New CGHS Guidelines: In a major relief to the beneficiaries of the Central Government Health Scheme (CGHS), the Ministry of Health and Family Welfare has issued a direction allowing patients to purchase OPD medicines from open market without a non-availability certificate (NAC).

NAC is a document required to be furnished under the CGHS if a certain medicine is unavailable at the CGHS wellness centre or hospital. The document confirms that the specific medicine prescribed by the doctor is unavailable. In such a case, the CGHS beneficiary becomes eligible for reimbursement when he or she purchases the prescribed medicine from outside the CGHS network.

The government’s decision to allow CGHS beneficiaries to buy medicines from the open market comes after multiple users reported difficulties in getting their medicines due to technical glitches during the transition to the new Health Management Information System (HMIS).

In continuation of the efforts to enhance digital infrastructure and service delivery under the CGHS, the HMIS has been migrated from the NIC platform to the Centre for Development of Advanced Computing (C-DAC) platform with effect from 28th April 2025, the health ministry said in a circular issued on May 9. The new platform is presently undergoing functional optimisation to manage the outpatient workload across CGHS wellness centres, it added.

Also read: Major changes in CGHS guidelines: What Central Government employees need to know about new payment rules

Until now, there were two digital platforms (www.cghs.gov.in and http://www.cghs.nic.in). These platforms were deactivated last month, and the new platform (www.cghs.mohfw.gov.in) is now the official portal.

Due to this change, transparency and speed is expected in taking medicines and other facilities under CGHS, according to the government.

Relief from shortage of medicines: Exemption to buy medicines from the open market for one month

At the same time, given the problems being faced by OPD patients due to some technical difficulties during the shift to the new HMIS platform, the Ministry of Health has given a special exemption regarding drug reimbursement for one month. Now, CGHS beneficiaries can buy medicines for one month from the open market based on a valid prescription even without NAC. The exemption period is from 28.04.2025 to 31.05.2025 – both dates inclusive.

Reimbursement process and eligibility under CGHS

Reimbursement of medicines will be done in the following departments with a valid prescription and bill:

Pensioner CGHS cardholders: To the CGHS Additional Director of the concerned city/zone, after forwarding by the CMO

Serving employees: Department in which the employee is working

MPs: Through Rajya Sabha/Lok Sabha Secretariat

Autonomous bodies and Air India beneficiaries: Through the office of the concerned institution

Also read: CGHS rules for central govt employees revamped: Old websites shut down, major service changes from Apr 28

20 year old system ends, now fully digital CGHS system implemented

The old software of the CGHS was created in 2005 and has never been updated in the last 20 years. This old system, which is technically backward, is now completely shut down.

To implement the change, all CGHS wellness centres were closed to the general public on 26 April 2025, and the old websites were also closed from 28 April. Now, all services are available only on the new portal.