Timelines for settlement of MRC of Pensioner CGHS beneficiaries
Government of India
Ministry of Health and Family Welfare
Department of Health & Family Welfare
Directorate General of CGHS
Office of the Director, CGHS
No: Z.15025/38/2018 /DIR/CGHS
545-A Nirman Bhawan, New Delhi
Dated the 14th May, 2018
OFFICE MEMORANDUM
Subject :- Prescription of Timelines under CGHS for settlement of Medical claims of Pensioner CGHS beneficiaries
With reference to the above subject the undersigned is directed to draw attention to the OM No Z 15025/79/1/DIR/CGHS dated the 5th October 2016 and to state that it has now been decided to review the timelines prescribed for processing and settlement of medical claims of pensioner CGHS beneficiaries in compliance of the directions of Honble Supreme Court of India in their Judgement in the WP(Civil) No 694 of 2015 between Shiva Kant Jha Vs UOI delivered on 13th April 2018 and in supersession of the earlier guidelines as per the details given under:
Medical Claims not requiring Special approvals
Pensioner CGHS beneficiaries shall submit the Medical claims to the CMO I/C of the CGHS Wellness Centre , where the CGHS Card is enrolled . CMO 1/C of CGHS Wellness Centre issues Serial Number and sends the claim papers to the office of the Addl. Director, CGHS for processing. The Bills shall be processed by the Dealing Asstants and CMO and after the approval by the Additional Director, the bill for payment shall be sent to the Pay & Accounts Office for payment to the beneficiary by ECS. The payment shall be completed within 30 days of submission of the Medical claim papers at the CGHS Wellness Centre.
Medical claims requiring approval of higher authorities
Total time within   45 days in Delhi
Total time within   60 days in other cities
Medical claims requiring opinion of specialists
Total time       45 days
2. Chief Medical Officer in charge shall thoroughly check the papers initially for the completeness of the requisite documents before accepting the claim papers to ensure that the claim papers are not returned subsequently fo want of some documents.
3.  If approval of Directorate or Ministry is involved, the Addl. Directors shall submit only e-file with self-contained note and recommendation, enclosing only relevant scanned documents. Care shall be taken not to regret medical claims of pensioner CGHS beneficiaries on minor technical objections if , they fall under procedural lapses, which can be condoned.
Small Family Norms in House Building Advance Rules-2017 as per the 7th Central Pay Commission Recommendation
Government of India (Bharat Sarkar)
Ministry of Railway (Rail Mantralaya)
(Railway Board)
PC-VII No.:102/2018
RBE No.63/2018
New Delhi, Dated 27-04-2018
No.F(E)Spl./2008/ADV.3/6 (7th CPC)
The General Managers and PFAs
All Indian Railways & Production Units
(As per Standard List)
Subject: Small Family Norms in House Building Advance Rules-2017 as per the 7th Central Pay Commission Recommendations.
A copy of Ministry of Housing & Urban Affairs (Housing-III section)’s OM No.I.17011/11(4)/2016-H-III dated 31.01.2018 pertaining to small family norms in HBA rules-2017 is sent herewith for applying mutatis-mutandis to Railway Employees. As per the said OM, interest rebate avaliable to HBA beneficiaries for promoting small family norms shall cease to exist with effect from 01.07.2017. Ministry of finance’s OM dated 07.07.2017 cited in the aforesaid MoH&UA’s OM dated 31.01.2018 has already been circulated by pay commission directorate vide Board’s letter No.PC-V/2017/A/FPA/1 dated 28.07.2017 (RBE No.77/2017)
Encl: as above
(G.Priya Sudarsan)
Joint Director Finance (Estt.)
Railway Board
Eligibility of Permanently Disabled Unmarried Son of a CGHS Beneficiary to avail CGHS facility
No.4-24/96-C&P/CGHS(P)/EHS
Government of India
Ministry of Health & Family Welfare
Department of Health & Family Welfare
EHS Section
Nirman Bhawan, New Delhi
Dated: the 7th May, 2018
OFFICE MEMORANDUM
Subject: Eligibility of Permanently Disabled Unmarried Son of a CGHS Beneficiary to avail CGHS facility – Reg.
The undersigned is directed to refer to this Ministry’s Office Memoranda of even number dated 31.05.2007, 29.08.2007 and 02.08.2010 vide which the entitlement of the son of a CGHS beneficiary beyond the age of 25 years was conveyed. As per the two Office Memoranda under reference, it was indicated that an unmarried son of a CGHS beneficiary suffering from any permanent disability of any kind (physical or mental) will be entitled to CGHS facility even after attaining the age of 25 years.
2. Since then this Ministry is in receipt of several representations for inclusion of more conditions in view of modification to the PwD Act, 1995 by “The Rights of Persons with Disabilities Act, 2016 (Act No. 49 of 2016)” as notified by Mlo Law and Justice, Govt. of India on 27.12.2016. The matter has been reviewed by the Ministry and it is now decided that for the purpose of extending the CGHS benefits to dependent unmarried son of CGHS beneficiary beyond 25 years of age , the definition of `Permanent Disability’ shall include the following conditions :
I. Physical disability:
A. Locomotor disability including
a) Leprosy cured person- suffering from loss of sensation in hands or feet as well as loss of sensation and paresis in the eye and eye-lid but with no manifest deformity or suffering from manifest deformity and paresis or having extreme physical deformity as well as advanced age which prevents him/her from gainful occupation
b) Cerebral palsy – caused by damage to one or more specific areas of the brain usually occurring before, during or immediately after birth.
c) Dwarfism- a medical genetic. condition resulting in an adult height of 147 ems or less;
d) Muscular dystrophy- a. group of hereditary genetic muscle diseases characterized by progressive skeletal muscle weakness
e) Acid attack victims – disfigured due to violent assaults by throwing acid or similar corrosive substance
B. Visual impairment:
a) Blindness- where a person has any of the following conditions after best correction:
(i) Total absence of sight or
(ii) Visual acuity less than 3/60 or less than 10/200(Snellen) in the better eye with best possible correction
(iii) Limitation of field of vision subtending an angle of less than 10 degree
b) “Low vision” means any of the following conditions:
(i) visual acuity not exceeding 6/18 or less th.an20/60 upto 3/60 upto 10/200 (Snellen) in the better eye with best possible corrections; or
(ii) limitation of the field of vision subtending an angle of less than 40 degree up to 10 degree
C. Hearing Impairment
(a) “deaf’ means persons having 70 db hearing loss in speech frequencies in both ears;
(b) “hard of hearing” means persons having 60 db to 70 db hearing loss in speech frequencies in both ears;
D. “Speech and Language disability” permanent disability arising out of conditions such as Laryngectomy or aphasia affecting one or more components of speech and language due to organic or neuronal causes.
II. Intellectual disability- characterized by significant limitation both in intellectual functioning (reasoning, learning, problem solving) and in adaptive behavior , which cover a range of every day, social and practical skills , including-, social and practical skills , including
(a) “Specific language disabilities” – a heterogeneous group of conditions wherein there is deficit in processing language, spoken or written, that may manifest itself as a difficulty to comprehend., speak, read, write, spell, or to do the mathematical calculations and includes conditions such as perceptual disabilities, dyslexia, dysgraphia, dyscalculia, dyspraxia and developmental aphasia.
(b) “Autism spectrum disorder” –– a neuro-developmental disorder typically appearing uz the first three years of life that significantly affects a person’s ability to communicate, understand relationships and relate to others, and frequently associated with unusual or stereotypical rituals or behaviour.
III. Mental behaviour
“Mental illness”- a substantial disorder of thinking, mood, perception, orientation or memory that grossly impairs judgement, behaviour, capacity to recognize reality or ability to meet the ordinary demands of life, but does not include retardation.
IV. Mental Retardation
V. Disability caused due to
(a) Chronic neurological conditions such as
(i) Multiple Sclerosis
(ii) Parkinson’s disease
(b) Blood disorder
{i) Haemophila
(ii) Thalassemia
(iii) Sickle Cell Disease
VI. Multiple Disabilities ( more than one of the above disabilities)- including deaf blindness
3. Bench Mark Disability- unmarried permanently disabled and financially dependent sons of CGHS beneficiaries suffering 40% or more of one or more disabilities as certified by a Medical Board shall be eligible to avail CGHS facilities even after attaining the age of 25 years.
4. This OM will be effective from the date of its issue.
(Rajeev Attri)
Under Secretary to the Govt. of India