Denying cashless care under RGHS to be treated as serious offence

The Rajasthan health department has warned that any denial of cashless services to a patient in emergency, in-patient or day care will be treated as a serious offence under the newly issued standard operating procedures (SOPs) for hospitals empanelled under the Rajasthan Govt Health Scheme (RGHS).

The SOPs also bar empanelled hospitals from taking cash from RGHS beneficiaries. If an RGHS-approved doctor is absent, the hospital must refer the patient outside and state the reasons, but “in any case, cash will not be taken from beneficiaries.”

“All empanelled hospitals, pharmacy stores, diagnostic and imaging centres (HCNPs) are directed to carefully study and strictly adhere to the provisions, procedures, protocols and instructions prescribed in the SOPs,” a senior health department official said.

Private hospitals empanelled under RGHS have been told to display a detailed list of available specialties and empanelled specialists, along with items not covered under the scheme. Hospitals must also ensure the help desk is staffed round the clock and that a roster and contact number of the RGHS nodal officer are displayed and maintained at the desk.

From June 15, 2026, the department will require that medical attendance provided to RGHS beneficiaries outside empanelled hospital premises be recorded only through the “OPD at Residence” module on the RGHS portal to tighten controls and curb fraud.

Under the new provision, any prescription, consultation record or medical attendance document not generated through the module will be rejected by RGHS-empanelled pharmacies, making portal-based documentation mandatory for home-visit care.

“All RGHS empanelled pharmacies will ensure strict compliance with the new instructions and will dispense medicines only against prescriptions generated through the prescribed module for OPD consultations conducted outside empanelled hospitals run by private players or govt-run hospitals,” the official said.

The department said violations will invite action under RGHS and other applicable rules. It also warned that misuse of an RGHS-approved doctor’s name or specialty to obtain benefits is “strictly prohibited” and will be treated as fraud.