S-11030/51/2010-CGHS (P)
Government of India
Ministry of Health & Family Welfare
Department of Health & Family Welfare


Nirman Bhavan New Delhi
Dated : November 22 , 2010

OFFICE MEMORANDUM (Circular No. 1/2010)

Subject : Streamlining of functioning of CGHS dispensaries.

The question of streamlining the functioning of CGHS dispensaries has been engaging the attention of the Ministry of Health & Family Welfare for some time now. After considering the suggestions received from various quarters and after discussing the matter with officials of CGHS, it has been decided, as an initial measure, to streamline the functioning of CGHS dispensaries as below :-

(i) There is a need for officers and staff in CGHS dispensaries to further improve the delivery of service to CGHS beneficiaries. There should be a constant and conscious effort to redress most of the grievances and problems of these beneficiaries at the dispensary level so that there is no inconvenience caused to them forcing them to approach higher authorities for redressal of their grievances. The entire staff at the dispensary level have to ensure a polite, positive and responsible attitude to make the service delivery better. The CMO In-charge must make every effort to ensure this user friendly environment. Complaints of rude/impolite behavior need to be checked and stern action taken by CMOs (Incharge).

(ii) It is well established that CGHS beneficiaries need to be provided better service. Senior citizens/pensioners among the CGHS beneficiaries deserve special attention and response. It is re-iterated that senior citizens/pensioners need to be given out of queue treatment and service at each activity level. Despite repeated instructions in this regard, this system is generally not being enforced at the dispensary level. CMOs incharge must ensure compliance of these instructions.

(iii) CMOs In-charge of the dispensaries shall personally make rounds of the dispensary particularly during peak hours to ensure that there is proper environment and beneficiaries particularly pensioners/Senior Citizens are being treated promptly;

(iv) The Zonal Additional Directors/Joint Directors shall convene the meetings of Pensioners Associations once in two months alongwith CMOs (Incharge) without fail.

(v) A complaint/suggestion/feedback Box with details like number of complaints received and disposed etc. under a seal and lock will be kept at each dispensary and will be opened by the CMO In-charge in the presence of at least two members of the Advisory Committee when the Advisory Committee meeting is being held and necessary action taken by the Advisory Committee with regard to complaints/ suggestions/feedback thus received and, wherever required, the matter will be referred to higher authorities for necessary action.

(vi) All Zonal Additional Directors and Joint Directors shall conduct at least five surprise inspections of the dispensaries in Delhi and at least two in other cities in a month and report the outcome of the inspection indicating the areas such as punctuality, availability and behavior of officers/staff, special care for pensioners/Senior Citizens, deficit areas/complaints and also the good work done in each of the dispensaries inspected, by way of a confidential monthly d.o. letter to reach AS & DG (CGHS) without fail on or before 10th of the succeeding month;

(vii) It is seen that a large number of beneficiaries go to the dispensaries for taking repeat medicines. Authorization of repeat medicines will hereinafter be done by any of the CMOs, apart from the CMO In-charge, available in the dispensary;

(viii) The Zonal Additional Directors/Joint Directors will personally monitor and ensure that the empanelled hospitals etc. do adhere to the terms & conditions of MOAs. They will also supervise the services, if any, being provided by the private parties in their zones such as dialysis, dental services etc.

2. Director, CGHS and all Additional Directors/Joint Directors and CMOs In-charge are hereby directed to fully comply with the instructions contained in this Office Memorandum in both letter and spirit. Noncompliance shall be viewed seriously.

(L.C. Goyal)
AS & DG (CGHS)
Empanelment of Pvt. Hospitals and revision of room rent under CGHS

No: S.11011/23/2009-CGHS D.II/Hospital Cell (Part I)
Government of India
Ministry of Health & Family Welfare
Department of Health & Family Welfare

Maulana Azad Road, Nirman Bhawan
New Delhi 110 108 dated the 16th November , 2010

O F F I C E M E M O R A N D U M
Subject:     Fresh empanelment of private hospitals and revision of Room Rent applicable under CGHS.
The undersigned is directed to state that CGHS had initiated action for fresh empanelment of private hospitals under CGHS and also for the revision of package rates (which were fixed in 2006-07), to be paid to hospitals, by floating tender for the same. On the basis of the responses received package rates for various procedures / treatments have been arrived at and have been uploaded in the website of CGHS:www.mohfw.nic.in\cghsnew\index.asp and can be downl oaded.

2.“Package Rate” shall mean and include lump sum cost of inpatient treatment / day care / diagnostic procedure for which a CGHS beneficiary has been permitted by the competent authority or for treatment under emergency from the time of admission to the time of discharge including (but not limited to) –
(i) Registration charges,
(ii) Admission charges,
(iii) Accommodation charges including patients diet,
(iv) Operation charges,
(v) Injection charges,
(vi) Dressing charges,
(vii) Doctor / consultant visit charges,
(viii) ICU / ICCU charges,
(ix) Monitoring charges,
(x) Transfusion charges,
(xi) Anesthesia charges,
(xii) Operation theatre charges,
(xiii) Procedural charges / surgeon’s fee,
(xiv) Cost of surgical disposables and all sundries used during hospitalization,
(xv) Cost of medicines,
(xvi) Related routine and essential investigations,
(xvii) Physiotherapy charges etc.
(xviii) Nursing care and charges for its services.
(b) Cost of Implants / stents / grafts is reimbursable in addition to package rates as per CGHS ceiling rates for Implants / stents / grafts or as per actual, in case there is no CGHS prescribed ceiling rates.
(c) Treatment charges for new born baby are separately reimbursable in addition to delivery chares for mother.
d) The hospitals empanel led under CGHS shall not charge more than the package rates / rates.

2.2 Package rates envisage upto a maximum duration of indoor treatment as follows:
 12 days for Specialised (Super Specialties) treatment;
 7 days for other Major Surgeries;
 3 days for Lapar oscopic surgeries / normal deliveries; and
 1 day for day car e / Minor (OPD) surgeries.

2.3 However, there are certain procedures where there is no prescribed package rate under CGHS. Similarly, there are medical emergencies where the treatment is mainly conservative. The admissible amount in such cases is calculated item wise, room rent, procedures, investigation , etc. Therefore , it has now been decided to revise the rates applicable for room rent (Accommodation Charges) for different categor ies of wards as given below:
General ward -Rs.1000/- per day
Semi-private ward -Rs. 2000/ – per day
Private ward -Rs.3000/- per day

3. CGHS beneficiaries are entitled to facilities of private, semi-private or general ward depending on their basic pay / pension. The entitlement is as follows:-

S. No.

Basic Pay (without the inclusion of grade pay)

Entitlement

1.

Upto Rs. 13,950/-

General Ward

2.

Between Rs.13,951/ – and Rs.19,530/-

Semi-Private
Ward

3.

Rs. 19,540/- and above

Private Ward

4.2 This issues with the concurrence of Internal Finance Division in the Ministry of Health & Family Welfare, vide Dy. No: AS & FA / 3932 /2010 dated the 8th November , 2010. The revised rates will come into effect from the date of issue of this Office Memorandum. A copy of this Office Memorandum along with rate list and a copy of MOA are placed on the internet at http://mohfw.nic.in/cghsnew/index.asp.
[R Ravi ]
Director
[Tel: 2306 3483]

'List of empaneled hospitals, Chandigarh

LIST OF CGHS EMPANNELLED HOSPITALS / DIAGNOSTIC CENTRES, CHANDIGARH
(As on1st December, 2010)

1. Silveroaks Hospital
Phase 9, Sector 63, SAS Nagar, Mohali
CHANDIGARH
For: General and specialized purpose (Renal) transplantation, Haemodialysis, Laparoscopic surgery, TURP, Joint replacement and Super Specialty in (Cardiology, Cardiovascular and cardiothoracic surgery) and diagnostic services (laboratory, x-Ray, USG), Bio-Chemistry, Pathology, Microbiology, Serology.

2 Grewal Eye Institute Pvt, Ltd
SCO 168-169, Sector 9C, Madhya Marg, Chandigarh
For: Super-specialty Eye Care (Cataract/Glaucoma, Retinal-Medical & Vitreoretinal surgery, strabismus

3 Mukat Hospital & Heart Institute
Sector 34-A, Chandigarh
For: Multispecialty general purpose and specialized purpose in Cardiology, Cardiothoracic and Cardiovascular surgery, Orthopedic surgery including Arthroscopic surgery and joint replacement), Oncology (Medical and surgical) and Endoscopic surgery.

4 Dr. Shamer Singh memorial Radio Diagnostic Centre
SCF 13-14, Sector 16D, Chandigarh
For: Diagnostic Centre (MRI, CT, Mammography, USG/Colour Dopplar, X-Ray, Bone Densitometry)

5 Prime Diagnostic Centre & Heart Institute
SCO 49, Sector 8 C, Chandigarh
For: Diagnostic Centre (USG/Colour Dopplar, ECHO, TMT, Holter and ABPM, Physomnography and ECG)

6 Fortis Hospital
Sector 62, Phase VIII, Mohali, Chandigarh (Likely to be empanelled very shortly)

Minutes of the meeting held by Addl Director CGHS on 7.01.2011

Details of Meeting called by Additional Director CGHS, Chandigarh
(7 January, 2011)

Welcome
The additional Director CGHS, Dr S C Anand, while welcoming  the representatives of Pensioners apprised them that this meeting has been called on instructions from CGHS HQs New Delhi, and will form a regular feature in future also by holding such meetings every two months rotation. He wished them a happy and healthy New Year 2011. The details of points discussed are given in the succeeding paras.

2          The addl Director CGHS asked the participants regarding any difficulties or problems faced by the pensioner beneficiaries. The representatives of Pensioners Associations expressed their complete satisfaction with the functioning of the office of Addl Director CGHS as well as the Wellness Centre. Following requests were made:- 

  1. The lone Wellness Centre in Sector 45, Chandigarh is overcrowded, and there is need to open more Wellness Centres for the Tricity of Chandigarh, Mohali and Panchkula. There are over 6,000 card holders dependants on this lone dispensary. With a view to reduce the waiting time and other connected bottlenecks, there is need to establish at least one more Wellness Centre in Chandigarh and one each in Mohali and Panchkula to cope with the rush of OPD. It was confirmed by the CMO i/c Wellness Centre that there are almost 24,000 beneficiaries dependant on this Wellness Centre. The daily registered attendance touched more than 300 on an average, which does not include those who come to collect indented medicines only, figure for which touches almost 200 daily. It was a very high burden on the limited staff of 4 Medical Officers and the supporting Paramedical staff.

There is need for Homeopathy and Ayurvedic dispensaries for CGHS, Chandigarh.

                 The Addl Director was requested to take up case in this connection         strongly with the higher authorities. He assured to take up case with higher authorities at New Delhi soon

  1. While passing the Medical Reimbursement Claims, details and the reason for disallowing any amount may kindly be intimated. Addl Director informed that in future details of deductions will be indicated, by enclosing the Calculation Sheet with the cheque to the beneficiaries. Till date (Jan, 2011) MRC bills up to Oct, 2010 have been cleared by his office.
  2. Shri Rajpal Sharma, Chairman, CCCGPA, took up the case of Sh S K Bajaj, who had undergone a Stent implant at the Mukat Hospital, and had to deposit some additional amount at the hospital on the surgeon’s advice. His re-imbursement case is pending. The Addl Director assured to look into this case and would decide the same as per rules.
  3. Shri P S Bedi, Chairman Paramilitary Forces Retired Officers association, took up the case of revision of rates of Special Nursing & Ayah/Attendant Charges for CGHS beneficiaries. These rates had been fixed in terms of Ministry of H &F W, vide No 1-4/94-R & H/CGHS (P) dated 15-9-1995 and have not been revised since then. One of the CGHS beneficiary Sh O P Asija (Card No P-0352) , who has a Mentally challenged son and has to resort to engaging an attendant, is badly affected due to this anomaly. The addl Director assured to take up case with higher authorities in this behalf.
  4. Pensioners also requested the CGHS authorities to introduce Electronic Token Display System and Intercom at the Wellness Centre for speedy mutual consultations and avoid long queue.

3          Other points discussed and the information given by the Addl Director is as under:-:-
  (a)    Empanelment of Hospitals and Diagnostic Centres for CGHS , Chandigarh
The Addl Director intimated that the scheme for continued empanelment of Private Hospitals and Diagnostic Centres for CGHS in the Tricity is open till            31-5-2011. The private Hospitals, having accreditation approval by NABH, and Diagnostic Centres, having accreditation approval by NABL can apply for empanelment as per CGHS norms. The details can be downloaded from the website of Ministry of Health & Family Welfare www.mohfw.nic.in

Regarding setting up of a ‘Collection Centre’ at CGHS Wellness Centre, Sector 45, Chandigarh, by Silver Oaks, Mohali for various Laboratory tests, the hospital has expressed inability to do so. The addl Director, however, assured to take up case in this regard with the concerned hospital. It is also learnt that Chandigarh Clinical Laboratory has applied for CGHS empanelment, but it will take some time to finalise the case. (This point was raised by Sh G S Bhogal from Zirakpur)

 (b)Grant of Fixed Medical Allowance
   Central Govt Pensioners residing in areas not covered by CGHS Wellness Centres  can opt for Fixed Medical Allowance of Rs 300/-, in terms of Ministry of P P G & P ( Dept of P&PW)  OM No 4/25/2008-P&PW(D) dated 26 May, 2010. In Chandigarh, the pensioners residing in areas  not covered by Wellness Centre can opt for CGHS Cards for IN-PATIENT treatment only, where the incumbents will be entitled to FMA of Rs 300/-. They will, however, not be entitled to OPD consultation at the Wellness Centre or draw medicines on regular basis from there. Interested pensioners may contact office of Addln Director CGHS,                     Sector 34 D, Chandigarh. (This point was raised by Sh P S Bedi)

The details of areas covered by CGHS Wellness Centre Chandigarh are also available in the office of Addl Director CGHS, Chandigarh and at the Wellness Centre in Sector 45, Chandigarh.

4          It was also intimated by the Addl Director CGHS that a plot measuring              4.4 kanals in Sector 41 B, Chandigarh has been allotted/ earmarked for the CGHS set-up.

5          Following members attended the meeting:-
      (1)  Dr S C Anand, Add Director CGHS, Chandigarh
      (2)  Dr Ashwani Kumar, CMO (NFSG) I/C CGHS Wellness Centre, Chandigarh
      (3)  Shri Rajpal Sharma, CCCGPA, Chandigarh
      (4)  Shri P S Bedi, DIG (Retd) BSF, Paramilitary Forces assn.
      (5) Shri K K Joshi, Defence services Civilian Pensioners Assn
      (6)  Shri Y P Doshi, Assn Retd Officers of IA & AD
      (7)  Shri Ramesh Capoor, Assn Retd Officers of IA & AD
      (8)  Shri S C Malik, Assn Retd Officers of IA & AD
      (9)  Shri M C Arya, Defence Accounts Pensioners Assn
      (10) Shri G S Bhogal, Senior Citizens Forum, Zirakpur
      (11) Shri S K Gupta, Senior Citizens Forum, Zirakpur

(Based on the actual discussions during the meeting with inputs from Minutes of the meeting circulated by the Office of Add Director CGHS, Chandigarh                                                                            vide No AD/CGHS-CHD/AC/2011/296-308 dated 10-01-2011)

Minutes of Advisory Committee CGHS- 26-02-2011

Govt. Of India
MINISTRY OF HEALTH & FAMILY WELFARE
C.G.H.S.WELLNESS CENTRE NO-1.
SECTOR 45, CHANDIGARH

No: CMO/CGHSWC-I /Advisory Committee/Minutes/
Dated: 26-02-11
MINUTES OF THE MEETING OF ADVISROY COMMITTEE HELD ON 26-02-11 IN THE CGHS WELLNESS CENTRE NO-1,SECTOR 45, CHANDIGARH

The meeting was attended by the following members:-
(1). Sh.P.S.Bedi DIG(Retd),
Sr.Vice Chairman, Central Govt.Pensioner Coordination Committee, Chandigarh
(2). Sh.G.S.Bhogal, Gen.Secy, Senior Citizens Forum, Zirakpur.
(3). Sh.M.C.Arya, Gen.Secy, Defence Accounts Pensioner Welfare Association, Chandigarh    
(4). Sh.D.D.Sharma, Survey Assistant, Survey of India-Chandigarh
(5). Sh.Raj Kumar, Representative of Goyale medicos, local chemist.
(6). Dr. Ashwani Kumar Seniaray, Chairperson, Advisory Committee,
Chief Medical Officer (NFSG)I/C, CGHSWC-1, Sector 45, Chandigarh.

Welcome Address:
Dr. Ashwani Kumar Seniaray, CMO In charge welcomed all the members of the Advisory Committee 
The proceeding of the meeting commenced in right earnestness with following subjects discussed.
MRC status/Pendency of claims:
CMO I/C informed the members that there are no pending claims of the employees in the Wellness Centre, as the bills of the employees are cleared on day to day basis. The CMO I/C  again brought to the notice of all the members the OM No:4-18/2005-C&P dated 20 feb 2009 regarding relaxation of procedures for MRC, also for serving employees in which case the parent department has to clear the MRC bills as per the given guidelines in the order. It was intimated to the members that as per information provided by AD office, the MRC bills of pensioners have been cleared up to Dec’10. The members again reiterated that the AD office may be requested to provide the status of pendency of MRC claims before the meeting of the advisory committee on regular basis.
Performance of Local Chemist:  
CMO I/C informed that performance of local chemist is satisfactory and drugs are supplied in time and no substitute medicines are supplied by the local chemist. The local chemist was directed to intimate the CGHS authorities about imported drugs whenever indented, for which Indian brands are available, as per the M/O Health & Family welfare order no: 28-2/09-10/CGHS/MSD dated 25-06-10. 
Availability of Drugs in the WC:
The members were informed that there are 34 Generic items and 101 Proprietary items available in the WC store.

Amenities for the Beneficiaries:
The members felt that there is an urgent need for opening of another Wellness Centre in Chandigarh to accommodate the increasing number of beneficiaries. To Sh.G.S Bhogal’s last meetings proposal, the CMO I/C informed that one laboratory from Chandigarh is under final stage of approval, as per the information received from the AD office and very soon beneficiaries will have a CGHS recognized lab in Chandigarh.
Staff Punctuality & Behavior:
There is no complaint against the staff behavior by any beneficiary. CMO I/C informed that all the staff is punctual and courteous in dealing with the beneficiaries.
Cleanliness & Maintenance of Wellness Centre:
The members found cleanliness in the Wellness Centre well maintained.
Grievance Redressal: 
Sh.P.S.Bedi raised the issue of giving medicines for two months at a time to the beneficiaries coming from outside Tricity. The CMO I/C informed the members that the beneficiaries are already being issued medicine for 2 to 3 months at a time on the basis of valid prescription of the govt specialist as per the Min of Health & Family welfare orders.
The complaint box was opened by Sh.M.C.Arya and no letter was found.
The meeting ended with the vote of thanks by the CMO I/C to all the members.                                                                                                                                      
(Dr. Ashwani Kumar Seniaray)
CMO (NFSG) I/C                                           
CGHS WELLNESS CENTRE NO-1,
Sector 45, Chandigarh.
Copy forwarded to:-
1. Dr. S.C. Anand, Addl. Director CGHS Chandigarh for information.
2. All the committee members.


Minutes of Advisory Committee CGHS- 26-03-2011

Govt. Of India
MINISTRY OF HEALTH & FAMILY WELFARE
C.G.H.S.WELLNESS CENTRE NO-1.
SECTOR 45, CHANDIGARH


No: CMO/CGHSWC-I /Advisory Committee/Minutes
Dated: 26-03-11

MINUTES OF THE MEETING OF ADVISROY COMMITTEE HELD ON 26-03-2011 IN THE CGHS WELLNESS CENTRE NO-1, SECTOR 45, CHANDIGARH

The meeting was attended by the following members:-

(1) Sh.P.S.Bedi-DIG (Retd)-Sr.Vice Chairman, Central Govt.Pensioner Coordination Committee, Chandigarh. (2186, Sector 35 C,Chandigarh- Tele; 2615048)

(2). Sh.G.S.Bhogal, Gen.Sec, Senior Citizens Forum, Zirakpur .( F-23, Panchsheel Enclave, Ambala Road, Zirakpur- M- 9872639304)

(3). Sh.M.C.Arya, Gen.Sec,Defence Accounts Pensioner Welfare Association, Chandigarh .(260 Swastik Vihar, Patiala Road, Zirakpur- M- 9417495648)

(4). Sh.Raj Kumar, Representative of Goyal medicose, local chemist.

(5). Dr. Ashwani Kumar Seniaray, Chairperson, Advisory Committee, Chief Medical Officer (NFSG)I/C, CGHS WC-1, Sector 45, Chandigarh.

Welcome Address:
Dr. Ashwani Kumar Seniaray, CMO Incharge, while welcoming the members of the Advisory Committee, informed that our Wellness Centre has been adjudged as the ‘Best CGHS performing Wellness Center for the Year 2010’ in Northern India, in a survey carried out on an All India level by a high level CGHS committee. A certificate of Merit has been issued by the Ministry Of Health & Family Welfare, Govt of India signed by the Secretary, Health & Family Welfare, Min of H & F W Govt of India, Ms K Sujatha Rao. The CMO expressed his appreciation for the cooperation and positive contribution to improve the functioning of the Wellness Centre to the outgoing CGHS Advisory & Grievances Committee members (2008-2010), for this honour. The present members of the Advisory Committee extended their felicitations to the CMO and the Staff of the CGHS Wellness Centre No 1, Chandigarh for this great achievement. The proceeding of the meeting commenced in right earnestness with following subjects discussed.

MRC status/Pendency of claims:

CMO I/C informed the members that there are no pending claims of the employees in the Wellness Centre, as the bills of the employees are cleared on day to day basis. . It was intimated to the members that as per information provided by AD office, the MRC bills of pensioners have been cleared up to January, 2011. The members again reiterated that the AD office may be requested to provide the status of pending MRC claims before the meeting of the advisory committee on regular basis. Performance of Local Chemist: Performance of local chemist has been satisfactory and drugs are supplied in time and there has been no case of supply of substitute medicines by the local chemist. The local chemist was directed to intimate the CGHS authorities about imported drugs whenever indented, for which Indian brands are available, as per Min of Health & Family Welfare order No: 28-2/09-10/CGHS/MSD dated 25-06-2010.

Availability of Drugs in the WC:
As per the records,there are 36 Generic items and 141 Proprietary items available in the WC store. The CMO informed that the Generic drugs contain the ‘Basic Salts Formulations’ and do not carry any Brand Name e.g. Paracetamol is a Generic drug, whereas Crocine (containing same salt formulations) is a Proprietary drug. The Generic drugs are much cheaper.

Amenities for the Beneficiaries:
The members felt that there is an urgent need for opening of another Wellness Centre in Chandigarh to accommodate the increasing number of beneficiaries. Sh P S Bedi, raised a point for ambulance services at the Wellness Center. The CMO informed that there is provision for engaging the services of ambulance in emergency cases, for which the incumbents can claim re-imbursement, vide Min of H & F W, OM No S-4924/20/2010/CGHS (R&H)/CGHS (P) dated 17 Jan, 2011.

Staff Punctuality & Behavior:
The conduct and behavior of the staff of the Wellness Center has been very good. They are courteous and helpful to the senior/aged CGHS beneficiaries. Regarding a case of complaint against a doctor, brought to the notice of the CMO, by one of the Pensioners association, the misunderstanding was resolved amicably to the satisfaction of all, by calling a meeting of Wellness Center staff and briefing them to be more courteous to senior pensioner beneficiaries.

Cleanliness & Maintenance of Wellness Centre:
The Wellness Centre was found to be clean and well maintained. The Toilet has also been repaired to the best possible extent and its upkeep by the staff ensured. There was a suggestion to place Air Purifier (Odonil) in the toilet block. Grievance Redressal There is also a demand for opening a Wellness Center in Panchkula to mitigate the difficulties faced by pensioners residing in and around Panchkula. The CMO informed that case for opening Wellness Center one each in Panchkula and Jalandhar (Punjab) is under active consideration of the govt. The CMO also intimated that case for empanelment of Fortis Hospital and a Diagnostic Centre in Chandigarh are in an advance stage and formal orders for their empanelment are expected soon. The complaint box was opened by Sh.M.C.Arya and no letter was found.

Best Worker
In deference to the latest instructions regarding nomination of Best Worker, the Advisory Committee unanimously approved the name of Ms Meenaksi Tanwar, Staff Nurse, as the best and most helpful staff member of the Wellness center No 1, Chandigarh for the Quarter ending 31 March,2011.

The meeting ended with the vote of thanks by the CMO I/C to all the members.

(Dr. Ashwani Kumar Seniaray)
CMO (NFSG) I/C CGHS WELLNESS CENTRE NO-1,
Sector 45, Chandigarh.
Copy forwarded to:-
1. Dr. S.C. Anand, Addl. Director CGHS Chandigarh for information
2. All the committee members.

Minutes of Advisory Committee CGHS- 28-05-2011

Govt. Of India
MINISTRY OF HEALTH & FAMILY WELFARE
C.G.H.S.WELLNESS CENTRE NO-1.
SECTOR 45, CHANDIGARH


No: CMO/CGHSWC-I /Advisory Committee/Minutes
Dated: 28-05-11

MINUTES OF THE MEETING OF ADVISROY COMMITTEE HELD ON 28-05-2011 IN THE CGHS WELLNESS CENTRE NO-1, SECTOR 45, CHANDIGARH

The meeting was attended by the following members:-

(1) Sh Raghuvir Singh, IAAS (Retd) formerly Add. Secy, Min of H & F W.

(2) Sh.P.S.Bedi-DIG (Retd)-Sr.Vice Chairman, Central Govt.Pensioner Coordination Committee, Chandigarh. (2186, Sector 35 C,Chandigarh- Tele; 2615048)

(3). Sh.G.S.Bhogal, Gen.Sec, Senior Citizens Forum, Zirakpur .( F-23, Panchsheel Enclave, Ambala Road, Zirakpur- M- 9872639304)

(4). Sh.M.C.Arya, Gen.Sec,Defence Accounts Pensioner Welfare Association, Chandigarh .(260 Swastik Vihar, Patiala Road, Zirakpur- M- 9417495648)

(5) Sh D D Sharma, Survey of India, Sector 32, Chandigarh.

(6). Sh.Raj Kumar, Representative of Goyal medicose, local chemist.

(7). Dr. Ashwani Kumar Seniaray, Chairperson, Advisory Committee, Chief Medical Officer (NFSG)I/C, CGHS WC-1, Sector 45, Chandigarh.

Welcome Address:

Dr. Ashwani Kumar Seniaray, CMO In charge, welcomed the members of the Advisory Committee. He apprised the members regarding the action taken to improve the functioning of the Wellness Center.

MRC status/Pendency of claims:

The members again reiterated that the AD office may be requested to provide the status of pending MRC claims before the meeting of the advisory committee on regular basis. This is a statutory requirement in terms of Ministry of H & F W OM No 4-27/2005-CGHS/C & P/Pt1 dated 27 Feb,2010 Para 3 (vii).It was suggested that Add Director may be requested to take necessary action on this issue.

Performance of Local Chemist:

Performance of local chemist has been satisfactory and drugs are supplied in time and there has been no case of supply of substitute medicines by the local chemist.

Availability of Drugs in the WC:
As per the records, there are 32 Generic items and 82 Proprietary items available in the WC. It was reiterated that Add Director CGHS, Chandigarh be requested to expedite the procurement of drugs/items for the Wellness Center.


Amenities for the Beneficiaries:

Regarding Token Display System to be installed at the Wellness Center to mitigate the patients stress and avoid long queues, it was intimated by the CMO that Add Director CGHS, Chandigarh has, in principle, approved the same, and it would be installed shortly.

Shri D D Sharma, representative of serving CGHS beneficiaries, point regarding giving preference to serving employees in the morning hours from 07.30 to 9.30 a.m. will be implemented w.e.f Monday, 30 May, 2011. However, emergency cases and acutely ill patients will be attended to on top priority as per norms.

Regarding need to have a Ceiling fan at the Local Purchase Dispensing Area, no action could be taken as the area is prone to theft. It was suggested to have the fan welded to the frame of the roof; in the manner it is done in the trains, to forestall any attempt by unsocial elements to remove the same. The CMO assured to look into this.

The report of the sub-committee members to Silver Oaks Hospital & Diagnostic Centre was discussed. It was reiterated that Add Director CGHS, Chandigarh may take suitable action as per Memorandum of Understanding.

Shri M C Arya enquired about the issue of Plastic Cards to the CGHS beneficiaries in Chandigarh and to expedite the same to facilitate hassle free treatment of CGHS patients. The CMO assured to take up the case with Add Director to expedite the same.

Sh M C Arya also took up the case of one of the beneficiaries regarding issue of an injection, Aurogreen, to him as prescribed by the PGI, Chandigarh. The CMO explained that as  this is a Dye used in carrying out some diagnostic tests ( and not a medicine) it will have to be purchased by the patient, as per the existing rules and thereafter claim reimbursement. The beneficiary was also explained the position over telephone.

Sh D D Sharma, Representative of Serving employees, raised the point regarding the instructions issued by Survey of India authorities to claim reimbursement on form MED-97 and get it countersigned by the treating surgeon and Hospital Superintendent etc. The CMO explained that these instructions have since been modified by the Health Ministry of Health & Family Welfare Govt Of India,  in terms of Ministry’s  OM No 4-18/2005-C & P (Vol 1-Pt (1) dated 20 Feb, 2009 and further clarification issued vide Ministry’s OM of even No dated 20 May, 2009. As per the orders the MRC has to be submitted in the Modified reimbursement form, to avoid hardship to the employees and pensioners, which is also available on CGHS website.


Staff Punctuality & Behavior:

The conduct and behavior of the staff of the Wellness Center has been very good. They are courteous and helpful to the senior/aged CGHS beneficiaries.

Cleanliness & Maintenance of Wellness Centre:
The Wellness Centre was found to be clean and well maintained.  

Grievance Redressal:

The complaint box was opened by Sh.M.C.Arya and one letter, in which one of the beneficiaries had requested that patients requiring issue of repeat medicines should not be required to appear before the CGHS doctors and be issued the medicines directly by any staff member. The CMO explained that this was not feasible, as medicines can only be repeated/prescribed by the doctors only. It is in Patients own interest to see the doctor at appropriate intervals.

The meeting ended with the vote of thanks by the CMO to all the members.

(Dr. Ashwani Kumar Seniaray)
CMO (NFSG) I/C CGHS WELLNESS CENTRE NO-1,
Sector 45, Chandigarh.

Copy forwarded to:-
1. Dr. S.C. Anand, Addl. Director CGHS Chandigarh for information
2. All the committee members.

 

CGHS cover to Pensioners in Chandigarh

Coordination committee of central government pensioners associations, CHANDIGARH
(Regd. No. 2234 – Under Registration of Societies Act-1860)

Rajpal Sharma,
Chairman, CCCGPA
1046,Sector 18C, Chandigarh
(Ph: 2774778, 9316122214)
Email: rajpalsharma1983@yahoo.in

P. S. Bedi,
Sr. Vice Chairman, CCCGPA,
2186, Sector 35, Chandigarh.
(Ph: 2604002 & 2615048)
Email: psbedi03@yahoo.co.in

Harchandan Singh,
Secretary General, CCCGPA
H.O.32, Phase-6, Mohali-160055
(Ph. 2228306,  09316131599569631598)
Email: cccgpa@yahoo.in

No: CCCGPA –CHD / CGHS

               Dated   16 June, 2011

To,
The Director General, CGHS,
Ministry Of Health & Family Welfare,
Nirman Bhawan,
NEW DELHI

Sub:   CGHS cover to Pensioners in Chandigarh

Sir,
            The CGHS set-up in Chandigarh is a great boon to the aged pensioners, who are prone to various ailments. It is, however, lately felt that there is need to further improve the services rendered by the CGHS. Following points may kindly be considered sympathetically:

  1. The lone Wellness Center No 1, located in Sector 45, Chandigarh, while doing a yeoman’s job, is hindered due to huge rush of patients. It is catering for large number of CGHS beneficiaries covering not only the Tricity of Chandigarh, Mohali and Panchkula, but also various cities of Punjab , Haryana and Himachal Pradesh. As per information available with us, there are 7516 Card Holders with more than 21,500 beneficiaries dependant on this lone dispensary. This has resulted in long waiting time for the patients to consult the doctors, leading to extra and strenuous fatigue to the aged pensioners in standing in the long queues. There is, therefore, dire need for more dispensaries in the Chandigarh region, and it requires immediate attention of the authorities for establishing at least one more Wellness Center in Chandigarh and one each at Mohali and Panchkula.

  2. The CGHS has been completely computerized in the country, but the beneficiaries in Chandigarh have not been issued the Smart Cards till date. To enable the CGHS beneficiaries of Chandigarh region to obtain unobtrusive medical treatment at any CGHS Wellness Center in the country, action to issue Smart cards to CGHS beneficiaries in Chandigarh be initiated at the earliest.
  3. The case for empanelment of Fortis Hospital is pending for a long time. This Hospital , amongst the private hospitals of the region, is  the best equipped Health Center catering for major ailments like Heart, Cancer and various other diseases with which the aged and elderly pensioners are afflicted. It is, strongly enjoined that early empanelment of Fortis Hospital be expedited at the earliest.
  4. There is need to empanel some Diagnostic Center located in Chandigarh. The Diagnostic Center at Silver Oaks Hospital, located in Mohali is at considerable distance from the residents of aged pensioners in Panchkula and Chandigarh. Case for empanelment of suitable Diagnostic Centres in Chandigarh be expedited without further delay.

On behalf of aged and elderly pensioners, I earnestly request you to consider the above points to mitigate theproblems faced by the pensioners of Chandigarh region.

Hoping for an early action.
           

Yours sincerely

(RAJPAL SHARMA)
Chairman


Copy to:
Additional Director, CGHS,
CHANDIGARH

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