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Empanelment Criteria

  • All the Hospitals have been graded based on the NABH & Non-NABH Accreditation. As the Hospitals keep upgrading their infrastructure and facilities, the grades shall keep changing based on whichever grade they meet in the mechanism. Rates of the procedures shall be linked with grade of that hospital.
  • Provider hereby declares that the bed capacity of the hospital is equal to or more than 20 for Multi-specialty, (with exception for single-specialty hospitals like Eye and ENT) with adequate spacing and supporting staff as per norms. The general ward should have 80sq ft per bed, or more in a room with basic amenities such as bed, mattress, linen, water, electricity, cleanliness, patient friendly common washroom etc. Non-AC but with fan/Cooler and heater in winter agrees to provide separate male and female wards with toilet and other basic amenities.
  • Provider hereby declares that the hospital has requisite infrastructure as per guidelines in relation to specialty wise services for which empanelment is done and agrees to provide quality diagnostic and treatment services as per the standard protocols.
  • Provider declares that hospital has a well-equipped Post op ICU care with ventilator support to meet the emergency requirements of the beneficiaries for all the categories empanelled for and agrees to facilitate round the clock diagnostic and specialist services as per the criteria fixed for empanelment and as mentioned in Article 5.
  • Provider agrees not to refuse admission of CMAAY beneficiaries in any specialty to which it has been empanelled.
  • Provider hereby declares that hospital did not exclude any other specialty service deliberately from the scheme in spite of having such facility and agrees to empanel for all the specialties for which adequate infrastructure is available.
  • Provider hereby declares that support systems like Pharmacy, Blood Bank, Laboratory, X-ray facility (mandatory) etc., either ‘In-House’ or with ‘Outsourcing arrangements’, preferably with NABL accredited laboratories, with appropriate agreements and in nearby vicinity and round-the-clock Ambulance facilities (own or tie-up) has been arranged.
  • Declaration by the Provider about tie-up diagnostics facilities:(Annexure- II)
    • The Hospital should have sufficient diagnostic equipment and support services in the specific identified fields for which the Hospital is empanelled as per the requirements specified. In case the Provider is having tie up with independent diagnostic center for advanced diagnostic facilities, the Provider shall reimburse the diagnostic charges as fixed by the CMAAY and ensure cashless services at the diagnostic centre. (Pre-op Investigation charges Annexure)