Guidelines & Ceiling Rates for Lung Transplant, Heart Transplant surgery in respect of CGHS/CS(MA) beneficiaries: MoHFW

Guidelines & Ceiling Rates for Lung Transplant, Heart Transplant surgery in respect of CGHS/CS(MA) beneficiaries: MoHFW OM dated 01.12.2023

File No. Z-42011/11/2021-MG/EHS
Government of India
Ministry of Health & Family Welfare
EHS Section

Nirman Bhawan, New Delhi-110011
Dated 1st December, 2023

OFFICE MEMORANDUM

Subject: Guidelines & Ceiling Rates for Lung Transplant, Heart Transplant surgery in respect of CGHS/CS(MA) beneficiaries-reg.

The undersigned is directed to refer to above mentioned subject and to say that proposal for issuing guidelines & ceiling rates for Lung Transplant and Heart Transplant was examined in this Ministry, in consultation with Dte. of CGHS and Dte. General Health Services. The under signed is now, directed to convey the approval of the Competent Authority to issue guidelines for Lung Transplant/ Heart Transplant surgery in respect of CGHS/CS(MA) beneficiaries as per the details given below:

i. The ceiling rates for the surgery are as under:

a) Lungs Transplant Rs.25 lakhs
b) Heart Transplant Rs.15 lakhs
c) Heart & Lungs transplant (combined) Rs.35 lakhs

ii. Government has constituted Standing Committees for consideration of requests for Lung / Heart Transplant cases from CGHS/CS(MA) beneficiaries as per the details given below:

A) Composition of Standing Committee for CGHS beneficiaries:

B) Composition of Standing Committee for CS(MA) beneficiaries:

iii. Since, Lung/Heart transplant surgery is a planned procedure, prior permission has to be obtained before the surgery is undertaken.

However, if for any reason it was undertaken under medical emergency to save the life of a patient, the Standing Committees shall consider the cases referred to them for consideration of grant of ex-post-facto approval, on a case to case basis.

iv. Procedure for submission of Application:

a. CGHS beneficiaries shall submit the requests for permission for Lung/Heart transplant surgery to the Additional Director, CGHS of concerned city through the concerned Ministry/Department for placing the same before the duly constituted Standing Committee. Pensioner CGHS beneficiaries, etc., shall submit the applications to the additional Director of concerned Zone/City through the Wellness Centre.

b. In case of CS(MA) beneficiaries shall submit the requests for permission for Lung/Heart transplant surgery to the Under Secretary, EHS , MOHFW through the concerned Ministry/Department for placing the same before the duly constituted Standing Committee.

2. These guidelines has the approval of Competent Authority and concurrence of Integrated Finance Division, MoHFW vide CD No. 2401 dated 09.11.2023.

signed by
Hemlata Singh
Date 01.12.2023
Under Secretary to the Government of India
Tel. No. 011-23061778

Source: MoHFW