DELHI DEVELOPMENT AUTHORITY. No. F.8(3)09-10/MC Dated OFFICE MEMORANDUM

Transcription

1 1 DELHI DEVELOPMENT AUTHORITY No. F.8(3)09-10/MC Dated OFFICE MEMORANDUM Sub: Empanelment of Hospitals and Diagnostic Centers under Delhi Development Authority for treatment and diagnostic procedures and fixation of package rates. Vice Chairman, DDA has been pleased to approve empanelment / reempanelment of the Hospitals in Delhi and NCR, for OPD and Indoor treatment of DDA employees, Pensioners and their dependents at the CGHS package rates and on the revised pattern of CGHS. The names and addresses of such Hospitals approved for empanelment (including those already empanelled vide O.M. No.F.8(3)09-10/MC/58 dated ) are given in Annexure A. Rest of the Hospitals empanelled vide O.M. No.F.8(3)09-10/MC/1272 dated 14,10,2009, F.8(3)09-10/MC/1944 dated and O.M. No.F.8(3)09-10/1545 dated have been withdrawn from the approved panel. Accordingly it is imperative that DDA should follow the CGHS rates and CGHS instructions from time to time for its working mutatis mutandis. 2. It is further clarified that: (a) Package Rate appearing in the CGHS Rate List shall mean and include lump sum cost of inpatient treatment / day care /diagnostic procedure for which the beneficiary has been admitted for treatment from the time of admission to the time of discharge including (but not limited to)

2 2 (i) Registration charges, (ii) Admission charges, (iii) Accommodation charges including patient's diet, (iv) Operation charges, (v) Injection charges, (vi) Dressing charges, (vii) Doctor /consultant visit charges, (viii) ICU / ICCU charges, (ix) Monitoring charges, (x) Transfusion charges,(xi) Anesthesia charges, (xii) Operation theatre charges, (xiii) Procedural charges / surgeon s fee, (xiv)cost of surgical disposables and all sundries used during hospitalization, (xv) Cost of medicines, (xvi) Related routine and essential investigations, (xvii) Physiotherapy charges etc. (xviii) Nursing care and charges for its services. (b) Cost of Implants/stents/grafts is reimbursable in addition to package rates as per CGHS ceiling rates for implants/stents/grafts or as per actual, in case there is no CGHS prescribed ceiling rates. (c) Treatment charges for new born baby are separately reimbursable in addition to delivery charges for mother. d) Hospitals empanelled under DDA shall not charge more than the package rates/ rates. (e) Expenses incurred on toiletries, cosmetics, telephone bills etc, are not reimbursable and are not included in package rates. 3. Package rates envisage duration of indoor treatment as follows: Upto 12 days: for Specialized (Super Specialties) treatment Upto 7 days : for other Major Surgeries Upto 3 days : for Laparoscopic surgeries/ normal Deliveries 1 day : for day care / Minor (OPD) surgeries. 4. However, if the beneficiary has to stay in the hospital for his/her recovery for period more than the period covered in the package rate, in

3 3 exceptional cases, supported by relevant medical records and certified as such by the hospital the additional reimbursement shall be limited to accommodation charges as per entitlement, investigations charges at approved rates and doctors visit charges (not more than 2 visits per day per visits by specialist/consultants) and cost of medicines for additional stay. 5. No additional charge on account of extended period of stay shall be allowed if that extension is due to infection on the consequences of surgical procedure or due to any improper procedure and is not justified as the same is as per terms & conditions of the empanelment of Hospitals with DDA. 6. However, there are certain procedures where there is no prescribed package rage under CGHS. Similarly there are medical emergencies where the treatment is mainly conservative. The admissible amount in such cases is calculated item wise, room rent, procedures, investigations etc. The revised rates of Room Rent for different type of category are as under: General ward Rs.1000/- per day. Semi-Private ward Rs.2000/- per day. Private ward Rs.3000/- per day. 7.(a) DDA beneficiaries are entitled to facilities of private, semi-private or general ward depending on their basic pay / pension. The entitlement of the ward is as follows:-

4 4 S.No. Basic Pay without the inclusion of grade Entitlement pay existing or at the time of retirement. 1. Upto Rs.13,950/- General Ward 2. Rs. 13,951/- to 19,530/- Semi-private ward 3. Rs.19,540 and above Private Ward b) The package rates given in rate list are for semi-private ward. c) It has now been decided that the DDA employees and pensioner beneficiaries taking treatment in the empanelled hospitals will be entitled for reimbursement after payment, as per the package rates/ rates of CGHS given on the web site at index.asp The package rates are for semi-private ward. If the beneficiary is entitled for general ward there will be a decrease of 10% in the rates; for private ward entitlement, there will be an increase of 15%. However, the rates shall be same for investigation irrespective of entitlement, whether the patient is admitted or not and the test, per-se, does not require admission to the Hospital. (d) A hospital empanelled under DDA whose normal rates for treatment procedure / test are lower than the CGHS prescribed rates shall charge as per the rates charged by them for that procedure/treatment from a non- DDA/CGHS beneficiary and will furnish a certificate to the effect that the rates charged form the DDA beneficiaries are not more than the rates charged by them from non-dda/cghs beneficiaries. 8.(a) Private ward is defined as a hospital room where single patient is accommodated and which has an attached toilet (lavatory and bath). The

5 5 room should have furnishings like wardrobe, dressing table, bed-side table, sofa set, carpet etc. as well as a bed for attendant. The room has to be airconditioned. (b) Semi Private ward is defined as a hospital room where two to three patients are accommodated and which has attached toilet facilities and necessary furnishings. (c) General ward is defined as halls that accommodate four to ten patients. (d) Normally the treatment in higher Category of accommodation than the entitled category is not permissible. However, in case of an emergency when the entitled category accommodation is not available, admission in the immediate higher category may be allowed till the entitled category accommodation becomes available. However, if a particular hospital does not have the ward as per entitlement of beneficiary, then the hospital can bill as per entitlement of the beneficiary even though the treatment was given in higher type of ward. 9. The beneficiary shall have the option of availing specific treatment/investigation from any of the empanelled hospital of his her choice (provided the hospital is empanelled for that treatment procedure/test) 10. The hospitals shall entertain the patient directly and provide the treatment on production of valid Medical Identity Cards issued by the DDA. 11. During in-patient treatment of the DDA beneficiary, the hospital will not ask the beneficiary or his / her attendant to purchase separately the medicines / sundries / equipment or accessories from outside and will

6 6 provide the treatment within the package rates fixed by the CGHS/DDA which includes the cost of all the items. 12. If one or more minor procedures form part of the major treatment procedure, then package charges would be permissible for major procedure and only at 50% of charges for minor procedure. 13. Any legal liability arising out of such services shall be the sole responsibility and shall be dealt hospital themselves. with by the concerned empanelled 14. Services will be provided by the Hospitals as per the terms of Agreement. 15. The hospitals will give a discount of 10% (Ten percent) on every cash payment charged from the beneficiaries. 16. The Hospitals which are non- at present will be allowed Non- rates. As and when they get Accreditation, rates will automatically be admissible/applicable in such cases. Similarly, Hospital getting Super-speciality status subsequently will automatically be allowed rates of the Super-speciality category. 17. Specialties covered under the Super-Speciality hospitals are Cardiology & Cardio-thoracic Surgery, Joint replacement surgery made under orthopaedics, Nephrology & Urology including renal transplantation, Endocrinology, Neurosurgery, Gastro-enterology & G.I. Surgery and Oncology. 18. This will supersede all earlier orders relating to empanelment of Hospitals for specialized and General purpose treatment for Delhi, Faridabad, Ghaziabad, Gurgaon, NOIDA areas etc. The empanelment of the lab/ Diagnostic Centre already done will, however, remain the same till further orders.

7 7 19. A copy of this Office Memorandum along with specimen copy of MOA (of CGHS) is placed on the internet at DDA s website dda.org.in 20. Cases not covered by the aforesaid guidelines will be regulated with the approval of F.M., DDA being the competent authority. For any clarification with regard to the above, orders of the Govt. of India Ministry of Health - CGHS on the subject may be referred to. (PAWAN KUMAR) CHIEF ACCOUNTS OFFICER (P.T.O)

8 8 Copy to : 1. OSD to Lt. Governor of Delhi; 2. OSD to VC, DDA; 3. OSD to FM, DDA; 4. PS to EM, DDA; 5. All Principal Commissioners; 6. Chief Vigilance Officer; 7. PS to CAO, DDA; 8. Chief Legal Advisor/ Chief Architect; 9. Commissioner-cum-Secretary; 10. All Commissioners; 11. All Chief Engineers; 12. FA(H)/Director(LC)/Director(IA)/Director(Finance)/Director(MM)/ Director(P)/Director(Works)/Director(W/C)/Director(Hort.)SE&N W; 13. All Dy.CAOs (HQ),Zones,Vig.,LC/Dy.FA(H)-I&II 14. Sr.AO (Contingency)/PAO(EW)/Sr.AO(PE); 15. Guard File 16. Notice Board Dy. CAO (F&E)/NMS

9 9 ANNEXURE A List of the Hospitals empanelled with DDA S.No Name & address of the Hospital Specialities/purpose for which empanelled 1. Mohan Eye Institute, Ganga Ram Hospital Marg, New Delhi. Eye Care Centre. Category- / /Super speciality , Jeewan Nursing Home & Hospital, 2- B Pusa Road, New Delhi , , , 48, Goyal Eye Institute, East Patel Nagar, New Delhi , Primus Super Speciality Hospital, Chankya Puri, New Delhi , , , Chief Councellor Bansal Hospital, A-1, New Friends Colony. New Delhi lines 6. Dr. Kapur s The Healing Touch Eye Centre, D-8, Vikas Puri, New Delhi General purpose Eye Care Centre Orthopedics Endoscopic surgery Eye Care Centre NON-

10 , Kukreja Hospital & Heart Centre Pvt. Ltd., C-1, Vishal Enclave, Rajouri Garden, New Delhi (30 Lines), Park Hospital, Meera Enclave (Chaukhandi), Near Keshopur Bus Depot, Out Ring Road, New Delhi , , , Chief Counselor Jeevan Anmol Hospital, Mayur Vihar Phase-I, Delhi , , Kukreja Hospital, D-36, Acharya Niketan, Mayur Vihar, Phase- I, Delhi , , Orthonova Hospital, C-5/29, S.D.A., Opp. Main IIT Gate, New Delhi Satya Medical Centre, A-98A, Sector- 34, NOIDA , Jain Hospital , Jagriti Enclave, Vikas Marg Ext., Delhi Cardiological Investigation, Endoscopic surgery & eye. General purpose including cardiology & cardiothoracic surgery. General purpose Endoscopic surgery Orthopaedics Arthroscopic and joint replacement surgery. Endoscopic surgery Neurology & Neurosurgery , , Sharp Eye Centre, 81, Defence Eye Care centre

11 11 Enclave, Vikas Marg, Delhi , , , Vision Eye Centre, 12/27, West Patel Nagar, Near Arya Samaj Mandir, New Delhi , Delhi Heart & Lungs Institute, 3-mm- II, Panchkuian Road, New Delhi , , Emergency Number Prakash Hospital, D-12, 12A & 12-B, Sector -33, NOIDA, G.B. Nagar, (UP) (30 lines) 18. Khandelwal Hospital & Urology Centre, B-16, Main Raod, East Krishna Nagar, Swaran Cinema Road, Delhi , , Sanjeevan Medical Centre(P)Ltd. 24, Ansari Road, Darya Ganj, New Delhi , , National Heart Institute, 49-50, Community Centre, East of Kailash, New Dlehi Eye Care centre Cardiology & Cardiothoracic surgery General purpose including joint replacement. Urology Urology including dialysis & lithotripsy Cardiology & Cardiovascular surgery , Help Line , Surbhi Hospital, Morna, Golf Course General Purpose.

12 12 Road, Sector-35, NOIDA. (120) , Jeewan Mala Hospital, 67/1,New Rohtak Raod, New Delhi , , to Bajaj Eye Care Centre, 101, Vikas Surya Plaza, Plot No.7, DDA Community Centre, Rod No.44, Pitam -pura, Delhi , , Chaudhary Eye Centre & Laser Vision, 4802, Bharat Ram Raod, Daryaganj, New Delhi , , Centre for Sight, B-5/24, Opp. Dear Park, Safdarjung Enclave, New Delhi , , Bhagwati Hospital, CS/OCF-6(Near Poular Apartment& Mother Dairy Booth) Sector-13, Rohini, Delhi , , , , Navneesh Dental Clinic, Unit No.2, Bdgum Zaidi Market, Motibagh Part I, New Delhi , Garg Hospital, 8-9, AGCR Enclave (Opp. Kakardooma Court) Delhi- General purpose including joint replacement Eye Care Centre Eye Care Centre Eye Care Centre Endoscopic surgery and eye care. Dental Clinic Endoscopic Surgery & Eye Care

13 , SMH Curie Cancer Centre, shanty Mukand Hospital # 2, Institutional Area, Vikas Marg Ext. Karkardooma, Delhi Dr. Patnaik s Laser Eye Institute, C-2, Ground Flloor, Lajpat Nagar-3, New Delhi , B.M. Gupta Nursing Home Pvt. Ltd. H-11 to 15, Uttam Nagar, New Delhi , , Bhatia Global Hospital & Endo- Surgery Institute, 305, 307 & , , , Chandra Laxmi Hospital, Sector-4, Plot No.337, Vaishali Ghaziabad , 84, Dharmshilla Cancer Hospital, Vasundhara Enclave, Delhi , Batra Hospital & Medical Research Centre, Tughlakabad Institutional Area, Mehauli Badarpur Raod, New Delhi , ,86 & 87 Cancer treatment Eye Care Centre General Purpose Endoscopic/Laparosco pic surgery in the filed of surgery, Urology, gynaecology, oncology and plastic surgery etc. Laparoscopic surgery. Cancer treatment Oncology Superspeciality rate for cancer Radiotherapy & Chemotherapy and procedures as per O.M All other

14 14 36 Kalra Hospital, Kirti Nagar, New Delhi Ph & Metro Heart Institute with Multispeciality, Sector-16A, Faridabad. Ph Sunder Lal Jain Hospital., Ashok Vihar Phase-III,Delhi Ph Sardana Eye Institute, Rajouri Garden, New Delhi Ph , & QRG Central Hospital,69, Sector- 20A, Near Neelam Flyover, Ajronda Chowk, Mathura road, Faridabad Contact No Ph. No , 310. Services offered at Rates. General purpose including cardiological investigations, cardiothoracic surgery and joint replacement. Cardiology & Cardiothoracic surgery and Pulmonary Function Test and all other facilities available at the hospital General Purpose and Cardiology & Cardiovascular Surgery and Orthopaedics Eye Care Centre Multi-speciality General Purpose and specialized purpse in Cardiology, cardiovascular & Cardio thoracic surgery, Gastroenterology & GI Surgery, Orthopedic surgery including joint replacement, & Arthroscopic surgery, Neurology & Neurosurgery, Oncology (Surgery & chemotherapy) {Pediatric & {Pediatric Surgery Endoscopic

15 Bharti Eye Foundation, 1/3, East Patel Nagar, New Delhi Ph. No , Visitech Eye Centre, R-13, Greater Kailash I, New Delhi , Umkal Healthcare Private Ltd., H block, Opp. Chancellor Club, Plaam Vihar Gurgaon, Max Super Specialty Hospital (East Block) ( A Unit of Devki Devi Foundation, 2- Press Enclave Road, Saket, New Delhi (Existing empanelment revised ) , , till 202, Duty Manage surgery & ENT. Eye care Centre Eye Care Centre Cardiology, Cardiovascular & Cardiothoracic surgery, endoscopic surgery and Medicine, Nephrology, Gastroenterology, Endoscopy, colonoscopy, ERCP, Critical Care, spinesurgery & joint replacement, Neonatology, Diagnostic Services; CT Scan, NCV studies, EEG Bronchoscopy, dialysis & Executive Health checkups. (i)cardiology, Cardiac Thoracic & Cardiovascular Surgeries (ii) ICU/CCU Procedures (Special care cases) (iii)nephrology & Urology (iv)nuclear Medicine (a)radio Isotope rates of CGHS Super Speciality Rates of CGHS

16 Max Super Specialty Hospital (West Block) ( A Unit of Max Healthcare Institute Ltd. 1- Press Enclave Road, Saket, New Delhi , 6666, 4444, 5077, 4577, Max Super Speciality Hospital (A Unit of Balaji Medical Diagnostic Research Centre, 108 A, I.P. Ext. Patparganj, New Delhi , 30800, Duty Manager , Therapy (b)linear Accelerator (c)brachytherapy- High Dose Radiation (d)chemotherapy (v)nephrological procedures i)orthopedic & Joint Replacement (ii) ICU/CCU Procedures (Special care cases) (iii)nephrology & Urology (iv)neurosurgery (v)gastroenterology (vi)nephrological procedures i)cardiology, Cardiac Thoracic & Cardiovascular Surgeries, Orthopedic & Joint Replacement. ii) ICU/CCU Procedures (Special care cases) (iii)nephrology & Urology (iv)neurosurgery (v)nuclear Medicine (a) Radio Isotope Therapy (b)linear Accelerator (c)brachytherapy- High dose radiation. (d)chemotherapy. (vi) Gastroenterology Rates of CGHS Super Speciality Rates of CGHS Rates of CGHS Super Speciality rates of CGHS

17 17 (vii)nephrological procedures 47. Max Hospitals ( A Unit of Max Healthcare Institute Ltd. Near TV Tower, Pitampura Wazirpur Distt. Centre, New Delhi (Existing empanelment revised ) , , to 202, Duty Manager i)orthopedic & Joint Replacement. (ii) ICU/CCU Procedures (Special care cases) (iii)nephrology & Urology (iv)neurosurgery (v) Gastroenterology (vi)nephrological procedures Rates of CGHS Super Speciality rates of CGHS 48 Max Hospitals ( A unit of ALPS Hospitals Ltd.), Sushantlok Phase-I Gurgaon, Haryana. (Existing empanelment revised ) , Flt. Lt. Rajan Dhall Charitable Trust, Sec.-B, Pocket -1, Aruna Asaf Ari Marg, Vasant Kunj, new Delhi , i)orthopedic & Joint Replacement. (ii) ICU/CCU Procedures (Special care cases) (iii)nephrology & Urology (iv)neurosurgery (v) Gastroenterology (vi)nephrological procedures 1. Cadiology & Cardiothoracic Surgery and Orthopedics 1. Neurosciences (Neurology & Neuro-surgery 2. Gastroenterolo gy(including G.I. Surgery) 3. Oncology NON- Rates of CGHS Super Speciality Rate of CGHS Rates of CGHS Super speciality Rates of CGHS

18 18 50 Escort Heart Institute & Research Centre Ltd., Okhla Road, New Delhi (Existing empanelment revised ) , Emergency Number Fortis International Hospital, B-22, Sector-62, Noida , Escort Hospital & Research Centre Ltd. Neelam Bata Road, Faridabad (Existing empanelment revised ) (Onco-surgery, medical Oncology & Radiation Therapy) 4. Urology (including Kidney transplant) 1. Cadiology & Cardiothoracic Surgery 2. Orthopedics 1. Cadiology & Cardiothoracic Surgery 2. Orthopedics 3. Neurosciences (Neurology & Neuro-surgery 4. Gastroenterolo gy(including G.I. Surgery) 5. Oncology (Onco-surgery, medical Oncology & Radiation Therapy) 6. Urology (including Kidney transplant) 1. General Purpose including Cardiological Investigation, Cardio-thoracic Rates of CGHS Rates of CGHS Super speciality Rates of CGHS Rates of CGHS

19 surgery and Joint Replacement. 2. Neurosciences (Neurology & Neuro-surgery Super Speciality rates. 53. Fortis Hospital, Shalimar Bagh, New Delhi , Cadiology & Cardiothoracic Surgery 2. Orthopedics rates of CGHS 54. Fortis R.B. Seth Jessa Ram Hospital, WEA, Karol Bagh, New Delhi , Emergency Neurosciences (Neurology & Neuro-surgery) 2. Gastroenterolo gy (including surgery) 3. Orthopedics 4. All other existing specialities. Non Rates CGHS of 55. Indraprastha Hospital, Okhla, Sarita Vihar, Delhi Mathura Raod, New Delhi , , Moolchand Medicity, Lajpat Nagar III, New Delhi-24. Cardiology, Cardiac Surgery, Cardio- Thoracic & Vascular Surgery, Joint Replacement, Organ Transplant (Renal & Liver transplant), all radiological investigations, Nuclear Medicine, Radiation Therapy, Laparoscopic Surgery, Urology, Lithotripsy and Dialysis. Cardiology & Cardio Thoracic Surgery, Joint Replacement Super Speciality Rates

20 surgery, Ophthalmic Surgeries, ENT, Nephrology, Medical Oncology at Category rates. NOTE: The Hospitals at S.No.44 to 56 were empanelled vide office Memorandum No.F.8(3)09-10/MC/38 dated (PAWAN KUMAR) CHIEF ACCOUNTS OFFICER

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