F.No. 7.15025/8/2021/DIR/CGHS Government of India
Office of the FA (DS) Ministry of Health & Family Welfare Dy. No.3964 Department of Health Data.30.09.2021). Nirman Bhawan, New Delhi Dated the September, 2021
OFFICE MEMORANDUM
Sub: Grant of Medical Advance for all treatment (OPD and IPD) under CGHS/ CS(MA) Rules - clarification regarding
The undersigned is directed to refer to this Ministry's O.M. No 14025/18/2015-MS/EHSS dated 17.10.2016 on the subject mentioned above and to say that a numbers of references seeking clarification on grant of medical advance to CGHS/CS(MA) beneficiaries in respect of treatment procedures for which there are no prescribed CGHS package rates, are being received in this ministry..
In view of the difficulties being faced by CGHS / CS(MA) beneficiaries, the matter has been examined in this Ministry and it has been decided that In case of treatment procedures without Package rates, the admissible amount is calculated item-wise at CGHS rate. Item(s) for which there are no CGHS rates, AIIMS rates shall be considered. If there is no CGHS/AIIMS rate, actual estimate for the procedure shall be considered..
3. The Hospital seeking advance shall provide item-wise break-up of the estimate to facilitate processing of the requests for medical advance. 90% of the admissible rates arrived at, as per para (2) above, would be considered for grant of Medical advance.
4. The other terms and conditions mentioned in the OM No 14025/18/2015-MS/EHSS dated 17th October 2016 shall remain unchanged.
