The government has introduced new rules for CGHS cardholders. Private hospitals can no longer refuse treatment to CGHS cardholders and members or assign them to lower-category hospital beds.
They are also prohibited from charging above the rates specified by the government.
The Union Ministry of Health and Family Welfare has issued these guidelines to address complaints of overcharging and refusal of services to CGHS beneficiaries.
The aim is to ensure affordable, transparent, and quality healthcare for CGHS members.
Government changed the rules for CGHS beneficiaries
1. Mandatory Treatment
CGHS-empanelled hospitals must provide treatment to all eligible beneficiaries and cannot deny services.
The Health Ministry has clarified that all services will be offered without any discrimination.
2. Transparency in Cost and Services
Hospitals must prominently display treatment-related information, including the rates specified by CGHS.
The status of available beds in wards and ICUs must be clearly displayed. Additionally, information about the ward categories assigned to beneficiaries should be provided.
Hospitals will be prohibited from offering certain categories of services.
They must also display information about the hospital’s empanelment city, credit eligibility, and contact details of the nodal officer.
3. Mandatory Reporting
Hospitals are required to inform the concerned CGHS Additional Director via email about emergency cases, non-referral cases, and direct visits or admissions of beneficiaries aged above 70 within 24 hours.
Cases not reported within this timeframe will not be considered valid.
4. Accountability in Critical Cases
If a patient passes away or falls into a coma, the hospital must include the signature and contact details of the beneficiary’s attendants on the final bill.
5. Prescription Guidelines
Prescriptions should include only generic drug names and must be written in capital letters. Hospitals are not allowed to require patients to purchase a specific brand.
6. Permission will have to be taken first for expensive treatment
Hospitals must obtain prior approval for expensive treatments to prevent unnecessary or excessive charges.
7. Penalties for Not Following the Rules
Hospitals that fail to follow these guidelines could face penalties, such as removal from the CGHS network.
These new rules aim to protect the rights of CGHS beneficiaries and ensure they receive affordable and transparent healthcare services.