Chapter 27

0(',&$/)$&,/,7(6727+(&(175$/*29(510(17 0(',&$/)$&,/,7(6727+(&(175$/*29(510(17 0(',&$/)$&,/,7(6727+(&(175$/*29(510(17 0(',&$/)$&,/,7(6727+(&(175$/*29(510(17

(03/2<((6,1&/8',1*&*+6 (03/2<((6,1&/8',1*&*+6 (03/2<((6,1&/8',1*&*+6 (03/2<((6,1&/8',1*&*+6



27.1 TIc Ccniral Covcrnncni scrvanis arc cniiilcd io ncdical faciliiics undcr
iIc Ccniral Scrviccs (Mcdical Aiicndancc} Fulcs, 1944, iIc salicni fcaiurcs of
wIicI arc givcn Icrcundcr.

27.2 TIcsc Fulcs arc alicallc io all govcrnncni scrvanis oiIcr iIan (i} iIosc
in Failway Scrvicc, and (ii} iIosc of non-gazciicd ranl siaiioncd in or assing
iIrougI Kollaia, wIosc condiiions of scrvicc arc rcscrilcd ly rulcs nadc or
dccncd io Iavc lccn nadc ly iIc Ccniral Covcrnncni, wIcn iIcy arc on duiy,
lcavc or forcign scrvicc in India or wIcn undcr suscnsion. Following ncdical
faciliiics arc availallc undcr iIcsc rulcs.

,Q,QGLDRQO\

1. Aviianinosis and Hyoviianinosis.
2. Corrcciion of squini (cyc}. Tcsiing of cyc sigIi for glasscs of iIc
cnloyccs oncc in iIrcc ycars.
3. Discasc(s} causing gcncral dcliliiy and sccondary anacnia.
4. Trcaincni for innunizing and roIylaciic uroscs in iIc casc of
connunicallc discascs only.
5. Vcncrcal discascs and Dcliriun Trcncns.
6. Trcaincni of sicriliiy and ocraiion for sicrilizaiion.
7. Mcdical icrninaiion of rcgnancy crforncd ai govcrnncni
Iosiial/rccogniscd insiiiuiions cic.
8. Confincncni including ai rcsidcncc if aiicndcd ly CIild Wclfarc and
Maicrniiy Ccnircs siaff ; rcnaial and osi - naial ircaincni.
9. Dlood and llood iransfusion cIargcs.
10. Dcnial ircaincni (only in govcrnncni Iosiials, rivaic rccogniscd
Iosiials} - Surgical ocraiions nccdcd for rcnoval of Odonioncs
and inacicd wisdon - iooiI, Trcaincni of gun loils, Eiraciion,
Scaling and gun ircaincni including yorrIoca and Cingiviiis,
Filling of icciI , Fooi canal ircaincni cic.
11. Anii-ralic ircaincni.
12. Cosi of Hcaiiiis Vaccinc D & C.

Following ircaincni can lc availcd RXWVLGH,QGLD also -

a} Cardio vascular Surgcry.
l} Kidncy and oiIcr organ Translani.
c} Joini rclaccncni and surgcry.
d} Donc-narrow iranslani.
c} Ccriain iycs of ncdical and oncological disordcr, sucI as
Lculacnia and ncolasiic condiiions.
f} Micro vascular and ncuro surgcry.
g} Trcaincni wiiI lascr wIicI olviaics iIc nccd of ocn surgcry.
I} Trcaincni wiiI Argon, Kryion and Yag Lascr in OIiIalnic cascs.
i} Eira cororcal sionc disinicgraiion ly ulirasonic sIocl wavcs.

27.3 A govcrnncni scrvani dcsirous of availing ncdical ircaincni ouisidc India
nay nalc an alicaiion in iIc rcscrilcd forn iIrougI Iis Dcarincni/Minisiry
io iIc Sianding Conniiicc csiallisIcd undcr iIis rulc. On rcccii of sucI
alicaiion, iIc Sianding Conniiicc, if aficr duc considcraiion ii is saiisficd iIai
iIc aiicni can lc ircaicd only ouisidc India, nay issuc a ccriificaic io iIc
conccrncd Dcarincni/Minisiry convcying iis aroval of iIc alicaiion and iIc
conccrncd Dcarincni/Minisiry sIall, on iIc sircngiI of iIai ccriificaic incur
ncccssary ccndiiurc in gciiing iIc govcrnncni scrvani conccrncd or iIc
ncnlcr of Iis fanily ircaicd in accordancc wiiI iIc roccdurc laid down ly iIc
Conniiicc (Fulcs 8 & 11}.

27.4 For gciiing ncdical ircaincni ly iIc Ccniral Covcrnncni scrvani and Iis
fanily ncnlcrs in India, iIc following Hosiials/Insiiiuiions arc rccogniscd.

1. All Siaic Covcrnncni Iosiials including iIosc nainiaincd ly
Local Dodics.

2. All Iosiials, rinary IcaliI ccnircs, naicrniiy and cIild wclfarc
ccnircs and discnsarics rccogniscd ly Siaic Covcrnncnis for ircaincni
of iIcir cnloyccs and/or ncnlcrs of iIcir fanilics.

3. All Iosiials/discnsarics aiiacIcd io Pullic Sccior
Undcrialings/Projccis/Pori Trusis.

4. Canionncni Iosiials in canionncni arcas wIcrc iIcrc arc no
govcrnncni Iosiials, for ircaincni of govcrnncni scrvanis and iIcir
fanily ncnlcrs rcsiding in iIosc arcas and also in iIc adjoining arcas
ouisidc canionncni liniis.

5. All railway Iosiials.

6. Pay Clinics in DiIar, Punjal, Haryana, Uiiar PradcsI, MadIya
PradcsI, FajasiIan and CIandigarI.

7. Privaic Iosiials in ariicular siaiions noiificd ly iIc Covcrnncni
of India fron iinc io iinc (Fulc 2}.

27.5 In addiiion io iIc alovc, Hcad of Dcarincni as sccificd in SF 2(10} is
cnowcrcd io aoini Mcdical Officcrs undcr iIc cnloyncni of iIc
Ccniral/Siaic Covcrnncnis and Union Tcrriiorics, as also Mcdical Officcrs noi in
govcrnncni cnloyncni i.c. Privaic Fcgisicrcd Mcdical Praciiiioncrs as
AuiIoriscd Mcdical Aiicndanis.

27.6 Privaic Mcdical Praciiiioncrs arc aoinicd as AMAs wIcrc adcquaic
nunlcr of govcrnncni dociors in various sysicns of ncdicincs arc noi availallc
or wIcn iIcir scrviccs arc noi availallc wiiIin a radius of fivc liloncircs or
lccausc of iIc rcnoicncss of iIc arca (Fulc 2}. TIc AMA so aoinicd, will lc
lound ly iIc icrns and condiiions rcscrilcd ly iIc govcrnncni fron iinc io
iinc undcr iIcsc rulcs. If iIc condiiion of iIc aiicni so rcquircs, iIc AMA can
scnd iIc aiicni io iIc ncarcsi sccialisi or oiIcr ncdical officcr or sunnon iIcn
io aiicnd iIc aiicni (Fulc 5}.

27.7 TIc ircaincni ai iIc consuliing roon of iIc AMA is liniicd io icn days
wiiI a nainun of four consuliaiions and nornally icn injcciions. TIc linii of
four consuliaiions wiiIin 10 days is alicallc for aiicndancc wiiI a
Sccialisi/oiIcr Mcdical Officcr and will couni fron iIc daic fron wIicI iIc
Sccialisi/oiIcr Mcdical Officcr is consulicd. Consuliaiion on iIc 10iI day of
ircaincni is crnissillc, if no ncdicinc is rcscrilcd on iIai consuliaiion.

27.8 Cascs of ncdical ircaincni rcquiring Iosiializaiion arc rcfcrrcd io
govcrnncni/ rccogniscd Iosiial. If Iosiializaiion is noi considcrcd ncccssary
lui ircaincni is cccicd io lc rolongcd, iIc aiicni sIould lc rcfcrrcd io OPD
of govcrnncni / rccogniscd Iosiial.

27.9 WIcn a aiicni consulis iIc sanc AMA in rcgard io iIc sucr inosiiion of
anoiIcr discasc during iIc coursc of ircaincni of onc discasc, ii is rcgardcd as a
frcsI consuliaiion and will lc cIargcd ai full raics as rcscrilcd ly iIc
govcrnncni fron iinc io iinc. To jusiify a frcsI clain for iIc rccurrcncc of iIc
sanc discasc for a sccond iinc, iIcrc sIould lc a rcasonallc ga lciwccn iIc
closing of iIc firsi scll and iIc rccurrcncc of iIc sccond scll. A scaraic clain
is io lc rcfcrrcd in rcscci of cacI scll of illncss and or an cniircly ncw discasc
(CID (21} in Fulc 2}.

27.10 TIc clain for rcinlurscncni sIould lc rcccivcd wiiIin 3 noniIs fron iIc
daic of lasi ircaincni. Howcvcr, suljcci io ccriain condiiions, iIc Dcarincni
nay condonc iIc dclay. (CIDs (9} and (10} Scciion-1}.

27.11 TIc govcrnncni scrvani and iIcir fanily ncnlcrs nay rcccivc ircaincni
for all discascs for wIicI ircaincni is rovidcd undcr iIc rulcs in a
govcrnncni/rccogniscd Iosiial ouisidc iIc disirici/siaic lui wiiIin India,
rovidcd .

(i} Ncccssary and suiiallc faciliiics for ircaincni arc noi availallc in a govcrnncni or
rccogniscd Iosiial ai iIc disirici or siaic Icadquaricrs or wiiIin iIc disirici or
siaic wIcrc onc falls ill and

(ii} TIc ircaincni ouisidc iIc disirici/siaic is rcconncndcd ly iIc AuiIoriscd
Mcdical Aiicndani and counicrsigncd ly iIc CIicf Mcdical Officcr of iIc disirici if
iIc ircaincni is undcrialcn ouisidc iIc disirici or ly iIc CIicf Adninisiraiivc
Mcdical Officcr of iIc siaic if ii is io lc undcrialcn ouisidc iIc siaic. (C.I.D.(4}
undcr Fulc 6}.

27.12 TraveIIIng AIIowance Ior medIcaI treatment and attendance

TIc govcrnncni cnloyccs and iIcir fanily ncnlcrs arc cniiilcd io
undcrialc journcys io ialc aroriaic ncdical aiicndancc and ircaincni, if ii is
ccriificd ly iIc AMA/Sccialisi/Mcdical Officcr aiiacIcd io iIc Iosiial io wIon
iIc aiicni was rcfcrrcd, iIai iIc journcy was unavoidally ncccssary io oliain iIc
ircaincni. TIc aiicni ( govcrnncni scrvani or Iis fanily ncnlcr } and aiicndani
also ( wIcrcvcr rcconncndcd} will lc cniiilcd io TA lus DA for iIc criod of
journcy undcrialcn ly rail, road, sca and air. No DA will lc adnissillc for Iali.
TIc govcrnncni scrvani is cligillc for rcinlurscncni of iIc iravclling ccnscs of
iIc donor of a lidncy io Iin or io a ncnlcr of Iis fanily for iIc journcys nadc
in conncciion wiiI iIc iranslaniaiion.

27.13 CentraI Government HeaIth Scheme(CGHS)

TIc ncdical faciliiics undcr iIc Ccniral Covcrnncni HcaliI ScIcnc arc
availallc io all iIc cnloyccs aid fron iIc civil csiinaics and iIcir fanily
ncnlcrs rcsiding in iIc arca covcrcd ly iIc scIcnc. An cnloycc can oi oui of
iIc scIcnc and avail of iIc ncdical faciliiics rovidcd ly iIc cnloycr of Iis
sousc. If an cnloycc or a ncnlcr of Iis fanily covcrcd undcr iIc ScIcnc falls
ill ai a lacc noi covcrcd undcr CCHS, iIc ircaincni sIall lc adnissillc undcr
CS(MA} Fulcs
1|1|
.

27.14 TIc ncdical faciliiics io iIc Ccniral Covcrnncni cnloyccs and iIcir
dccndcni fanily ncnlcrs arc rovidcd undcr iIc Ccniral Covcrnncni HcaliI
ScIcnc in iIc following ciiics.

AIncdalad CIazialad Mccrui AllaIalad
Curgaon Munlai Dangalorc CuwaIaii
Nagur DIulancsIwar Hydcralad Noida
Kollaia Jaiur Paina CIcnnai
Jalalur Punc Kanur FancIi
DclIi/Ncw DclIi Faridalad Luclnow TIiruvananiIauran


1|1|
OM No.S.1101/6/92-CCHS Dcsl-CCHS(P} daicd 4.8.94.
27.15 DeIInItIon oI FamIIy. ' Fanily' ncans cnloycc's

(i} Husland/Wifc including norc iIan onc wifc and also judicially
scaraicd wifc.

(ii} Parcnis and SicnoiIcr. In iIc casc of adoiion, only iIc adoiivc
and noi iIc rcal arcnis. If iIc adoiivc faiIcr Ias norc iIan onc
wifc, iIc firsi wifc only.

A fcnalc cnloycc Ias a cIoicc io includc ciiIcr Icr arcnis or Icr
arcnis-in-law; oiion ccrciscd can lc cIangcd only oncc during scrvicc.

(iii} CIildrcn including lcgally adoicd cIildrcn, siccIildrcn and
cIildrcn ialcn as wards suljcci io iIc following condiiions .

Son -Till Ic siaris carning, irrcscciivc of agc linii.
DaugIicr -Till sIc siaris carning or gcis narricd, wIicIcvcr is carlicr,
irrcscciivc of agc-linii.
Son suffcring fron -No agc -linii.
Pcrnancni disaliliiy of any
lind (Iysical or ncnial}

(iv} Widowcd daugIicrs and dccndcni divorccd/scaraicd daugIicrs.

(v} Sisicrs including widowcd sisicrs.

(vi} Minor loriIcrs and dccndcni lroiIcrs.

27.15.1 Dui iIc alovc crsons sIould rcsidc wiiI iIc govcrnncni scrvanis and
iIcir inconc fron all sourccs sIould noi lc norc iIan Fs.1500/- cr noniI
2|2|
.

27.16 ContrIbutIon

A conulsory noniIly coniriluiion is cIargcd fron all iIc cniiilcd classcs
of govcrnncni scrvanis on iIc lasis of raics ficd ly iIc govcrnncni fron iinc io
iinc. TIc rcscni raics of coniriluiion arc as undcr.

Pay Rate oI monthIy contrIbutIon (Rs.)
U io Fs.3000/- 15/-
Fs.3001 io 6000/- 40/-
Fs.6001 io 10000/- 70/-
Fs.10001 io 15000/- 100/-
Fs.15001/- and alovc 150/-


2|2|
OM No.ND 12014(7}/92-CCHS(D} daicd 31.12.1993.
27.16.1 WIcn loiI Iusland and wifc arc Ccniral Covcrnncni scrvanis covcrcd ly
iIc scIcnc, iIc coniriluiion will lc rccovcrcd fron only onc of iIcn wIosc ay
is IigIcr
3|3|
.

27.16.2 An cnloycc iransfcrrcd io anoiIcr CCHS siaiion or onc wIo gocs io scrvc
alroad lcaving Iis fanily ai iIc old siaiion nay coniinuc io ay iIc coniriluiion
and Iis fanily can avail iIc faciliiics ai iIc old siaiion for iIai duraiion
4|4|
.

27.17 FacIIItIes avaIIabIe under the Scheme
5|5|


i) Mcdical aiicndancc including consuliaiion wiiI iIc AMA ai a CCHS
Discnsary.
ii) X-Fay, Laloraiory and oiIcr diagnosiic faciliiics ai CCHS
Laloraiorics or oiIcr laloraiorics of CCHS wing of Hosiials/Privaic
Hosiials rccogniscd ly CCHS.
iii) Hosiial scrviccs in iIc CCHS wing of Hosiials/Fcfcrral/Privaic
Hosiials rccogniscd ly iIc CCHS.
iv) Nursing Honc faciliiics for iIosc Iaving a lasic ay alovc Fs.
12000/-.
v) Sccial ircaincni for discascs lilc TD, Canccr, Kidncy Translani
and Dy-ass Surgcry and faciliiics for Dcnial ircaincni (for fcw discascs}.
vi) Anic naial/confincncni/osi naial carc faciliiics.
vii) Sccialisi consuliaiion in sclccicd ccnircs/oly clinics/Iosiials
cic.
viii) Inira - ocular lcns inlaniaiion/ircaincni and cosi of scciaclcs
aficr caiaraci ocraiion.
ix) Posi-ocraiivc ircaincni rclaiing io Ncurosurgcry, Cardiac
Discascs, Canccr, Kidncy iranslaniaiion and Ii/lncc rclaccncni
surgcry in iIc sanc insiiiuiions/Iosiials wIcrc iIc surgcry was carlicr
carricd oui wiiI rior crnission of CCHS.
x) Mcdicincs rcscrilcd during OPD ircaincni arc rovidcd ly iIc
CCHS discnsary conccrncd. No rcinlurscncni is allowcd for sucI
ncdicincs urcIascd fron ouisidc.
xi) TIc scalc of Iosiial acconnodaiion is rcscrilcd as undcr.

Dasic Pay Privaic Hosiials
rccogniscd ly
CCHS
AIIMS
N.DclIi
Covcrnncni/Municial
Iosiials
Uio Fs.7500 Ccncral Ward Ccncral Ward .
7500 and alovc . . Nursing Honc faciliiics
7501 io 10500 Scni-rivaic Ward Ccncral Ward -do-

3|3|
OM No.S-11011/6/98-CHS(P}daicd 27.5.1998.
4|4|
OM No.S-12015/1/85-CCHS(P} daicd 8.7.85 and ancndcd fron iinc io iinc.
5|5|
OM NO.S-11022/1/98-CCHS (P} daicd 4.9.1998.

10501 io 13499 Privaic Ward Privaic Ward -do-
13500 and
alovc
-do Dcluc Ward -do-


27.18 Procedure Ior reIerence to ReIerraIJRecognIsed HospItaIs under CGHS
-

TIc lcncficiarics will Iavc iIc oiion io avail sccialiscd ircaincni ai
CCHS rccogniscd Iosiials of Iis/Icr cIoicc if iIc sccialisi of iIc CCHS
discnsary or govcrnncni Iosiial rcconncnds iIc aiicni for sucI sccialiscd
ircaincni.

27.18.1 Aficr iIc sccialisi adviscs a roccdurc in wriiing, iIc crnission lciicr for
ialing sucI ircaincni in a CCHS rccogniscd rivaic/rcfcrral Iosiial of iIc
cIoicc of iIc cnloycc in iIc sanc ciiy, would lc givcn ly iIc arcni
dcarincni/officc
6|6|
.

27.18.2 In casc iIc lcncficiary, insiic of iIc faciliiy lcing availallc in iIc ciiy siill
cIooscs io gci ircaincni in anoiIcr ciiy, crnission of iIc CCHS auiIoriiics of
iIc ciiy would Iavc io lc oliaincd. In sucI cascs, no TA/DA will lc aid ly iIc
govcrnncni
7|7|
.

27.18.3 TIc govcrnncni scrvani is allowcd io ialc ircaincni fron
rcfcrral/rccogniscd Iosiials undcr CCHS in cncrgcncy. Howcvcr, iIc icrn
'cncrgcncy' will lc dccidcd ly iIc Addiiional Dirccior, CCHS conccrncd wIciIcr
iIc casc is/was of rcal 'Encrgcncy' lcforc rcinlurscncni is nadc ly iIc arcni
dcarincni on iIc lasis of raics ficd ly iIc CCHS fron iinc io iinc.

27.18.4 E osi facio crnission for ircaincni in govcrnncni rcfcrral Iosiials lilc
PCI CIandigarI cic. can lc givcn ly iIc arcni dcarincni
8|8|
.

27.19 MedIcaI Advance -

TIc ncdical advancc io iIc scrving govcrnncni scrvani for sclf ircaincni
or ircaincni of iIc dccndcnis on rcccii of csiinaic fron iIc ircaiing docior of a
govcrnncni/rccogniscd Iosiial is availallc suljcci io iIc following condiiions.

i} Fs.10,000/- or iIc anouni rcconncndcd ly iIc docior, wIicIcvcr
is lcss for indoor ircaincni in Iosiial and for OPD ircaincni in
casc of TD/Canccr.

6|6|
OM No.S-11011/6/96-CCHS(P} daicd 11.6.1997
7|7|
OM No.S-11011/6/96-CCHS(P} daicd 11.7.97
8|8|
OM No.S-12020/4/97-CCHS(P} daicd 4.7.1999
ii} In casc of najor illncss lilc ly-ass urgcry, lidncy iranslani cic.,
iIc advancc nay lc liniicd io 90% of iIc aclagc dcal wIcrcvcr ii
cisis or iIc anouni dcnandcd ly iIc Iosiial conccrncd
9|9|
.
iii} TIc advancc is aid dirccily io iIc Iosiial conccrncd on rcccii of
an csiinaic.
iv} For sciilcncni of advancc, iIc cnloycc conccrncd nay lc rcquircd
io sulnii iIc adjusincni lills wiiIin a criod of onc noniI fron iIc
daic of Iis discIargc fron iIc Iosiial. In casc iIc cniirc advancc
Ias noi lccn uiiliscd for iIc ircaincni of iIc aiicni, iIc Icad of
officc conccrncd will corrcsond wiiI iIc Iosiial for rcfund of iIc
unuiiliscd lalancc of ncdical advancc
10|10|
.

27.20 SettIement oI CIaIm -

TIc govcrnncni scrvani is rcquircd io rcfcr clain/lill wiiIin 3 noniIs,
fron iIc daic of discIargc fron iIc Iosiial. If iIc clain gcis iinc larrcd,
rclaaiion of dclay is allowcd ly iIc dcarincni dccnding on iIc circunsianccs
of dclay.

27.20.1 TIc clain sIould Iavc iIc following docuncnis conlcicd.

a} Clain Forn Mcd. '97' and Esscniialiiy Ccriificaic 'A' for Ouidoor
ircaincni and 'D' for Indoor ircaincni.
l} All original lills vcrificd ly iIc ircaiing docior wiiI Iis sian.
c} PIoiocoy of CCHS Tolcn Card.
d} DiscIargc Sli of iIc Hosiial in casc of Indoor Trcaincni.
c} A dciailcd lisi of all ncdicincs, laloraiory icsis, invcsiigaiions,
nunlcr of dociors visiis cic.
f} Sclf clanaiory lciicr fron iIc lcncficiary claining iIc cncrgcncy
circunsianccs in casc of cncrgcncy.
g} Lcgal Icir ccriificaic in casc of dcaiI of iIc card Ioldcr.

27.20.2 Dascd on iIc raics ficd ly iIc CCHS, iIc adnissillc anouni is worlcd
oui ly iIc dcarincni. If iIc raics claincd ly iIc conccrncd arc lcss iIan iIc
raics ficd ly iIc govcrnncni, iIc aciual anouni is rcinlurscd. In casc CCHS
raics arc noi availallc for a ariicular iicn, iIc rcinlurscncni is allowcd on iIc
lasis of raic lisi of AIIMS. Incidcnially, wIcrc AIIMS raics arc also noi availallc,
iIc aciual anouni aid ly iIc aiicni is rcinlurscd. Iicns ncniioncd in iIc lisi
of inadnissillc iicns undcr CS(MA} Fulcs arc noi rcinlursallc. Sccial Nursing
CIargcs arc io lc rcinlurscd as ficd ly iIc Minisiry of HcaliI fron iinc io
iinc
11|11|
.


9|9|
OM No.S.12025/1/96-CCS(P} daicd.13.5.1997
10|10|
OM No.S.12015/3/93-CCHS(P} daicd 30.12.1993
11|11|
OM NO. S-11012/1/91-CCHS(P} (Vol.I} daicd 18.3.1992

27.20.3In normal cases, AO(A)/AO(E)/SsP upto the amount of Rs. 1000/-, DIsG upto the amount
of Rs. 5000/- and JDs upto the amount of Rs. 10000/- are empowered to accord sanction for
reimbursement. In other cases claims are submitted to DCBI through JDs concerned for
consideration.