CGHS issued guidelines for issue of medicines to CGHS beneficiaries from CGHS Wellness Centres for Chronic illness
S 11011/2/2014-CGHS (P)
Government of India
Ministry of Health and Family Welfare
CGHS (Policy) Division
Nirman Bhawan, New Delhi
Dated; the 28th March, 2014
OFFICE MEMORANDUM
Subject: Guidelines for issue of medicines to CGHS beneficiaries from CGHS Wellness Centres – reg.
The undersigned is directed to refer to this Ministry’s O.M No.S.11011/8/99-CGHS (P) dated 13.10.1999 vide which CMO in-charge of CGHS dispensaries have been permitted to issue medicines for a maximum period of 3 (three) months at a time against a valid prescription of Government specialist to CGHS beneficiaries suffering from chronic illness like diabetes, tuberculosis, heart ailment, hypertension, I.H.D,epilepsy, etc.
2. This Ministry has been receiving representations from beneficiaries regarding the requirement of fresh consultation with Government specialist every three months for re-issue of the prescribed medicines. Requests have been received from beneficiaries to relax this condition as getting an appointment with Government specialists is difficult, especially for the old aged and physically challenged beneficiaries suffering from chronic diseases and requiring constant medication.
3. Acknowledging the difficulties being faced by the beneficiaries in obtaining prescription of Government specialist every three months, it has been decided to clarify that the CMO In-charge of CGHS Wellness Centres are competent to revalidate the prescription on the request of patient, after professionally satisfying himself / herself about the medical condition of the patient and repeat the medicines prescribed by Government specialist to beneficiaries for another three months subject to the following conditions :-
a) Medicines shall be issued against a valid original prescription from a Government specialist for advising the same.
b) CMO I/c may issue the medicines prescribed by a Government specialist fix three months at a tine during the entire treatment period indicated clearly (e.g., six months / one year) on the prescription.
c) CMO I/c may examine and advise the patient on whether to continue with the same medicines as prescribed by the Government specialist or may refer him to the Government specialist for fresh consultation, If required medically.
d) CGHS GDMOs of the Wellness Centre may prescribe routine diagnostic tests to the patients before their follow up consultation with the specialist. They should however, use discretion and not to advice specialized tests/investigations as they can only be advised by the specialists, wherever required.
e) Beneficiaries will be issued medicines for maximum three months period at a time. In such cases, where the advice of specialist is only for three months and the CMO I/c is satisfied after professional examination that the same medicines are required to be continued for treatment, the prescription may be re validated and medicines can be issued for another 3 (three) months, i.e., to a total of 6 (six) months. After six months, the beneficiaries will have to consult the Government specialist and obtain fresh prescription or get the prescription re validated from the Government specialist in cases where the treatment period is not clearly indicated on the prescription.
4. This issues with the approval of Additional Secretary and Director General, CGHS.
sd/-
(V.P.Singh)
Deputy Secretary to the Government of India
Source: www.cghs.nic.in
The struggle of All India DRDO Technical Officers’ Association & Confederation of Central Government Gazetted Officers Organisations (CCGGOO) along with All Pensioners & Retired Persons Association (APRPA) and other orgns. for better medical facilities under CGHS led to the withdrawal of OM dt.25/08/2014 on 13/03/2015 which is against the interests of 36,67,795 CGHS beneficiaries.
In the name of streamlining the procedures regarding issue of medicines, reimbursement of expenditure on investigations, treatment procedures, implants and medical devices under CGHS and on the pretext of plugging the loopholes in the system, Ministry of Health & Family Welfare issued OM dt.25/08/2014 restricting the facilities as follows:
a) CGHS shall supply / indent only those medicines, which are included in the CGHS formulary.
b) Anti Cancer and other similar medicines are however supplied on a case to case basis. Only the medicines approved by DCGI for use in India shall be supplied. In case an Indian version is available, which is cheaper than the imported medicine, only the Indian medicine shall be supplied even if, an imported medicine has been prescribed.
c) Medicines shall be supplied for a maximum period of one month.
d) In case of CGHS beneficiaries going abroad, issue of medicines shall be restricted for a maximum period of three months.
e) CGHS shall hereinafter allow only the listed investigations / treatment procedures for which there are prescribed CGHS rates, to be under taken in CGHS empanelled diagnostic centres and hospitals.
f) Similarly, only listed implants / medical devices with a CGHS prescribed ceiling rate shall be permitted for treatment / reimbursement under CGHS.
g) In those cases where any unlisted investigation / treatment procedure is undertaken the reimbursement shall be limited to the rate of nearest similar investigation / treatment procedure under CGHS. Addl. Director of the city /zone shall take a decision based on justification in such cases, in consultation with experts in the field, if necessary.
h) In those cases where any unlisted implant / device is installed reimbursement shall be limited to the CGHS rate of nearest similar implant / device. Addl. Director of the city / zone shall take a decision based on justification in such cases in consultation with experts in the field, if necessary.
The Govt.tried to pacify us by modifying OM on 01/10/2014 and 23/12/2014.But due to relentless efforts,finally MH&FW had to withdraw the draconian OM.
You are aware that CCGGOO & AIDTOA were partially successful previously in getting medicines from the treating private hospital at the time of discharge for a period upto 7 days.
AIDTOA & CCGGOO thank all those who contributed directly or indirectly in the efforts for betterment of medical facilities to CGHS beneficiaries.
Let us fight unitedly against reduction in welfare measures and for better living conditions.
If we all stand together, we are a force that can shake the whole world”.
Together ………. we can
Yours fraternally
V.Krishna Mohan (DMRL)
(M)9440668281
(O)040-24586891
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