CGHS – CS(MA) Rules – Medical Reimbursement – Clarification

Clarification on Medical Reimbursement of Central Government Health Scheme (CGHS). 

The Department of Health and Family Welfare has published various orders regarding the empanelled hospitals and the revision of package rates on its website regularly. Still there is lot of problems with some of the empanelled hospitals while getting treatment. They did not bother about the package rates and they used some other medical words in discharge summary of the particular treatments. 

Hence the amount of reimbursement is reduced or the total claim is ignored. The reimbursement will be made on the basis of the medical bills and reports as in the discharge summary. The pertinent package rates has been searched by the competent authority to sanction his claim of medical treatment according to given reports by the employee.

Department of Health and Family Welfare issued a detailed clarification on 30.09.2011, “if CGHS rate is not available for any procedure / investigation / category (say super-specialty) in any CGHS covered city, the CGHS rate notified for such procedure / investigation / category for the nearest CGHS city or the rate notified under CGHS, Delhi, whichever is lower shall be applicable as CGHS rate for such procedure / investigation / category for that city”. 

The above reference file place : http://msotransparent.nic.in/cghsnew/index.asp

Posting of husband and wife at the same station

Concerning the posting at the same place of husband and wife who are working in Government service, the transfer issues have been raised in Parliament on several occasions. In 1980s these demands began to show its seriousness, because the percentage of women employees were increased in joining the Government services. The Central Government also observed this issue from various forums, a circular had been issued by the Department of Social Welfare in Feb 1976 to all Head of Departments to give serious consideration to the requests of posting of husband and wife at the same station. In order to that order, lot of women employees started to send their request to transfer at the place where their husbands are posted.

The Central Government gave its utmost importance to this issue and as far as possible and within the constraints of adminstrative feasibility, the husband and wife should be posted at the same station to enable them to lead a normal family life and to ensure the education and welfare of thier children. The Department of Personnel and Training issued an OM on 3.4.86, in accordance with the guidelines and instructions in the order given by the Government, all cadre controlling authorities should consider such requests with the utmost sympathy.

The Department of Personnel and Training issued various office memorandums regarding this matter from time to time. The motive of the Government on the petitioners, said in the orders repeatedly, to give utmost importance attached to the enhancement of women’s status in all walks of life and to enable them to lead a normal family life as also to ensure the education and welfare of the children.