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CGHS : Constitution of High Powered Committee for Grievance redressal of CGHS beneficiaries pertaining to medical claims.

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CGHS : Constitution of High Powered Committee for Grievance redressal of CGHS beneficiaries pertaining to medical claims.

भारत सरकार के स्वास्थ्य एवं परिवार कल्याण मंत्रालय ने माननीय सर्वोच्च न्यायालय के निर्देशानुसार सीजीएचएस लाभार्थियों के दावों से सम्बन्धित विवादों के निबटारे हेतु एक उच्चाधिकार प्राप्त समिति के गठन हेतु सक्षम प्राधिकारी की अनुमति प्रदान कर ​दी। यह उच्चाधिकार प्राप्त समिति सिर्फ मान्य सीजीएचएस कार्डधारियों के विवादों का ही निबटारा करेगी।


 Government of India
Ministry of Health and Family Welfare
Department of Health & Family Welfare
EHS Section 

No: Z.15025/38/2018/DIR/CGHS/EHS
Nirman Bhawan, New Delhi
Dated the 22nd May, 2018

OFFICE MEMORANDUM

Subject: - Constitution of High Powered Committee for Grievance redressal of CGHS beneficiaries pertaining to medical claims

With reference to the above mentioned subject the undersigned is directed to convey the approval of competent authority for Constitution of a High Powered Committee for Grievance redressal of CGHS beneficiaries pertaining to their medical claims in compliance of the directions of Hon’ble Supreme Court of India in their Judgement in the WP (Civil) No. 694 of 2015 filed by Sh. Shiva Kant Jha Vs UoI delivered on 13th April 2018 as per the details given under:

i. Special Director General ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Chairperson
ii. Directorate General, CGHS or his nominee ... ... ... ... ... ... ... ... ... ..Member
iii. Additional Director , CGHS(HQ)/ Addl. DDG(HQ), CGHS ... ... ...Member
iv. Addl. Director, CGHS(R&H) ... ... ... ... ... ... ... ... ... ... ... .. ... ... ...  Member Secretary
v. One Government Specialist 
(of concerned Speciality) ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... .. Member


2. The High Powered Committee shall however, consider the representations of only those CGHS beneficiaries having a valid CGHS Card.

3. High Powered Committee shall meet once in a month and action on the decisions taken shall be completed within seven days of meeting, with the concurrence of the IF D, wherever, it is deemed necessary.

4. The High Powered Committee shall consider the grievances pertaining to the settlement of medical claims of CGHS beneficiaries holding a valid CGHS card at the time of treatment and to examine the requests pertaining to approval of reimbursement under the following conditions: 

a) Settlement of medical claims in relaxation of rules 
b) Approval for air-fare with or without attendant on the advice of treating doctor for treatment in another city even though he/she is not eligible for air travel treatment facilities are available in city of residence 
c) Representations from CGHS beneficiaries seeking full reimbursements under special Circumstances, which are not notified.

Sd/-
(Rajeev Attri)
Under Secretary to Government of India
Tel: 011- 2306 1883


Source: click here to view/download signed pdf
[http://cghs.gov.in/showfile.php?lid=4996]
 
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