Clarification regarding issue of medicines under CGHS

No. 2-2/2014/CGHS(HQ)/PPTY / CGHS(P)
Government of India
Ministry of Health & Family Welfare
Department of Health & Family Welfare
Nirman Bhawan, Maulana Azad Road
New Delhi 110 108

Dated: the 23rd December, 2014

OFFICE MEMORANDUM

With reference to the above mentioned subject the undersigned is directed to state that the situation arising out of issue of Office Memorandum No 2/2014/CGHS(HQ)/PPTY / CGHS(P) dated the 25th August ,2014 has been engaging the attention of Government for quite some time. Various representations about the difficulties being encountered have been received from different stakeholders i.e., beneficiaries and doctors, necessitating a review of the matter. It was accordingly considered by a Committee under the Chairmanship of AS&DG,CGHS. After careful review and keeping the recommendations of the Committee in mind, the following guidelines are issued to streamline the functioning of the Wellness Centres:

i. The medicines are to be issued as per the CGHS Formulary and guidelines issued by this Ministry in this behalf.

ii. In case the prescribed medicines are not available in CGHS formulary, but are essential for the treatment of the patient, they can be issued / indented by the doctors of the CGHS Wellness Centre on the basis of a valid prescription of the authorized specialist subject to the condition that such medicines are neither dietary supplements/ food items nor banned drugs. Instructions on this issue i.e., non-admissibility of food items etc. issued vide O.M .No. 39-3/2003-04/CGHS/MSD/RS dated 23rd July 2009 and 3rd August 2009 must be followed.

iii. In case of anti-cancer drugs and other life-saving drugs that are not approved by the DCG1 for use in India, each case should be considered by the Expert Committee under the Chairmanship of Special DG(DGHS).

iv. The technical Standing Committee constituted vide 2-2/2014/CGHS(HQ)/PPTY / CGHS(P) dated 27.08.2014 of this Ministry will review addition or deletion of drugs in the CGHS Formulary/ list of Treatment procedures / investigations / listed implants. The Technical Committee will meet once in three months or as per need, whichever is earlier. In the meantime reimbursement for unlisted procedures / implants will be made at the rates approved by AIIMS/GB Pant Hospital / actuals, whichever is less.

2. The O.M. of even number dated 25.08.2014 is superseded to the above extent while O.M. of even number dated 1.10.2014 is withdrawn.

Sd/-

(Bindu Tiwari)
Director, CGHS(P)
(Tel 2306 1831)