Entitlement of wards in private hospitals empanelled under CGHS – Clarification on issues raised

HomeCghs

Entitlement of wards in private hospitals empanelled under CGHS – Clarification on issues raised

Entitlement of wards in private hospitals empanelled under CGHS – Clarification on issues raised: Department of Health & Family Welfare O.M. dated 22.11.2022

File No: S.11011/11/2016-CGHS(P)
Government of India
Ministry of Health & Family Welfare
Department of Health & Family Welfare
(EHS Section)

Nirman Bhawan, New Delhi
Dated the 22nd November, 2022

OFFICE MEMORANDUM

Subject: Revision of rates of subscription under Central Government Health Scheme due to revision of pay and allowances of Central Government employees and revision of pension/ family pension on account of implementation of recommendations of the Seventh Central Pay Commission-reg.

In continuation of this Ministry’s OM of even number dated 28.10.2022 (copy enclosed) on the subject cited above, the undersigned is directed to issue clarifications, with regard to several clarification requests received in this Ministry. The clarifications on such issues raised may be seen as under:

View: Entitlement of wards in private hospitals empanelled under CGHS w.e.f. 28.10.2022 – Genuineness of the Order

Sl.No. Issues raised Clarification
i. Is this OM applicable to pensioners of autonomous bodies under CGHS too? Autonomous Bodies/ Statutory Bodies are provided only OPD facilities, under CGHS, on cost to cost basis. IPD treatment costs are borne by the concerned ABs/SBs through their own resources. Therefore, it is for the concerned ABs/SBs to whom CGHS facilities have been extended, to take a decision in the matter.
ii. Is this OM applicable to pensioners who have retired prior to October 2022? Out of retirees, some have given life time contribution while others contribute on a yearly basis. The OM dated 28.10.2022 has been issued with the approval of D/o Expenditure, M/o Finance, to rectify certain anomalies in the ward entitlement of beneficiaries post 7th CPC, as fixed vide OM dated 09.01.2017.There is no change in the subscription rate as already fixed vide OM dated 09.01.2017. There is no linkage between CGHS subscription and ward entitlement. Therefore, all CGHS beneficiaries (Serving & Pensioners) who are eligible for upgradation of the ward entitlement, according to the revised basic pay slabs, as mentioned in OM dated 28.10.2022, may apply for fresh CGHS card. However, Medical claim cases for treatment taken by beneficiaries prior to 28.10.2022, will not be re-opened for the purpose of reimbursement with regard to revised ward entitlement(s).
iii. Many pensioners who have retired on 31/10/2022 had applied for pensioners’ card with contribution before 28/10/2022. What would be the status of their ward entitlement?

2. This issues with approval of Competent Authority.

(Hemlata Singh)
Under Secretary to the Government of India
Tel No. 011-23061778

Encl. As above.

Encl:-Entitlement of wards in private hospitals empanelled under CGHS as per 7th CPC Basic Pay- Revision by MoHFW w.e.f. 28.10.2022

To

  1. All the Ministries/ Departments, Government of India.
Click to view/download PDF

 

COMMENTS

WORDPRESS: 4
  • J R RATURI 1 year ago

    यह तो घोर injustice है, उन केन्द्रीय रिटायर्ड पेंशनरों के साथ जो जनवरी 2017 से पहले रिटायर हुए हैं। यह सरकार ने अपने आदेश 28/10/22 and 22/11/2022 के अंतर्गत,जो ward entitlement का आदेश निकाला है, एकतरफा निर्णय है। इसमें जनवरी 2017 से पहले रिटायर हुए पेंशनरों का क्या दोष है । अगर सरकार को कुछ अधिक अंसदान चाहिए था, तो डिफरेन्स बताकर स्कीम को आपसनल किया जा सकता था । CGHS WC देहरादून ने साफ कह दिया है कि जनवरी 2017 से पहले रिटायर्ड पेंशनरों के ward entitlement amend नहीं होगा। 7th PC के अंतर्गत सभी रिटायर्ड पेंशनरों का बेतन/पेंशन रिवाइज। हो रखी है । केंद्र सरकार/Ministry of Health and Family welfare
    /CGHS DIRECTOR,भारत सरकार इस बिषय में उचित स्पष्टीकरण शीघ्र देने जरूरत है।

    • Dayaldas Parwani 12 months ago

      As pension is 50% of last pay drawn. Therefore pensioners should be considered accordingly for ward entitlement as well as contribution towards CGHS irrespective date of retirement. In other words if pensioner is drawing pension @ Rs 20000 he should be considered entitlement for 40000 without considering grade pay in 6th cpc or retirement date in 7th cpc or 5th cpc.

  • J B Mane 1 year ago

    Yes, as per MOH &FW, OM dt 28/10,22/11 and further clarification by cghs HQ, the ward upgradation benefit is not restricted to the pensioner’s those retired after January 2017,as per my opinion, being similarly placed, there can’t be & need not be any discrimination, hence, in terms of OM /clarification ibid,it’s applicable even to all pensioner’s retired prior to Jan 2017(based on 7th CPC pay upgradation )provided they approach concerned AD, cghs with application/documents etc

  • Sir. There is some clarification required for orders issued by Deptt of Health &Family Welfare under OM No.S 1101/11/2016-CGHS(P/EHS) dated 28.10.22 regarding entitlement of Wards in private hospitals under CGHS. This was issued in partial modification of OM under even No dated 9th Jan 2017.Upgradion was ordered on the basis of corresponding Basic Pay in 7th CPC. Clarification is necessary whether upgradation is entitle to those retired prior to 1.1.2017 beneficiaries based on their corresponding basic pay as per 7th CPC.