CGHS Clarification – Condition of producing original prescription for reimbursement of expenses incurred for tests / investigations at private hospitals/diagnostic laboratories / imaging centres relaxed
Government of India
Ministry of Health &, Family Welfare
Department of Health & Family Welfare
Nirman Bhawan, New Delhi
Dated the 22nd February, 2013
Subject: Regarding tests investigations at private hospitals/diagnostic laboratories / imaging centres empanelled under CGHS.
The undersigned is directed to refer to the Office Memorandum of even no. dated 1st January, 2013 on the above subject wherein it has been provided under Para 3 that the serving government employees / CGHS beneficiaries shall submit medical prescription in original while claiming reimbursement of expenses incurred on diagnostic tests and investigations, from their office. Keeping in view the inconvenience and difficulties faced by the serving employees / CGHS beneficiaries in submission of prescription in original, it has been decided to relax the above condition and to allow a self attested photocopy of the medical prescription to claim reimbursement of medical expenses incurred on getting diagnostic tests / investigations carried out from a CGHS empanelled hospital / diagnostic laboratory / imaging centre on a valid prescription issued by a CGHS Medical Officer / Govt. Specialist, without a permission letter issued from the Department concerned.
2. The Serving beneficiaries will not require any permission from their Department for getting the diagnostic tests / investigations carried out in a CGHS empanelled private hospital /diagnostic laboratory / imaging centre in respect of investigations for which CGHS rates are available. They will get the prescribed tests done on payment basis and claim reimbursement from their Office. However, the serving employees of Ministry of Health and Family Welfare are eligible for credit facility from the CGHS empanelled private hospitals / diagnostic laboratories and imaging centres in terms of this Ministry’s OM No. Rec.1- 008/Gr./CGHS/Delhi/CGHS (P) dated 10.06.2008.
3. The medical prescription issued by a CGHS Medical Officer / Government Specialist prescribing diagnostic tests / investigations shall be treated as valid for a single use within a period of two weeks from the date of prescription. However the medical prescription shall remain valid beyond two weeks for undertaking diagnostic tests / investigations if specifically prescribed by the CGHS doctor / Government Specialist about the date or period by which the prescribed tests are to be conducted for a routine check up or follow up treatment. The medical prescription would require revalidation or issue of a fresh prescription from the prescribing CGHS doctor/Government Specialist for getting the prescribed tests done after expiry of the validity period of two weeks or as prescribed by the CGHS doctor / Govt Specialist, as the case may be.
Deputy Secretary to the Government of India