Purchase of Hearing Aids under CS(MA) Rules and CGHS: Revision of rate & guidelines for reimbursement of expenses
No S.11011/37/2019-EHS
Government of India
Ministry of Health & Family Welfare
Department of Health & Family Welfare
[EHS Section]
Nirman Bhawan, New Delhi
1st December, 2020
OFFICE MEMORANDUM
Subject: Revision of rate & guidelines for reimbursement of expenses on purchase of Hearing Aids under CS(MA) Rules, 1944 and CGHS.
The undersigned is directed to refer to the Office Memorandum No. S.14025/10/2002/MS dated 26th May, 2015 on the above mentioned subject and to state that on the basis of recommendations of an Expert committee, it has been decided to revise the rates and guidelines for hearing aids reimbursement under CS(MA) Rules, 1944 and CGHS.
2. The revised ceiling rates fixed for various types of hearing aids (for one ear) are as under:-
Digital. BTE Rs.8,000/- [Eight thousand only]
Digital ITC/CIC Rs.9,000/- [Nine thousand only]
The above revised cost of hearing aids shall include all taxes, including GST and shall carry three years’ warranty. The cost of BTE type hearing aids shall also include the cost of hearing mould. The cost of ITC/CIC type hearing aids shall also include the cost of customized shell.
Body worn/pocket type category and Analogue BTE category with ceiling rates Rs.3000/- per ear and Rs.7000/- per ear have been excluded, since they have become obsolete.
3. Beneficiaries covered under CS(MA) Rules/CGHS shall be eligible to obtain hearing aids as per the following guidelines:
i. Patients/beneficiaries should be properly referred to ENT Specialist of CGHS/Government Hospital/CGHS empanelled Hospital by Medical Officer of CGHS from CGHS wellness centre/AMA in case of CS(MA) beneficiary.
ii. It would be mandatory to carry CGHS beneficiary’s identity Card (in original) whenever the CGHS beneficiaries visit the CGHS/Government ENT Specialist/Specialist of CGHS /CS(MA) empanelled Hospital for consultation and Audiometric test.
iii. The ENT specialist of CGHS/Government hospital/CGHS/CS(MA) empanelled hospital shall then recommend a hearing aids on basis of Audiometric and Audio-logical assessment, specifying the type of hearing aids most suited for the beneficiary. The ‘Audiogram. Report’ shall be authenticated by the ENT specialist. The recommendation shall be as per the categories approved under CGHS and not as per any Brand name.
iv. The permission to procure hearing aids shall be granted by the Additional Director(Zonal) of CGHS-Zonal Office in case of CGHS pensioners beneficiaries, and by the Head of Department/Office in case of serving employees and CGHS beneficiaries of Autonomous bodies on the basis of recommendation of a CGHS/Government ENT specialist/ ENT Specialist of CGHS /CS(MA) empanelled hospital, and an ‘undertaking’ that the beneficiary has not been reimbursed the cost of hearing aids in the preceding five years.
4. Reimbursement claim shall be submitted to CGHS Zonal Office through the CMO, In-charge of the Concerned dispensary by CGHS pensioner beneficiaries and to concerned Ministry/Department/Office in case of serving employees and to concerned Autonomous Body(AB) in case of beneficiaries of ABs in the prescribed medical reimbursement claim form along with the following documents
a. Permission Letter for purchase of Hearing aids in original.
b. Copy of CGHS Card.
c. Bill / Receipt (in original) carrying details of the hearing aids seller.
d. Empty Box/boxes or the carton (s) with label showing details of the hearing aids supplied.
e. Reimbursement shall be limited to the ceiling rate or actual cost of the hearing aids, whichever is less.
5. Records of permission granted for procurement of hearing aids shall be maintained by CGHS in respect of pensioner CGHS beneficiaries and by the concerned Ministry / Department / Office in respect of other beneficiaries.
6. Replacement of hearing aids may be permitted after five years. Henceforth, there will be no requirement of submission of condemnation certificate by the beneficiary at the time of requesting the replacement of a hearing aid that has completed its five years mandated life.
7. Maintenance and repair and cost of batteries will be the responsibility of the beneficiary.
8. The revised rates and guidelines shall come into force from the date of issue of this O.M. and shall be valid till further revision and shall supersede all the earlier orders issued on the subject.
9. This issues with the approval of Integrated Finance Division (CD No.1486 dated: 29/09/2020) of Ministry of Health & Family Welfare.
[Dr. Anil Ranga]
Director [CGHS-Policyl
23061669
COMMENTS