C. G. Employees and their dependents can avail treatment in a non empanelled Private hospitals in emergency conditions and get reimbursement

(G.I MH OM No. F. No. S. 14025/14/2012-MS, dated 11.06.2013)

Revision of rates for reimbursement of medical expenses incurred in emergency conditions under CS (MA) Rules, 1944 

The undersigned is directed to state that the issue of revision of rates for reimbursement of medical expenses incurred on availing medical treatment in emergency conditions under CS (MA) Rules, 1944, when treatment is taken in a non-empanelled private hospital, has been under consideration of the Government for some time. 

2. It has now been decided that, reimbursement of medical expenses incurred by a Central Government employee covered under CS(MA) Rules, 1944 on availing medical treatment for himself and his dependent family members in emergency conditions, would be allowed as per the prevailing non –NABH CGHS rates as applicable to a CGHS covered city and non-NABH rates applicable to the nearest CGHS covered city in case of non-CGHS city, as the case may be, or the actuals, whichever is less. 

3. For the medical treatment in such cases where package rates are prescribed under CGHS, the non-NABH rates of the CGHS covered city and non-NABH rates of the nearest CGHS city (in case of non-CGHS covered city) or the actuals, whichever is less, will be applicable. 

4. This OM supersedes all earlier orders issued from time to time under CS (MA) Rules, 1944 on this subject for allowing reimbursement of medical expenses in emergency conditions when treatment is taken in a non-empanelled private hospital. 

5. This OM will come into effect from the date of issue. 

6. This issue with the concurrence of the Integrated Finance Division vide their Dy. No. C-282, dated 22.05.2013.