Entitlement of wards in private hospitals empanelled under CGHS โ Clarification on issues raised: Department of Health & Family Welfare O.M. dated 22.11.2022
File No: S.11011/11/2016-CGHS(P)
Government of India
Ministry of Health & Family Welfare
Department of Health & Family Welfare
(EHS Section)
Nirman Bhawan, New Delhi
Dated the 22nd November, 2022
OFFICE MEMORANDUM
Subject: Revision of rates of subscription under Central Government Health Scheme due to revision of pay and allowances of Central Government employees and revision of pension/ family pension on account of implementation of recommendations of the Seventh Central Pay Commission-reg.
In continuation of this Ministryโs OM of even number dated 28.10.2022 (copy enclosed) on the subject cited above, the undersigned is directed to issue clarifications, with regard to several clarification requests received in this Ministry. The clarifications on such issues raised may be seen as under:
View: Entitlement of wards in private hospitals empanelled under CGHS w.e.f. 28.10.2022 โ Genuineness of the Order
| Sl.No. | Issues raised | Clarification |
| i. | Is this OM applicable to pensioners of autonomous bodies under CGHS too? | Autonomous Bodies/ Statutory Bodies are provided only OPD facilities, under CGHS, on cost to cost basis. IPD treatment costs are borne by the concerned ABs/SBs through their own resources. Therefore, it is for the concerned ABs/SBs to whom CGHS facilities have been extended, to take a decision in the matter. |
| ii. | Is this OM applicable to pensioners who have retired prior to October 2022? Out of retirees, some have given life time contribution while others contribute on a yearly basis. | The OM dated 28.10.2022 has been issued with the approval of D/o Expenditure, M/o Finance, to rectify certain anomalies in the ward entitlement of beneficiaries post 7th CPC, as fixed vide OM dated 09.01.2017.There is no change in the subscription rate as already fixed vide OM dated 09.01.2017. There is no linkage between CGHS subscription and ward entitlement. Therefore, all CGHS beneficiaries (Serving & Pensioners) who are eligible for upgradation of the ward entitlement, according to the revised basic pay slabs, as mentioned in OM dated 28.10.2022, may apply for fresh CGHS card. However, Medical claim cases for treatment taken by beneficiaries prior to 28.10.2022, will not be re-opened for the purpose of reimbursement with regard to revised ward entitlement(s). |
| iii. | Many pensioners who have retired on 31/10/2022 had applied for pensionersโ card with contribution before 28/10/2022. What would be the status of their ward entitlement? |
2. This issues with approval of Competent Authority.
(Hemlata Singh)
Under Secretary to the Government of India
Tel No. 011-23061778
Encl. As above.
Encl:-Entitlement of wards in private hospitals empanelled under CGHS as per 7th CPC Basic Pay- Revision by MoHFW w.e.f. 28.10.2022
To
- All the Ministries/ Departments, Government of India.
COMMENTS
เคฏเคน เคคเฅ เคเฅเคฐ injustice เคนเฅ, เคเคจ เคเฅเคจเฅเคฆเฅเคฐเฅเคฏ เคฐเคฟเคเคพเคฏเคฐเฅเคก เคชเฅเคเคถเคจเคฐเฅเค เคเฅ เคธเคพเคฅ เคเฅ เคเคจเคตเคฐเฅ 2017 เคธเฅ เคชเคนเคฒเฅ เคฐเคฟเคเคพเคฏเคฐ เคนเฅเค เคนเฅเคเฅค เคฏเคน เคธเคฐเคเคพเคฐ เคจเฅ เค เคชเคจเฅ เคเคฆเฅเคถ 28/10/22 and 22/11/2022 เคเฅ เค เคเคคเคฐเฅเคเคค,เคเฅ ward entitlement เคเคพ เคเคฆเฅเคถ เคจเคฟเคเคพเคฒเคพ เคนเฅ, เคเคเคคเคฐเคซเคพ เคจเคฟเคฐเฅเคฃเคฏ เคนเฅเฅค เคเคธเคฎเฅเค เคเคจเคตเคฐเฅ 2017 เคธเฅ เคชเคนเคฒเฅ เคฐเคฟเคเคพเคฏเคฐ เคนเฅเค เคชเฅเคเคถเคจเคฐเฅเค เคเคพ เคเฅเคฏเคพ เคฆเฅเคท เคนเฅ เฅค เค เคเคฐ เคธเคฐเคเคพเคฐ เคเฅ เคเฅเค เค เคงเคฟเค เค เคเคธเคฆเคพเคจ เคเคพเคนเคฟเค เคฅเคพ, เคคเฅ เคกเคฟเคซเคฐเฅเคจเฅเคธ เคฌเคคเคพเคเคฐ เคธเฅเคเฅเคฎ เคเฅ เคเคชเคธเคจเคฒ เคเคฟเคฏเคพ เคเคพ เคธเคเคคเคพ เคฅเคพ เฅค CGHS WC เคฆเฅเคนเคฐเคพเคฆเฅเคจ เคจเฅ เคธเคพเคซ เคเคน เคฆเคฟเคฏเคพ เคนเฅ เคเคฟ เคเคจเคตเคฐเฅ 2017 เคธเฅ เคชเคนเคฒเฅ เคฐเคฟเคเคพเคฏเคฐเฅเคก เคชเฅเคเคถเคจเคฐเฅเค เคเฅ ward entitlement amend เคจเคนเฅเค เคนเฅเคเคพเฅค 7th PC เคเฅ เค เคเคคเคฐเฅเคเคค เคธเคญเฅ เคฐเคฟเคเคพเคฏเคฐเฅเคก เคชเฅเคเคถเคจเคฐเฅเค เคเคพ เคฌเฅเคคเคจ/เคชเฅเคเคถเคจ เคฐเคฟเคตเคพเคเคเฅค เคนเฅ เคฐเคเฅ เคนเฅ เฅค เคเฅเคเคฆเฅเคฐ เคธเคฐเคเคพเคฐ/Ministry of Health and Family welfare
/CGHS DIRECTOR,เคญเคพเคฐเคค เคธเคฐเคเคพเคฐ เคเคธ เคฌเคฟเคทเคฏ เคฎเฅเค เคเคเคฟเคค เคธเฅเคชเคทเฅเคเฅเคเคฐเคฃ เคถเฅเคเฅเคฐ เคฆเฅเคจเฅ เคเคฐเฅเคฐเคค เคนเฅเฅค
As pension is 50% of last pay drawn. Therefore pensioners should be considered accordingly for ward entitlement as well as contribution towards CGHS irrespective date of retirement. In other words if pensioner is drawing pension @ Rs 20000 he should be considered entitlement for 40000 without considering grade pay in 6th cpc or retirement date in 7th cpc or 5th cpc.
Yes, as per MOH &FW, OM dt 28/10,22/11 and further clarification by cghs HQ, the ward upgradation benefit is not restricted to the pensionerโs those retired after January 2017,as per my opinion, being similarly placed, there canโt be & need not be any discrimination, hence, in terms of OM /clarification ibid,itโs applicable even to all pensionerโs retired prior to Jan 2017(based on 7th CPC pay upgradation )provided they approach concerned AD, cghs with application/documents etc
Sir. There is some clarification required for orders issued by Deptt of Health &Family Welfare under OM No.S 1101/11/2016-CGHS(P/EHS) dated 28.10.22 regarding entitlement of Wards in private hospitals under CGHS. This was issued in partial modification of OM under even No dated 9th Jan 2017.Upgradion was ordered on the basis of corresponding Basic Pay in 7th CPC. Clarification is necessary whether upgradation is entitle to those retired prior to 1.1.2017 beneficiaries based on their corresponding basic pay as per 7th CPC.