AN OTHER WIN OF BPS- Provision of OPD consultation & related investigation for RELHS beneficiaries aged 75 years & above from specialists of Private Hospitals empanelled by Railway- As a PILOT PROJECT FOR ONE YEAR FROM 01.11.2023 TO 31.10.2024.
GOVERNMENT OF INDIA
MINISTRY OF
RAILWAYS
(RAILWAY BOARD)
No. 2023/11/28/1/RELHS/Empanelled (CGHS) Dtd: 09.2023
General Managers,
All Indian Railways
Including PUs, RDSO and NAIR,
Sub:- Provision of OPD consultation & related investigation for RELHS
beneficiaries aged 75 years & above from specialists of Private Hospitals empanelled
by Railway- As a PILOT PROJECT FOR ONE YEAR FROM 01.11.2023 TO
31.10.2024.
The matter of the provision of direct Outpatient
Department (OPD) consultation and related investigation from specialists of
private hospitals empanelled by Railway for RELHS beneficiaries aged 75 years
and above has been drawing the attention of the Ministry of Railway for some
time. After consideration of the issue, the Railway Board has decided as
under:-
(i)
RELHS beneficiaries aged 75 years and above may be
permitted to seek direct OPD
(ii) Consultation from specialists of Private
Hospitals empanelled by Railway, without a referral from Railway Hospital/
Health Unit under which beneficiary is registered.
(iii) If any CGHS-listed
investigation/procedures is advised and is required to be undertaken in an emergency,
no other authorization will be required, and the same may be undertaken from the
empanelled hospital at CGHS rates for that city/or as per MoU with Railways in
cashless procedure Bills along with a copy of UMID card, copy of prescription/
Reports and declaration form (copy enclosed) signed by the beneficiary and duly
endorsed by the competent authority of the empanelled hospital will be sent to
Railway under which the hospital is empanelled for payment.
(iv) In
non-emergency cases, approval of competent authority from Railways will be
required for undertaking (a) CGHS non-listed investigations/ planned
procedures; and (b) those CGHS listed investigations, which cost above Rs.
10000/-, whenever advised by specialist of empanelled hospitals.
(v) Medicines
prescribed by a specialist doctor of private railway empanelled hospitals will
be issued by concerned Railway hospitals/Health Units on authorization of
available railway doctor.
(vi) Private
Hospitals empanelled under Railways shall provide the above facilities on a cashless
basis at CGHS rates to Railway beneficiaries aged more than 75 years. The
hospitals shall submit the bills along with a valid UMID card and declaration
form signed by the beneficiary who has availed the facilities, duly endorsed by
the competent authority of the empanelled hospital.
(vii) This
facility will be available for only those aged 75 years & above REI-HS
beneficiaries who are eligible for OPD consultation at Railway Hospitals/
Health Units. This facility is not available
To beneficiaries holding
UMID cards with FMA.
(viii)
These guidelines will not supersede the instruction
issued vide Board's letter No. 201S/Transcell/Health/CGHS ( No.327783) dated
16.()6.2()21 which will remain in force for emergency cases/IPD eases as specified
therein.
(ix) This is a
Pilot Project only for one year i.e. 01.11.2023 to 31.10.2024. Railways will ensure
the period of Pilot procject
without fail.
(x) To ensure
that UMID cards are not misused, proper accountal of expenditure incurred on
the present scheme may be maintained by Railway/ PU.
(xi) Empanelled
hospitals need to be provided access to HMIS portal so that data is efficiently captured and can be retrieved
whenever required.
Sd/
Dr.A.K.Malhotra
Principal Executive Director/Health
Railway Board.
No. 2023/H/28/1/RELHS/Empane11ed(CGHS) New Delhi,
Dated:- .09.2023
Copy forwarded to:-
1. PCVDs/
PCMOs, All Indian Railways Including PUS, RDSO & NAIR.
2. PFAs/ All
Indian Railways Including PUS, RDSO & NAIR.
3. PCPOs, All Indian Railways
Including PUS, RDSO & NAIR.
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