CGHS AT A GLANCE.BLOGSPOT.COM /006/E                         Date 11/05/25 🏥 Clarification on Admissible & Non-Admissible Items under CGHS Issued by: Government of India, Ministry of Health & Family Welfare Date: 1st August, 2013 Reference No.: 2-1/2012/CGHS/VC/CGHS(P) 📄 About the Office Memorandum In compliance with the directions of the Hon’ble High Court of Delhi (W.P. (C) 9044/2011 – Sh. Kanhiya Singh Vs. UOI & Others ), this Office Memorandum provides detailed clarification regarding which medical items and services are reimbursable under the Central Government Health Scheme (CGHS), and which are not. This clarification is a reiteration and expansion of the earlier memorandum issued on 1st October 2012, meant for wider circulation and better understanding among CGHS beneficiaries. ✅ What Does...

    CGHS AT A GLANCE.BLOGSPOT.COM /003/E  CGHS BENEFICIARIES: IMPORTANT SOP CHANGES The Directorate General of CGHS has issued a significant update via Office Memorandum (OM) No. Z.15025/19/2024/DIR/CGHS/EHS (Comp No. 8281286) dated June 28, 2024. In response to multiple queries regarding the OM, a Standard Operating Procedure (SOP) has been introduced to: ✅ Enhance clarity and understanding of the OM’s contents. ✅ Standardize the uploading of medical bills to the TMS portal. All empanelled Health Care Organizations (HCOs) must strictly follow the attached SOP while handling referrals and bill uploads. This SOP is effective immediately from the date of issue.   ...

  CGHS AT A GLANCE.BLOGSPOT.COM /005/E      "Dependent Family Members under CGHS" The Central Government Health Scheme (CGHS) is not limited to the principal cardholder alone. It also extends to dependent family members, subject to certain conditions. Understanding these criteria is crucial for availing benefits under the scheme. Who Can Be Considered a Dependent? To be eligible as a dependent under CGHS, the following three key conditions must be met (except in the case of spouse and disabled son): Relationship with the principal CGHS cardholder Residence – they must be normally residing with the cardholder Income – their income from all sources, including pension and the pension equivalent of DCRG, must be less than ₹9,000 + DA per month. List of Eligible Dependents The following family members are considered dependent if they meet the above conditions: Spouse – automatically eligible regardless of income Son – up to ...

      CGHS AT A GLANCE.BLOGSPOT.COM /004/E "CGHS Cracks Down on Malpractices: New Guidelines for Empanelled Hospitals"      The Directorate has observed alarming issues concerning the operations of certain CGHS-empanelled Healthcare Organizations (HCOs). Reports of fraudulent billing practices on the NHA portal, overcharging of beneficiaries, denial of treatment, and other grievances have been received.                   In light of these complaints, all empanelled HCOs are hereby directed to strictly adhere to the following guidelines:   1. Provision of Services     No HCO should deny treatment to eligible CGHS beneficiaries under any circumstances.     In cases of patient death or coma, the signatures of the patient's attendant, along with their mobile numbers, must be recorded on the final bills for all services, including daycare, laboratory services, di...