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Monday 24 August 2020

Reimbursement of OPD Medicines: Special Sanction in view of COVID-19 – till 3oth September 2020

 

Z 15025/12/2020/DIR/CGHS

Government of India

Ministry of Health & Family Welfare

Directorate General of CGHS

Nirman Bhawan, New Delhi

Dated the 24th August, 2020

OFFICE MEMORANDUM

 

Sub: Reimbursement of OPD Medicines: Special Sanction in view of COVID-19 – till 3oth September 2020- regarding

In view of the Corona Virus Disease (COVID-19), all out efforts are made by the Government to contain its impact by instituting measures at community as well as at individual level.

2.         In this regard the undersigned is directed to draw attention to the Om of even number dated 27-3-2020, 29-04-2020 and 29-05-2020 vide which an option has been provided to CGHS beneficiaries getting medicines for chronic diseases, to purchase medicines based on the prescription held (prescribed CGHS Medical Officers/CGHS specialists/other Govt. Specialists /specialists from empanelled hospitals) till 31st July 2020 irrespective of Non-availability certificate from CGHS or otherwise.  However, several representation are received in the Ministry seeking extension of the period in view of the continued lock down.

3.         The matter has been reviewed by the Ministry it is now decided that CGHS beneficiaries getting medicines for Chronic diseases shall be permitted to purchase medicines based on the prescription held (prescribed CGHS Medical Officers/CGHS specialists/other Govt. Specialists /specialists from empanelled hospitals) till 30th September 2020 on the same conditions as per the earlier OM dated 27-03-2020.  It is also clarified that CGHS wellness centres are functional and CGHS beneficiaries also have the option to collect medicines through CGHS wellness centres as per normal practice instead of purchasing from market.

4.         .Issued with the approval of integrated finance division MoHFW vide CD No.1181 dated 24-08-2020

 

Sd.

Dr. Sanjay Jain

Director, CGHS

 

Friday 10 July 2020

CGHS - IMPORTANAT Advisory from the Additional Director, CGHS, Bengaluru to the Pensioner beneficiaries


CGHS - IMPORTANAT
Advisory from the Additional Director, CGHS, Bengaluru to the Pensioner beneficiaries
Dr.Revathi M , A D , CGHS , spoke to S Radhakrishna Secretary over the  phone on 2 July 2020.
Dr. Revathi AD CGHS expressing her serious concern towards  the welfare of beneficiaries, specially the senior and very senior  beneficiaries, in view of the present   alarming Pandemic  COVID- 19 situation in the city , with the number of virus infected people getting bigger day by day, which includes  many CGHS beneficiaries also, she made an impassioned appeal to all to take utmost care in their health and stay home unless needed  to go out for reasons of health requiring immediate medical attention in case of an emergency.  The following are some of the advices given by the AD and information given on facilities available under CGHS.
1.      Beneficiaries above the age of 65 years, need not visit the CHHS Wellness Centres for collecting repeat medicines. They may send a member of the family or any one authorised by them who is young  to collect the medicines.  Medicines for 3 months will be issued
2.      Routine Tests which are not of urgent nature may be postponed for the present.
3.      It is noticed that old  couple are attending WCs together for collecting medicines which is not at all  advisable
4.      Telemedicine facility has been started as a pilot project in CGHS  Bangalore for beneficiaries above 60 years of age. 
Ø  WC- 6, Jayanagar and WC-10, C V Raman Nagar, have been identified for Telemedicine. Will be extended to other WCs if feasible.
Ø  Beneficiaries can consult doctors at the two WCs by seeking appointment online. 
Ø  The doctors will respond to the queries online and the beneficiary will get the prescription online to his registered email id.
Ø  The medicines prescribed can be collected in person or through any one authorised by the beneficiary within 4 days.
5.      If they cannot send someone to fetch medicines for them, they can purchase the medicines locally and claim reimbursement of the cost of OPD medicines.
6.      The last date for local purchase of medicines has been extended up to 31st July, 2020. So, medicines required for the months upto September 2020 can be purchased locally before this month end.
7.      Time limit for submission of claims for reimbursement has been increased to 6 months now. Further, in deserving cases, the time limit can be extended by another 6 months under the discretion of the AD.
8.      The validity of CGHS cards of those pensioner beneficiaries who contribute the subscription on annual basis, cards valid upto 31.3.20 and thereafter is extended up to 31.7.2020.  Similarly, the validity of the cards of serving employees who retired on 31.3.20 and thereafter will be extended up to 31st July, 2020 on their request Therefore, they need not rush to CGHS Office for getting a new CGHS Pensioner card.

ON COVID-19              TREATMENT
On my request to her,  to enlighten us about the facilities available under CGHS  , for  treatment of  beneficiaries afflicted with the virus Covid-19, she stated as below.
a)      Beneficiaries having symptoms of Covid-19, like fever, cough etc. need not go to the CGHS WC but must directly report to the fever clinic identified by the State government/ local body for advice and  allotment of bed in the hospital providing treatment for Covid-19 infection.
b)      Beneficiary or their wards need not go to the CGHS WCs for getting a referral for admission in  to  a private hospital  identified by the State government for Covid-19 treatment.
c)      On allotment of a bed in any of the private hospitals EMPANELED under CGHS,  the beneficiary will be provided with  CREDIT FACILITY by the empaneled hospital as per existing CGHS norms.  Necessary instructions have been issued to empaneled hospitals.
d)     If a bed is allotted in a private hospital NOT EMPANELED UNDER CGHS,  and the beneficiary is admitted there for treatment, the case will be treated as  'medical treatment in emergency ' and the beneficiary will get reimbursement of the medical  expenditure at the rates approved by the government.
e)      Beneficiaries, in case of any difficulty faced for admission in private hospitals, may contact the Sr CMO    I/C of their Wellness Centre over the phone or the  Nodal officer, Dr Ravindra at CGHS office.  Difficulty arises only if they go to the hospitals on their own. If they go through the designated fever clinics it would be easy for them to get the required medical attention.
GENERAL
a.       Seniors should avoid going out for purchase of groceries, vegetables, fruits etc. One member of the family can get the essential items from the market instead of many shopping together. Daily outgoings for purchases should be avoided.
b.      Strict social distancing must be ensured when there is absolute necessity of going out.
c.       Hand hygiene is very important to ward off any infection.

d.      Prevention is better than cure.
Stay home Stay Safe

S Radhakrishna