Full reimbursement of Medical Treatment Expenditure incurred by Central Government Employees governed under CGHS and CS(MA) Rules (Ministry of Health & Family Welfare): Agenda Item No. NC-49/9/26 – 49th NC (JCM) Meeting.
(DoP&T O.M. No. 3/1/2025-JCA dated 03.06.2026)
Minutes of the 49th Meeting of the National Council (JCM) held on 11.05.2026 under the Chairmanship of Cabinet Secretary.
5.1 Item No. NC-49/9/26- Full reimbursement of Medical Treatment Expenditure incurred by Central Government Employees governed under CGHS and CS(MA) Rules (Ministry of Health & Family Welfare)
The demand in brief is that the recognized hospitals both under CGHS and CS(MA) charge more than the package rates codified by the CGHS for various medical procedure and treatment.
Secretary, Health & FW informed that the CGHS rates have been enhanced in October 2025. Vide new empanelment guidelines, the Health Care Organisations (HCOs) have been instructed to inform the beneficiaries details of the items which shall be disbursed and those for which payment is to be made by the beneficiaries. In case of treatment in non-empaneled Hospitals, full reimbursement in special specified circumstances which exceed prescribed CGHS rates for both CGHS and CS(MA) Rules has been allowed on the recommendation of the Standing Technical Committee (STC) / High Powered Committee (HPC).
Shri C. Srikumar, Member, Staff Side stated that reimbursement may be allowed for new procedures and non-medical items which are part of the Medical Treatment/Procedure. He further stated that reimbursement rates of Hearing Aids are not revised and it is very low. The rates must be revised taking into consideration of today’s market rates.
Secretary, Health & FW informed that the cost of hearing aids ranges from Rs 16,000 to Rs. 4 lakh. However, the said demand will be looked into. She also assured the revision in rates for hearing aids and for the items whose rates have not been revised in a long time. She mentioned that the Department will monitor the functioning of hospitals and will take strict action in any case of violation.
Decision: Chairman stated that the MoH&FW may examine / consider revision of the rates within 3 months for hearing aids and other items whose rates have not been revised in a long time.
COMMENTS