The Rajasthan health department has issued a stern warning 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 released standard operating procedures (SOPs) for hospitals empanelled under the Rajasthan Government Health Scheme (RGHS).
Strict Rules for Empanelled Hospitals
The SOPs also prohibit empanelled hospitals from accepting cash payments from RGHS beneficiaries. In the event that an RGHS-approved doctor is unavailable, the hospital must refer the patient to an external facility and provide reasons for doing so. However, under no circumstances shall cash be collected 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 stated.
Display Requirements and Help Desk
Private hospitals empanelled under RGHS are required to display a detailed list of available specialties and empanelled specialists, along with items not covered under the scheme. Hospitals must also ensure that 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.
New Module for Home Visits
Starting June 15, 2026, the department will mandate that medical attendance provided to RGHS beneficiaries outside empanelled hospital premises be recorded solely through the “OPD at Residence” module on the RGHS portal. This measure aims to tighten controls and curb fraudulent practices. 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 compulsory 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 added.
Penalties for Violations
The department has warned that violations will attract action under RGHS and other applicable rules. It also emphasized that misuse of an RGHS-approved doctor’s name or specialty to obtain benefits is “strictly prohibited” and will be treated as fraud.
