Temporary Reimbursement Allowed for CGHS Medicines Purchased from Open Market During CDAC Transition

In a major relief to Central Government Health Scheme (CGHS) beneficiaries, the Ministry of Health and Family Welfare has announced a one-time special sanction allowing the purchase and reimbursement of “Indent” (OPD) medicines from the open market without the requirement of a Non-Availability Certificate (NAC). The decision comes in light of the ongoing migration of the Hospital Management Information System (HMIS) from the NIC platform to the C-DAC platform, which began on April 28, 2025.

Transition Troubles Lead to Temporary Disruption

The HMIS migration, aimed at upgrading digital infrastructure and streamlining operations at CGHS Wellness Centres, has led to technical bottlenecks. These challenges have disrupted the routine supply of OPD medicines, particularly “Indent” medicines, causing hardship to thousands of beneficiaries across the country.

One-Month Procurement from Open Market Permitted

To mitigate this inconvenience, the CGHS Directorate has issued a special Office Memorandum permitting the following:

• CGHS beneficiaries can purchase Indent medicines for one month from any chemist based on a valid prescription, irrespective of the issuance of a Non-Availability Certificate (NAC).
• The prescription must still be valid (i.e., the treatment duration prescribed must not have expired on the date of purchase).
• This special arrangement is effective from April 28 to May 31, 2025.

Reimbursement Guidelines Issued

Reimbursement of the cost of such medicines will be allowed upon submission of the required claim documents, with the responsibility of processing varying by beneficiary category:

Category of Beneficiary	Claim Submission Authority
CGHS Pensioners (including Ex-MPs)	Additional Director, CGHS of the concerned city/zone
Serving Government Employees	Respective Administrative Department
Hon’ble Members of Parliament	Rajya Sabha / Lok Sabha Secretariat
Autonomous Bodies / Air India Beneficiaries	Respective Autonomous Body / Air India Office

All claims must be forwarded through the CMO In-charge of the concerned CGHS Wellness Centre.

What Documents Are Required?

Claimants must submit the following documents:

• CGHS card copies (for both main card holder and patient)
• Copy of valid prescription
• Original bill and receipt
• Cancelled cheque with name and account details
• Certification by CMO that the medicine was not supplied from the Wellness Centre

Note: Medicines already supplied by CGHS Centres, especially generic equivalents, will not be eligible for reimbursement.

CGHS Wellness Centres Remain Functional

Despite the transition, the Wellness Centres will remain operational. Beneficiaries are encouraged to continue procuring medicines from their respective Centres if available.

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