Empanelment of Private Day Care Therapy Centers for Ayurveda,Yoga & Naturopathy under CGHS
Ministry of Health &Family Welfare
Department of Health
Directorate General of CGHS
Office of the Director, CGHS
Nirman Bhavan, New Delhi-11
Date: 20thNovember, 2020
Subject: Empanelment of Private Day Care Therapy Centers for Ayurveda,Yoga & Naturopathy under CGHS
The matter regarding empanelment of private Ayurveda,Yoga & Naturopathy Day care Therapy Centers under CGHS has been under consideration of this Ministry for some time. In this regard it has now been decided to start empanelment of private Ayurveda,Yoga & Naturopathy Day Care Therapy Centers on pilot basis for a period of one year in Delhi / NCR region.
Empanelment of private Ayurveda,Yoga & Naturopathy Day Care Therapy Centers under CGHS is as per the details prescribed in the succeeding paragraphs.
1. Ayurveda,Yoga & Naturopathy Day Care Centre means and includes Dispensary, Clinic, Polyclinic or any such private health centre which is registered with the local authorities, wherever applicable and having facilities for carrying out treatment procedures / therapy and medical or para-surgical interventions or both under the supervision of registered Ayurveda,Yoga & Naturopathy Medjcal Practitioner (s) on Day Care basis.
2. Only treatment procedures / therapy as per CGHS list would be allowed to be taken from Day Care Centers in Ayurveda, Yoga & Naturopathy.
3. Room rent shall not be paid for treatment procedures/therapies administered in the Day Care Therapy Centers.
4. For Ayurveda Day Care treatment, permission / referral would be for maximum period of 15 days initially. The CGHS beneficiaries will be referred to the Ayurveda, Yoga & Naturopathy Day Care Therapy Centre on the basis of the requirement of the Day Care Therapy in a diseased condition where it is not treatable only by medication. The referral may be taken from the treating Ayurvedic physician from CGHS / Govt. Hospitals / National Ayurvedic Institutions / Local body Hospitals and Centers / State Govt. Ayurvedic Centers for therapies and duration as advised.
Extension of duration of treatment if any, will be admissible only with prior approval of CGHS/Govt, Ayurvedic Doctors in case of Ayurveda for a further period of maximum 15 days.
5. The empanelled Ayurveda Day Care Therapy Centers shall also be allowed to give OPD consultation after their empanelment as Day Care Therapy Center upon the referral by CMO I/c (mentioned at para-4). However, medicines prescribed shall be only from CGHS formulary and have to be obtained from CGHs Ayurvedic Wellness Centers only.
6. Only 2-3 therapies in single specialty (either Ayurveda or Yoga & Naturopathy) would be permitted in a day.
7. For Naturopathy and Yoga Day Care Therapy Centers treatment shall be obtained directly from empanelled facilities initially for a period of 15 days. After initial treatment of maximum 15 days further extension if required would be on endorsement from CMO I/C (Ayurveda) for pensioners and from concerned office in case of serving beneficiaries. No day care treatment would be allowed beyond 30 days in Ayurveda, Naturopathy and Yoga.
8. (a) It is clarified that the procedures suffixexd with package treatment in annexure A2, Y2, N2 are “Package treatment” and reimbursement shall be limited to the package rates.
(b) The “Package rate” includes all chages pertaining to a particular treatment/procedure including registration charges, cost of medicines, panch karma charges, charges for Ksar sutra operation/procedures charges Doctors/Consultation visit charges, monitoring charges, operation theatre charges, procedural charges/Surgeon’s fee, cost of disposable surgical charges and cost of all sundries used during therapy, routing investigations, physiotherapy charges etc. This also is inclusive of all sup-procedures and related procedures to complete the treatment.
(c) No additional charge on account of extended period shall be allowed if that extension is due to any improperly conducted procedure.
(d) The Hospital / Day Care Therapy Centre shall be notified as empanelled after signing MoA, submission of PBG & Letter of acceptance of rates.
9. The Ayurveda, Yoga & Naturopathy Hospitals / Day Care Therapy Centers will not refuse treatment to Central Government Employees or their dependent family members who are not CGHS beneficiaries if they produce certified / attested copies of identity cards issued by the Government of India and shall not charge more than the prescribed package rates. In such cases the Central government employee will make cash payment and claim reimbursement as per the prescribed rates. Similarly CGHS beneficiaries without referrals but with CGHS card would be offered CGHS rates.
10. An Ayurveda, Yoga & Naturopathy Hospital / Day Care Therapy Centre empanelled as above, whose rates for treatment procedures are lower than the prescribed rates shall charge lower rates.
11. The list of CGHS rates for Ayurveda, Yoga & Naturopathy are enclosed (A2, Y2, N2,). These rates are applicable to NABH accredited Ayurveda, Yoga & Naturopathy Hospitals and Non-NABH accredited Ayurveda, Yoga & Naturopathy Hospitals shall be entitled for 15% lower rates. For claiming NABH rates for Day Care Therapies a separate NABH accreditation for OPD facilities shall be needed.
12.For the purpose of Day Care Therapy in Ayurveda, Yoga & Naturopathy Government Hospitals, Autonomous Hospitals funded by Central Government, State Government, Hospitals managed and run by Councils functioning under Ministries, National Institutes funded by Central / State Government are deemed to be CGHS empanelled and the treatments taken in such hospitals shall be reimbursed as per CGHS rates or hospital rates whichever may be less.
13.Hospitals / Day Care Therapy Centers shall provide credit facility to the entitled class of CGHS beneficiaries which includes CGHS Government pensioners and other entitled class of beneficiary, serving employees of Ministry of Health & Family Welfare, Serving employees of DGHS / CGHS and other notified categories.
14. Hospital / Day Care Therapy Center credit bills in case of pensioners, former Governors former Vice-Presidents, ex-MPs, Freedom Fighters etc., shall be submitted to Additional Director, CGHS Delhi through BCA and to Rajya Sabha Secretariat / Lok Sabha Secretariat in case of sitting Members of Parliament. For serving beneficiaries of CGHS / DGHS and Ministry of Health & Family Welfare credit bills would be submitted to their Departments for consideration. For other. serving beneficiaries reimbursement would be claimed or serving employees from their respective Departments.
15. The unit rates mentioned in the rate list is inclusive of Man power, medicines and infrastructure hence no other add-on charges to be added to the procedures offered by the Hospital / Day Care Therapy Centers.
16. Any legal liability arising out of such services, responsibility solely rests on the Hospital and shall be dealt with by the concerned empanelled Hospital / Day Care Therapy Centre. Services will be provided by the Hospitals / Day Care Therapy Centre as per the terms of agreement to be signed by the Hospital / Day Care Therapy Centre and Additional Director, CGHS Delhi.
17. The shortlisted Hospitals / Day Care Therapy Centers recommended for empanelment shall have to sign MoA and submit Performance Bank Guarantee of requisite amount valid for a period of one year and six months before they are notified as empanelled under CGHS. The private AYUSH Hospitals already empanelled under CGHS have to enter in to a new MOA and acceptance of rates. However, they are not required to submit another PBG if their valid PBG of requisite amount and duration ts already there with the CGHS.
A copy of this OFFICE MEMORANDUM along with Application form and related Annexure are placed on the website of Ministry http://www.cghs.gov.in
(Dr. Sanjay Jain)