Healthcare Policy for Railway Employees and Pensioners – Administrative Instructions / Clarifications / Guidelines: Railway Board

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Healthcare Policy for Railway Employees and Pensioners – Administrative Instructions / Clarifications / Guidelines: Railway Board

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Healthcare Policy for Railway Employees and Pensioners – Administrative Instructions / Clarifications / Guidelines: Railway Board Order dated 30.04.2026

भारत सरकार GOVERNMENT OF INDIA
रेल मंत्रालय MINISTRY OF RAILWAYS
रेलवे बोर्ड RAILWAY BOARD

No. 2026/1 & Trans. Cell / Healthcare / Pt-I e-file 3516685

New Delhi, Date: 30/04/2026

The General Manager
PCMDS
PHODS
All Indian Railways

DG, RDSO
DG, CTIS

Sub: Administrative Instructions / Clarifications / Guidelines on Healthcare Policy – reg.

Ref: i. Healthcare Policy Instructions vide RB letter no. 2024/1 & Trans Cell/ Healthcare/P dt. 29.08.2024. ii. IR Healthcare Policy on Cancer Treatment vide RB letter no. 2025/1 & Trans Cell / Healthcare/2/P dt. 05.05.2025. iii. Standard instructions on referral for Transplant Cases vide RB letter no. 2022/H/8/HMIS/Pt-committee dt. 12.11.2025.

It has been the endeavor of Railway Administration to provide best healthcare services in Railway Hospitals and Health Units for railway employees, pensioners, dependent family members and beneficiaries covered under the Railway Medical Attendance Rules. The healthcare policy instructions under ref. issued by the Railway Board are based on synergistic leveraging of IT Systems, robust digital process re-engineering and a user-friendly experience.

2. All 128 Railway Hospitals and 582 Health Units on IR are 100% on HMIS. However, instances have been reported that HMIS digital processes are being compounded with (now redundant) paper-based processes, thus restricting the outreach / delivery of healthcare policy instructions issued by the Board. In order to summarily address such issues, Administrative Instructions /Clarifications / Guidelines as at Annexure-I are being issued for immediate strict compliance by Zonal Railway HQr and CMS/MDs of RHs.

healthcare-policy-for-railway-employees-and-pensioners

3. Grievances /issues reported by any staff /pensioner/ patient may be taken up for necessary compliance action by the ADRMs/DRMs and at Zonal/PU HQrs by the PHODs/AGMs. Railway Board, Health Directorate (Director/Health Policy & Projects) is the ‘single point of contact’ (SPOC) on healthcare policy and issues regarding HMIS.

4. This issues with the approval of DG (RHS) and the Chairman & CEO, Railway Board. Please acknowledge receipt and ensure compliance.

(Dr Ashutosh Garg)
Director / Health Policy & Projects
Railway Board

(Pranav Kumar Mallick)
ED/Transformation
Railway Board

Annexure-I

Administrative Instructions/Clarifications / Guidelines w.r.t. Healthcare Policy letters issued by the Railway Board

Section-A

100% paperless process for treatment & medicines at Railway Hospitals (RHs) / Health Units (HUs)

  1. Entire patient detail is already captured/available in HRMS and HMIS and hence Railway employees /pensioners/dependent family members/ eligible beneficiaries are required to only carry two things: (a) their UMID or e-UMID (in Digi-Locker as issued document) and (b) their HMIS registered cell-phones.
  2. For railway patients OPD/IPD/Tests/Discharge etc. is 100% paperless process.
  3. Zonal Railways shall ensure without fail that UMID details are in sync with HRMS details and any issue may be taken up with the concerned CPOs and FAs to ensure its scrupulous compliance.
  4. OPD/IPD/Tests & Diagnostics / Discharge etc. for treatment of non-dependent @ CGHS rates shall also be paperless and w.r.t. instructions contained in Railway Board letter under ref.
  5. All the due payments for treatment, including payment of diet charges or any other amount pertaining to the patient, shall be raised / billed on HMIS and paid by the primary UMID cardholder through the payment gateway (MERS) provided in HMIS App.
  6. Medicine – Despite 100% implementation of HMIS wherein all medicines are prescribed w.r.t. patient’s UMID on HMIS, it has been observed that patients are made to carry its paper print and submit at the railway pharmacy counter which checks (and issues) medicines w.r.t. HMIS. This is a redundant step. No paper print is required to be issued and once medicines have been prescribed by the Railway Doctor in HMIS, the patient would visit the railway pharmacy with UMID no. for collecting their medicines.

Section-B

Leveraging HMIS for Pensioners

  1. RELHS beneficiaries aged 70 years & above for availing cashless facility for direct OPD consultation & related investigation from specialists of the private empanelled HCOs in terms of Railway Board letter no. 2023/H/ 28/ 1/RELHS /Empanelled (CGHS) dated 02.01.2025 and inter alia not drawing Fixed medical Allowance (FMA).
    1. Such beneficiaries can avail of the above facility at any Empanelled HCO on IR (the directory of empanelled HCOs is already in-built in HMIS App) carrying only their UMID and HMIS registered cell-phone no.
    2. The Empanelled HCO shall use its HMIS login ID, punch patient’s UMID and click the form (visible on the screen as “RELHS 70+”) provided therein for this facility based on which an HMIS generated OTP verification/confirmation would be done and a unique digital token ref. ID would get generated.
    3. Patients would also be able to submit their feedback about the treatment/services at the Empanelled HCO from their HMIS App.
  2. UMID card for RELHS-
    1. “RELHS” is a scheme under which retired Railway employees and their dependent family members/ eligible beneficiaries are allowed to avail medical facilities under the Railway Medical Attendance Rules.
    2. It has been observed that Zonal Railways are issuing RELHS Card in addition to UMID. There is no requirement of issuing any RELHS Card and (to reiterate) Zonal Railways shall ensure that UMID details of pensioners are in sync with HRMS.
  3. Railway Healthcare Policy Instructions vide Railway Board letter no. 2024/1 & Trans Cell/ Healthcare/P dated 29.08.2024, para-5 stipulates “Those railway pensioners and/or their dependent beneficiaries, who are entitled to medical treatment/services/medicines at RH/ HU but no UMID has been issued to them, shall not be denied medical treatment/services/ medicines at RH/HU. Their UMID No. would be generated, at first opportunity, w.r.t. their PPO and Aadhaar, whenever they approach RH/HU, to enable them to avail of entitled facility. Remaining details /fields in UMID card would be verified and filled up in HMIS Database“

Section-C

Leveraging HMIS App for Submission of request for Re-validation / Extension of Referrals:

Railway employees / pensioners and their attendants visiting RH/HU for re-validation /extension of referral are avoidable footfalls at the RH/HU and the need for generating OPD appointment for these services is to be dispensed. Henceforth patient would submit request for re-validation / extension of referrals through HMIS App. Instructions are as below:

Type of Referral Case Situation in which Applicable Leveraging HMIS – under Digital Referral Protocol
Cancer cases [Policy instructions on comprehensive & inclusive cancer treatment issued vide RB letter dated 05.05.2025] If the validity of referral has expired/lapsed and digital token is not yet consumed (i.e. treatment not started within 90 days)

OR

if the sessions allowed for treatment have been exhausted
  • Patient can submit the request through HMIS App. Jurisdictional RH would extend within 3 days (72 hours), failing which (HMIS) Systems based extension would be auto-generated.

Note:

  • It has also come to the notice that certain RHs / ZRHs are denying or limiting cancer treatment like chemotherapy or radiotherapy or a particular protocol on piecemeal basis requiring new referral for every session. This is in breach of RB’s healthcare policy instructions on comprehensive & inclusive cancer referral treatment vide Railway Board letter under ref.-ii, which have been incorporated in HMIS.
  • IR has entered into a very exclusive & comprehensive MoU/Agreement for treatment of cancer leveraging HMIS’ digital referral protocol with Tata Memorial Centre /Hospital viz. TMCs /TMCH as one exclusive block of empanelled HCO. Copy of IR’s exclusive MOU/Agreement with Tata Memorial are available on Railway Board (web-page of Health Directorate) at www.indianrailways.gov.in
  1. TMCH – Mumbai, including ACTREC-Navi Mumbai
  2. ТMС- Muzaffarpur
  3. ТMC- Vishakhapatnam
  4. TMC -New Chandigarh
  5. TMC-Sangrur
  6. TMC – Varanasi
  7. TMC – Guwahati
Dialysis sessions if dialysis session/s allowed in the referral has been exhausted
  • Patient can submit the request for extension of the referral through HMIS App. The Jurisdictional RH would extend the same within 3 days (72 hours) of the submission, failing which, i.e., beyond 72 hours, the (HMIS) Systems based extension would be autogenerated – but every 3rd extension would be based on a clinical review and further treatment decision by the Railway Doctor.
Referral Cases
other than cancer		 where the treatment has not started within 30 days from the date of issue ofthe referral (i.e.,
30-day validity of referral has expired / lapsed and digital token has not been consumed
  • Patient can submit the request for extension of the referral through HMIS App based on which the jurisdictional RH, within 72 hours, would either approve the same in HMIS or may call the patient for a clinical review before granting the same. If the patient gets a message in HMIS App for having to come for a clinical review by the Railway Doctor, no OPD registration is required.

Section-D

Referrals for treatment of Railway Patients viz. serving railway employees, railway pensioners and their eligible family members/dependents.

Don’ts/Irregularities / inefficient practices in RHs/HUs (col.-I) Dos / instructions for 100% compliance by the CMS’/ MDs/ Sr DMOs / Officials in-charge of RHs / Hus col.-II
  • Complaints have been received that patients even with referral (in HMIS) are being denied treatment at the empanelled HCO by asking the patients to bring a further recommendation / endorsement / stamp / letter /e-mail /WhatsApp message etc. from the ZRH /RH with which the empanelled HCO has its MoU.
  • OPD Patients for whom referral has been processed/ initiated / recommended by the Railway Doctor – are not required to be present in the RH / HU. The patients should be informed and assured that they should go to their home or workplace and that the referral would automatically get reflected in their HMIS App by the same day. The patient would receive a message, in HMIS App, the moment their referral is initiated and also an update message when referral has been approved /issued in HMIS App.
  • Railway patients, having a prior referral in HMIS or in medical emergency for which no prior referral is required, can avail treatment at any IR empanelled HCO as per her/his choice.

[important reference: para-2-(i) and Annexure-I of the RB letter no. 2024/1 & Trans. Cell/ Healthcare/P dt 29.08.2024.]

  • The empanelled HCO must, without exception, register the patient in HMIS (using its HMIS login ID access for OTP based verification of patient’s UMID / acceptance of referral token) for treatment / admission / discharge. The healthcare policy instructions vide Railway Board letter under ref. may be referred to for guidance.
  • Box-D-I contains key steps in digital referral protocol as per RB’s healthcare policy instructions under ref
  • It has also been observed that for the same patient and same treatment, multiple referrals are being generated / insisted – one from the RH that had initially generated / gave the referral and another, at the insistence of the empanelled HCO on selective basis, from the RH / ZRH with which the empanelled HCO has its MoU. This is irregular.
  • It is reiterated that once a referral letter has been generated in HMIS, no further paper print-out /endorsement/ recommendation / stamp letter / email or telephonic message etc. is required from any Railway Doctor / Railway Hospital. Only the referral ID and digital token no. of the referral letter generated in HMIS is required. The patients will not be required to wait at the RH/ HU merely to collect and chase referral print-outs or local/private nos. The referral letter once generated would be visible on patient’s HMIS App.
  • Referral shall be given for complete treatment of the patient for the referred treatment as per the MoU and not in parts or specific number of days which may be then extendable in piecemeals by RHs at the request of the patient or empanelled HCOs.
  • However, wherever clinical condition of the patient necessitates any modification / extension of indoor treatment beyond standard treatment/period (if any) as per CGHS/MoU, the empanelled HCO shall generate modification / extension request through their HMIS login-ID and digital referral token therein w.r.t. which the patient is being treated.
  • note: in the clinical remarks on referral letter issued by Railway Doctor no extraneous / nonmedical comments would be recorded, but strictly only the patient’s clinical / medical condition and related remarks that require attention for imparting referred treatment.
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