Employees, pensioners, and family pensioners of the Government of West Bengal, along with AIS officers and pensioners who served the state, are entitled to medical treatment under the West Bengal Health Scheme (WBHS). Chittaranjan National Cancer Institute (CNCI), Newtown, is now offering cashless treatment facility to WBHS beneficiaries under specified terms and conditions.
Hospital Designation
- Special Category: CNCI, Newtown is classified as a Special Category of Govt. Aided Hospital.
- Code: 0310014 under WBHS.
Cashless Treatment Facility and Charges
- Tariff: CNCI shall charge 100% of the Tariff listed in Annexure-I for specific procedures/investigations.
- OPD and IPD: OPD treatment is on a cash basis; IPD treatment is cashless up to Rs. 2 lakh per treatment.
- Beds: Two bed categories – General Bed and Private (Cabin) Bed.
Also Read: WBHS Cashless Limit Increased
Bed Entitlement
- Private (Cabin) Bed: For employees with Basic Salary > Rs. 150000/- p.m. and pensioners with Basic Pension > Rs. 75000/- p.m.
- General Bed: For all other employees and pensioners.
- Critical Beds: ICU/ITU, Day Care, HDU, Isolation Bed available for all beneficiaries regardless of entitlement.
- Day Care Treatment: Minimum hospitalization period is 1 hour.
Medicines and Consumables
- Supply: CNCI to supply all medicines as per their pricing policy during IPD treatment.
- High Value Drugs: Beneficiaries may provide non-available high-value imported chemo/immunotherapy drugs with proper requisition and approval.
Additional Charges
- Higher Bed Choice: If a higher category bed is chosen, the excess cost must be borne by the employee/pensioner and is non-reimbursable.
- Inadmissible Items: Costs of inadmissible items are to be borne by the beneficiary.
Cost Exceeding Limits
- Treatment Cost > Rs. 5 lakh: Requires notification to WBHSA with a prognosis report for further treatment permission.
- Limited/Nil Prognosis: Only bed rent covered if prognosis is limited or nil; other costs borne by the beneficiary.
Also Read: Updated Guidelines for WBHS Enrollment and Claim Processing
Approval and Reimbursement
- Chemotherapy/Immunotherapy: Prior permission required if therapy per cycle exceeds Rs. 50,000/-, with justification from the treating oncologist.
- Investigation Charges: Beneficiaries can get cancer treatment investigations reimbursed on a cash basis if prescribed by an oncologist from another recognized/empanelled hospital.
Special Provisions
- Disposables/Cosumables: Ceiling limit from order no. 11253-F(MED), dated 16.12.2011, not applicable to CNCI.
- Cost Recovery: Hospital can recover inadmissible component costs as per order no. 6586-F(MED), dated 29.06.2019.
Dead Body Release
- Immediate Release: Hospital will release the body immediately post-death. Unsettled dues are to be sent to the Medical Cell of the Finance Department for clearance.
Validity Of Cashless Treatment Facility At CNCI
- Cashless Treatment Facility Start Date: 01.08.2023
- Validity Period: Until 31.03.2027.
Tariff Exclusivity
- Applicability: CNCI Tariff is exclusive to CNCI, Newtown and not applicable to other WBHS empanelled hospitals.
Also Read: WBHS Cashless Hospital List
Official Order
Government of West Bengal
Medical Cell, Finance Department
2nd Floor, Old Khadya Bhavan
Kolkata-700087
No.119-F(MED)WB ——————————————————————– Dated :31/07/2023
NOTIFICATION
Sub: Introduction of cashless facility at Chittaranjan National Cancer Institute, Newtown under West Bengal Health Scheme
Employees / Pensioners / Family Pensioners of Government of West Bengal and AIS officers and pensioners who renders/rendered service to the state affairs of West Bengal now get medical treatment facility under West Bengal Health Scheme (WBHS).
Beneficiaries of WBHS avail treatment at Govt. Aided Hospital in cash mode and get reimbursement of treatment cost from their offices. Chittaranjan National Cancer Institute (CNCI), Newtown has expressed their interest to provide cashless facility to the beneficiaries of WBHS as per Tariff enclosed with Annexure-I.
After careful consideration, the Governor is pleased to accept the proposal of the hospital for introducing the cashless treatment with the following terms and conditions;
- CNCI, Newtown shall be treated as Special Category of Govt. Aided Hospital. Code of the hospital under West Bengal Health Scheme will be 0310014.
- CNCI, Newtown shall charge 100% Tariff as mentioned at Annexure-I for a particular procedure / investigation from the beneficiary under the West Bengal Health Scheme.
- Beneficiaries of West Bengal Health Scheme may avail both Out-Patient Department (OPD) and In-Patient Department (IPD) treatment in CNCI, Newtown. Hospital shall provide OPD treatment on cash basis and IPD treatment in cashless mode up to Rs. 2 (two) lakh in each treatment.
- There are two types of bed accommodation i.e. General Bed and Private (Cabin) Bed in CNCI, Newtown for availing indoor treatment of the beneficiaries of West Bengal Health Scheme.
- Employees having Basic Salary above Rs. 150000/- p.m. and pensioners with Basic Pension more than Rs. 75000/- p.m. are entitled to get IPD treatment with Private (Cabin) bed category. All others are entitled to get General Bed for IPD treatment. Admissibility of such accommodation will be mentioned clearly in the enrolment certificate of each beneficiary. But other critical category of beds like ICU /ITU, Day Care, HDU along with Isolation Bed, will be applicable for IPD treatment of all beneficiaries irrespective of their bed entitlement.
- Day Care treatment for Chemotherapy and Radiation shall be considered as IPD treatment. Minimum hospitalization period for such day care treatment at CNCI, Newtown is 1 (one) hour.
- CNCI, Newtown shall supply all medicines as per their pricing policy and not to direct the patient or their relatives to purchase any medicines separately during the IPD treatment of the beneficiary under WBHS. But in case of non availability of high value imported chemo/immunotherapy drugs at the store of hospital, beneficiary may supply such drugs to the hospital as per proper requisition and approval of the treating consultant. Hospital has to acknowledge such arrangement of drugs and to record the same in the Form-D4 so that beneficiary can get reimbursement of it under WBHS.
- CNCI, Newtown shall provide suitable accommodation i.e. General Bed or Private (Cabin) to the IPD patients as per their entitlement mentioned in the enrolment certificate. If hospital provides higher bed as per choice of the patient, employee/pensioner will have to bear the excess amount over entitlement and hospital shall recover the same from the patient at the time of discharge. Such excess amount paid by the patient will not be reimbursable under WBHS.
- In case IPD treatment cost exceeds Rs. 5 (five) lakh, the matter is to be brought to the notice of the West Bengal Health Scheme Authority (WBHSA) by the CNCI with prognosis report of the patient as to whether it is limited/nil/poor/guarded issued by the treating consultant attaching up-to-date detailed bill for prior permission of the WBHSA for further treatment.
- Where, in the opinion of the attending consultant, prognosis of a case is limited or nil, if a patient under the scheme is kept in CNCI, Newtown for an indefinite period, no expenses other than bed rent is admissible under WBHS. Beneficiary will have to bear the entire treatment cost except bed rent from his/her own capacity.
- The cost of bed rent, consultation fees, medicines, investigations, implants, procedures and essential consumables shall be charged under WBHS. However, the cost of inadmissible items is to be borne by the beneficiary of WBHS.
- The cost of investigations includes the cost of drawing the samples.
- In case of cancer chemotherapy/immunotherapy, prior permission is to be obtained from WBHSA through WBHS Portal whenever the cost of therapy per cycle exceeds Rs.50,000/- (Rupees fifty thousand) only. A justification from the treating oncologist to be furnished at the time of seeking permission for the use of such drugs with regard to the expected prognosis of the patient clearly mentioning survival/palliation.
- The ceiling of disposables/ consumables mentioned in clause 9 order no. 11253- F(MED), dated; 16.12.2011 shall not be applicable for CNCI, Newtown.
- Hospital will have the full right to recover the cost of inadmissible components under WBHS as per order no. 6586-F(MED), dated; 29.06.2019, except the components or similar preparation mentioned in serial no. (B) from the employee/ pensioner/ family pensioner or from their dependents at the time of discharge from the hospital.
- Hospital shall release the dead body of employee/pensioner/family pensioner immediately in case of death while availing indoor treatment. If the hospital dues remain unsettled partially or fully, hospital authority will send the entire bills with necessary documents directly to the Medical Cell of Finance Department for clearance of their dues. The Medical Cell shall scrutinize the claim and calculate the admissible amount as per provision and refer the same to the concerned administrative department of the beneficiary for disbursing the same to the hospital.
- The Tariff of CNCI, Newtown shall exclusively be applicable for that hospital only and not to be applicable for any other hospitals empanelled under WBHS.
- A beneficiary may avail any investigation of cancer treatment in CNCI, Newtown on cash basis as per prescription of an oncologist of any other recognized/empanelled hospital under WBHS and s/he shall get reimbursement of such charges.
- Cashless facility will be available for all IPD treatment at CNCI, Newtown from 01.08.2023.
- This facility in CNCI, Newtown will remain valid up to 31.03.2027.
Enclo:- Approved Tariff List (Annexure-I).
SD/-
(Dr. Manoj Pant, IAS)
Additional Chief Secretary
Finance Department
Official Source: Click Here