Rules, Rights & Rites -193
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Decentralisation of Approval Procedure for Selected STC-Related Cases Under CGHS
• The guidelines apply to five specific categories: Category-1 (transplant cases with notified rates), Category-2 (listed procedures/devices such as TAVI, DBS, cochlear implants, CPAP, BIPAP, oxygen concentrators, and CSII pumps), Category-3 (STC-restricted medicines listed on the website), Category-4 (unlisted procedures, devices, and treatments), and Category-5 (robotic surgery for cancer cases).
• No separate referral, permission, or endorsement is needed for treatments received at AIIMS, Institutions of National Importance, Tata Memorial Hospital, or any Central/State Government medical institution.
• Approval for cases under Categories 1 to 5 will be granted by the concerned Additional Director (AD), CGHS, within delegated financial powers.
• Approvals require either the recommendation/prescription of one Government Specialist from a designated government/national institution or recommendations from two specialists of the concerned specialty from two different CGHS-empanelled hospitals.
• Every case must be examined by a three-member Local Technical Committee, headed by the Additional Director and including two GDMOs (preferably with Medicine/Surgery background).
• STC-restricted medicines must be verified against the approved indications and regulatory status set by the Central Drugs Standard Control Organisation (CDSCO).
• Document deficiencies must ordinarily be communicated within 3 working days, and complete cases must be decided within 15 working days upon receiving all required documents.
• Cases not falling under the specified categories or exceeding the financial delegation of the Additional Director must be referred directly to the CGHS Directorate.
• Post-facto approvals may be granted in emergency or unavoidable circumstances where prior permission was not feasible, subject to strict technical committee scrutiny rather than automatic entitlement.
• All previous Office Memoranda requiring case evaluation by the Standing Technical Committee (STC) are superseded and subsumed by this order.
(MOH & FW OM No.: 56-1/2026-27/CGHS/MSD/ Date: 01.09.2026)
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