**Executive Summary:**
The document addresses a Lok Sabha question regarding budgetary expenditure and functioning of the Central Government Health Scheme (CGHS). It provides details on annual expenditure, beneficiary numbers, initiatives to improve CGHS, medicine procurement and distribution procedures, and IT advancements. The response outlines the government's commitment to strengthening CGHS for eligible beneficiaries.
**Key Points / Main Content:**
* **CGHS Overview:**
* CGHS is a subscription-based medical scheme for Central Government employees, pensioners, and other eligible beneficiaries.
* The scheme aims to provide comprehensive healthcare.
* CGHS is funded through Grant-in-Aid from the Ministry of Health & Family Welfare.
* **Expenditure and Beneficiaries:**
* Annual expenditure and number of beneficiaries for the past five years:
* 2019-20: ₹3966.19 crores, 33,57,675 beneficiaries
* 2020-21: ₹4236.86 crores, 36,11,596 beneficiaries
* 2021-22: ₹4368.02 crores, 38,45,168 beneficiaries
* 2022-23: ₹6419.89 crores, 41,61,524 beneficiaries
* 2023-24: ₹6109.82 crores, 44,50,343 beneficiaries
* **Initiatives to Improve CGHS:**
* Expansion of CGHS Wellness Centers.
* Empanelment of private hospitals and diagnostic centers.
* Digitization initiatives: online appointments, teleconsultation.
* Telemedicine services via platforms like e-Sanjeevani.
* **Medicine Procurement and Distribution:**
* Routine Medicines: Procured from MSOGMSD via CGHS MSDs; Jan Aushadhi medicines sourced under PMJAYK.
* Delhi NCR Schedule: MSO drugs supplied to Wellness Centers every 35 days.
* Restricted Medicines: Supplied directly by MSD Delhi or through nodal centers on specialist prescription.
* Supply Timelines (Restricted Medicines): Next working day in Delhi, 3-4 working days in NCR (potential delays).
* Unavailable specialist-prescribed medicines are to be supplied by Authorized Local Chemists within 48 hours, subject to penalty for delays.
* **IT Advancements:**
* Electronic Medical Records (EMR) for beneficiaries.
* Medicine tracking feature.
* Online payment gateway for CGHS contributions for pensioners.
* MyCGHS 2.0 mobile app: real-time queue status, medicine tracking, online appointments, online card generation.
**Impact Analysis**
* **CGHS Beneficiaries:**
* *Impact:* Increased access to healthcare through expanded facilities, empanelled centers, and telemedicine. Improved convenience via online services and mobile app.
* *Action Required:* Utilize online platforms for appointments, medicine tracking, and accessing medical records.
* **CGHS Wellness Centers:**
* *Impact:* Responsible for procuring and distributing medicines according to prescribed procedures and timelines. Must manage medicine inventory and coordinate with suppliers.
* *Action Required:* Adhere to procurement timelines, manage medicine distribution efficiently, and update beneficiaries on medicine availability.
* **Ministry of Health and Family Welfare:**
* *Impact:* Responsible for funding, overseeing, and improving the CGHS scheme.
* *Action Required:* Continue to monitor expenditure, implement improvement initiatives, and address beneficiary complaints.
Key Entities Referenced
eSanjeevani: A digital platform used to provide telemedicine services under the CGHS scheme.
Jan Aushadhi: Medicines sourced under Pradhan Mantri Jan Aushadhi Yojana Kendra (PMJAYK) based on monthly demands sent by Wellness Centres.
Delhi NCR: The National Capital Region, where specific medicine supply schedules are implemented for CGHS Wellness Centres.
Central Government Health Scheme (CGHS): A subscription-based medical scheme for Central Government employees and pensioners, also providing healthcare facilities to Members of Parliament, judges, and freedom fighters.
Ministry of Health and Family Welfare: The government ministry responsible for health and family welfare policies and programs in India; the CGHS is funded through Grant-in-Aid from this ministry.
Direct Benefit Transfer: A potential alternative to the current CGHS system, under consideration by the Government.
Integrated Health Insurance Model: A potential alternative to the current CGHS system, under consideration by the Government.
Digital Prescription Network: A potential alternative to the current CGHS system, under consideration by the Government.
GOVERNMENTOFINDIA
MINISTRYOFHEALTH AND FAMILYWELFARE
DEPARTMENTOFHEALTH AND FAMILYWELFARE
LOK SABHA
UNSTARREDQUESTION NO. 2263
TO BE ANSWERED ON01STAUGUST, 2025
BUDGETARYEXPENDITURE UNDER CGHS SCHEME
†2263.SHRIASHOKKUMAR YADAV:
Will the Ministerof HEALTH AND FAMILYWELFAREbe pleasedtostate:
(a) whether a substantial amount of budgetary expenditure is incurred by the Government under
the CGHS scheme everyyear;
(b) if so, the annual expenditure incurred on CGHS and the number of beneficiaries thereof
during the last five years(2019-20 to2023-24), year-wise;
(c) whether the Government considers that CGHS is functioning at an expected level as a
healthcareservice providerat present, if so, the detailsthereof;
(d) the present structure for the distribution of generic and branded drugs through CGHS
dispensaries;
(e) the reasons behind the complaints received from beneficiaries regarding non-availability of
drugs regularly;
(f) whether any proposals toimprove the CGHS system or to explore alternatives (such as Direct
Benefit Transfer, Integrated Health Insurance Model or Digital Prescription Network) are under
considerationby the Government; and
(g) if so, the salient featuresof these proposals alongwith theircurrent status thereof?
ANSWER
THE MINISTER OFSTATE IN THE MINISTRYOFHEALTH AND
FAMILYWELFARE
(SHRIPRATAPRAO JADHAV)
(a)to(g): Central Government Health Scheme is a subscription based Medical Scheme for
the Central Government employees and pensioners. The scheme also provides healthcare
facilities to Hon’ble Members of Parliament, former Members of Parliament, sitting and retired
Judges of Supreme Court of India, former Judges of High Courts, Freedom fighters etc. The
CGHS is functioning satisfactorily and is continuously being strengthened to provide
comprehensive healthcare to eligible beneficiaries. The Government has undertaken several
initiativestoimprove the efficiencyandreach of CGHS. These include:
(i) Expansion of CGHS WellnessCentrestomore citiesacross the country.(ii) Empanelment of private hospitals and diagnostic centres to increase access to specialized
care.
(iii) Implementation of digitization initiatives such as online appointment booking,
tele-consultationservices.
(iv)Introduction of telemedicine services through digital platforms like e-sanjeevani,
enablingremote access tohealthcare.
CGHS is funded through Grant-in-Aid from the Ministry of Health & Family Welfare. The
details of annual expenditure incurred under CGHS and the number of beneficiaries during the
last five yearsare asfollows:
Actual No. of
Financial
Expenditure Beneficiaries
year
( incrores)
2019-20 3966.19 33,57,675
2020-21 4236.86 36,11,596
2021-22 4368.02 38,45,168
2022-23 6419.89 41,61,524
2023-24 6109.82 44,50,343
The Government has prescribed time-bound procedures for the procurement and
distribution of medicinesthrough CGHS WellnessCentres. The detailsare asfollows:
(i) Routine Medicines: CGHS Wellness Centres procure routine medicines from
MSO/GMSD via CGHS MSDs. Jan Aushadhi medicines are separately sourced under
PMJAYK based onmonthlydemandsent byWellnessCentrestothe respective AD zone.
(ii) Delhi-NCR Schedule: In Delhi-NCR, MSOdrugs are supplied toWellness Centresevery
35daysaspera fixedschedule shared with AD zonesandcentres.
(iii) Restricted Medicines: Procured on specialist prescription, these are supplied
directlybyMSDDelhi for Delhi beneficiaries andthrough nodal centresfor NCR.
(iv)Supply Timelines for Restricted Medicines: Such medicines are usually delivered next
working dayinDelhi andwithin 3–4working daysinNCR, thoughdelaysmayoccurdue
tosupply chainissues.
(v) Available medicines are dispensed the same day, while unavailable specialist-prescribed
medicines are indented through Authorized Local Chemists, who must supply them
within 48hours, failingwhich a penalty isimposed asperMemorandum of agreement.
The Ministry has undertaken the task of leveraging the use of Information Technology to
improve the service delivery. The website features include; availability of Electronic Medical
Records (EMR) for beneficiaries, Medicine tracking feature, integration with payment gateway
for online payment of CGHS Contribution for Pensioners. Additionally, the new mobile
application, MyCGHS 2.0, offers the same user-friendly functionalities such as real time Que
Status on visit at CGHS Wellness Centre, medicinetracking, online appointmentscheduling, and
online cardgeneration asa soft copyfollowing due process.
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