November 30, 2023

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India: Cashless Treatment for CGHS Beneficiaries

Image credit: MoHFW_INDIA; Twitter

The All-India Institute of Medical Sciences (AIIMS) New Delhi, the Post Graduate Institute of Medical Education and Research University (PGIMER) Chandigarh, and the Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER) Puducherry will now offer cashless treatment services to Central Government Health Scheme (CGHS) beneficiaries.

This initiative will include both serving and retired individuals. The three medical institutions signed a Memorandum of Agreement (MoA) with CGHS under the Ministry of Health and Family Welfare, to ensure this provision.

This initiative builds upon the six previously signed MoAs on 20 May this year between CGHS and various AIIMS institutes located in Bhopal, Bhubaneswar, Patna, Jodhpur, Raipur, and Rishikesh. CGHS provides comprehensive healthcare to central government employees, pensioners, and their dependent family members, Members of Parliament, ex-MPs, and other categories of beneficiaries. Presently, CGHS is operational in 79 cities.

The expansion of patient care services at AIIMS New Delhi, PGIMER Chandigarh, and JIPMER Puducherry is a step toward universal and comprehensive digital transformation in the healthcare sector of the country. The move eliminates the requirement for beneficiaries to submit individual reimbursement claims and follow up for approvals.

They will now have direct access to state-of-the-art treatment facilities available in these medical institutions, without the inconvenience of making upfront payments and seeking reimbursements from CGHS. This streamlined process will save time, reduce paperwork, and ensure the quicker settlement of individual claims. Previously, CGHS pensioner beneficiaries receiving treatment at these institutions had to make upfront payments and subsequently seek reimbursement from CGHS.

Under the MoA, cashless treatment will be available in outpatient departments (OPD), investigations, and indoor treatment for CGHS pensioners and other eligible categories of beneficiaries. The three institutions will raise credit bills for CGHS pensioners and other eligible individuals, and CGHS will make the payments within 30 days of receiving the bills.

To receive treatment at these institutions, CGHS beneficiaries will be required to present a valid CGHS Beneficiary ID Card at the institutions. To make the process more convenient, separate Help Desks and accounting systems will be created for CGHS beneficiaries.

Furthermore, medicines prescribed by the doctors at these institutions, whether for OPD treatment or at the time of discharge, will be collected by beneficiaries through CGHS. Beneficiaries will no longer need referrals to access healthcare facilities at these institutions.

The Union Health Secretary, Rajesh Bhushan, noted that CGHS plays a crucial role as a service-oriented branch of the Health Ministry, catering to the medical needs of both existing and retired employees. The government intends to increase the number of hospitals affiliated with CGHS to ensure excellent tertiary care facilities that meet the growing demands of patients.

Bhushan also said that this agreement will benefit a large segment of the population by simplifying lengthy formalities and expediting access to medical care. He also noted that this agreement will help expand the reach of CGHS services across the nation, allowing beneficiaries to avail of CGHS facilities at institutes of national importance in their respective states. Additionally, CGHS has revised certain rates of treatment and medical care, further facilitating access to treatment facilities for patients.

Digital technology has brought a significant transformation to India’s healthcare sector, revolutionising the way medical services are delivered and accessed. The integration of digital technology in healthcare has streamlined processes, improved patient care, and enhanced overall efficiency.


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