AGREEMENT

BETWEEN

CHIEF MEDICAL SUPERINTENDENT, BANGALORE, ON BEHALF OF SOUTH WESTERN

RAILWAY

AND

………………………………………………… Name of the Hospital

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This Agreement is made on the ……… day of March’ 2024 between the President of India acting
through CMS/SBC Government of India having its office at Bangalore (Hereinafter called Railway,
which expression shall, unless repugnant to the context or meaning thereof, be deemed to mean and
include its successors and assigns) of the First Part

AND

…………………….(Mention Hospital name), having its registered office at………….. (Name of the
Hospital with Address) of the Second Part.

WHEREAS. The Indian Railway Health Service (IRHS) is providing comprehensive medical Care
facilities to the Railway beneficiaries as are decided from time to time.

AND WHEREAS, IRHS proposes to provide treatment facilities and diagnostic facilities to the Railway
Medical Beneficiaries in the Private empanelled Hospital, in Bangalore.
AND WHEREAS…………………….. (Name of the Hospital) has agreed to give the treatment /
diagnostic facilities (As per Annexure – 1) to the Railway Beneficiaries in The Health Care Organization
at the rates offered by CGHS for Bangalore.

NOW, THEREFORE, IT IS HEREBY AGREED between the Parties as follows:

Terms & conditions for empanelment of Hospitals for Treatment & investigations: -

1. DEFINITIONS & INTERPRETATION

1.1 The following terms and expressions shall have the following meaning for Purposes
of this Agreement.
1.1.1 ’’Agreement’’ shall mean this Agreement and all Schedules, supplements,
Appendices, appendages and modifications thereof made in accordance with the
terms of this Agreement
1.1.2 “Benefit” shall mean the extent or degree of service the beneficiaries are entitled to
receive as per the rules on the subject.
1.1.3 “Card” shall mean the (UMID/CTSE etc.,) Photo Identity Card bearing details
including Aadhar no. of the beneficiary issued by any competent authority of
Railway Personnel department. MIC shall mean “Medical Identity card” issued by
any competent authority of Railway Personnel department bearing the name of the
Railway Employee or ex – Railway Employee and their family
members/dependents.
1.1.4 “Card Holder” shall mean a person having the (UMID /CTSE etc.,) card ( a
specimen of which has been shown to the hospital and a prototype has also been
provided )
1.1.5 Railway Beneficiary shall mean any person who is eligible to comprehensive
medical care by IRMS and has been issued, or whose name is included in a medial
card issued by competent authority and has not become ineligible on any account.
1.1.6
“Coverage” shall mean the types of persons to be eligible as the beneficiaries of the
Scheme to health service provided under the Scheme subject to the term’s
conditions and limitations.
1.1.7
“Emergency” shall mean any condition or symptom resulting from any cause arising
suddenly and if not treated at the early convenience be detrimental to the health of
the patient or will jeopardize the life/limb of the patient.
1.1.8
“Empanelment” shall mean authorization of the hospitals, by the Railway for
treatment / investigation purposes for a particular period.

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1.1.9
“Hospital” shall mean the HealthCare Global Enterprises Limited while performing
under this Agreement providing medical investigation treatment and the healthcare
of human beings.
1.1.10
De-recognition of Hospital “shall mean debarring the hospital on account of
adopting unethical practices or fraudulent means in providing medical treatment to
or not following the good industry practices of the health care for the UMID card/
CTSE Beneficiaries after following certain procedure of inquiry.
1.1.11
“Party” shall mean either the Railway or the Hospital and “Parties” shall mean both
the Railway and the Hospital.
1.1.12 “CGHS” Package Rate” shall mean all inclusive – including lump sum cost of
inpatient treatment / day care / diagnostic procedure for treatment under emergency
from the of admission to the time of discharge including ( but not limited to) –
(i)Registration Charges(ii)Admission charges (iii) Accommodation charges
including patient diet (iv) Operation charges (v) Injection charges (vi) Dressing
charges (vii) Doctor / consultant visit charges (viii) ICU /ICCU charges (ix)
Monitoring charges (x) Transfusion charges and Blood processing charges (xi) Pre
Anesthetic checkup and Anesthesia charges (xii) Operation theatre charges
(xiii)Procedural charges / surgeon’s fee (xiv) Cost of surgical disposables and all
sundries used during hospitalization (xv) Cost of medicines and consumables (xvi)
Related routine and essential investigation (xvii) Physiotherapy charges etc. (xviii)
Nursing care charges etc. Package rates also include two postoperative
consultations.
1.1.13 Cost of Implants / stents / grafts are reimbursable in addition to package rates as per
CGHS ceiling rates or as per actual whichever is lower.
1.1.14 In case a beneficiary demands a specific Brand of Stent / Implant and give his
consent in writing the difference in cost over and above the ceiling rate may be
charged from the beneficiary which is non reimbursable / not payable by Railway.
This component will be shown distinctly in the bill for sake of transparency
1.1.15 During in – patient treatment of the Railway beneficiary the hospital will not ask the
beneficiary or his / her attendant to purchase separately the medicines / sundries
/equipment or accessories from outside and will provide the treatment within the
package rate, fixed by the CGHS which includes the cost of all the items. However,
the following items are not admissible for reimbursement / Payment by Railway:
 Toiletries
 Sanitary napkins
 Talcum powder
 Mouth fresheners
 Diet charges for patient attendant/s
 Telephone bills/ Dietary/ Nutritional Supplements
Any other item as decided by Railway
1.1.16 In cases of conservative treatment / where there is no CGHS Package rate
calculation of admissible amount would be done item wise as per CGHS rates or as
per AIIMS rates, if there is no CGHS rate for a particular item.
1.1.17
Package rates envisage up to a maximum duration of indoor treatment as follows:

 Upto 12 days for Specialized (Super Specialties) treatment

 Upto 7 days for other major Surgeries
 Upto 3 days for Laparoscopic surgeries and
 1 day for day care / Minor (OPD) surgeries

However, if the beneficiary has to stay in the hospital for his / her recovery for a
period more than the period covered in package rate, the additional bill amount may

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 be allowed to the hospital, which shall be limited to accommodation charges as per
entitlement investigations charges at approved rates, doctors visit charges (not
more than 2 visits per day by specialists / consultants and cost of medicines for
additional stay). The circumstances for such extended stay should be supported by
relevant medical records and certified as such by hospital.
1.1.18
No additional charge on account of extended period of stay shall be allowed if that
extension is assessed to have been necessitated due to Hospital Acquired Infection
(HAI), infection as a consequence of surgical procedure / faulty investigation
procedure etc. The decision of Railway / will be final in this regard.

1.1.19
The empanelled hospital cannot charge more than CGHS approved rates or rates
agreed upon with Railways, when a Railway beneficiary is admitted under non-
emergency situation. In case of any instance of overcharging the overcharged
amount over and above CGHS rate (except inadmissible items and difference paid
due to implant/stent of a specific brand chosen by Railway beneficiary) shall be
considered as unethical practice by the hospital and may lead to cancellation of
contract.

1.1.20
IRHS has empanelled the……………………. (Name of the Hospital) for Railway
beneficiary for all the specialties for which it has been granted recognition by
CGHS. It may also refer any of its beneficiaries for a
treatment/procedure/investigation which is not available in house at the local health
institution of railway.

1.1.21
For any interaction with Railway the hospital shall be interacting with the signing
authority, or one of his authorized officers, of this agreement. However, a superior
office of the signing authority may call for any report by the hospital.

1.1.22
The applicable city specific CGHS rates are as per notification by the CGHS for that
city or nearest city. The rates will be as per applicable rate i.e. any change upwards
or downwards will be applicable from the date which is applicable in CGHS
OR
Mutually agreed rates with Railways ( in case of Government of India/Public Sector
undertaking hospitals or non CGHS hospitals.
Hospital will write prescription in Generic name and provide medicines for upto
seven days period. This is subject to following conditions:-
i. Only essential medicines in generic form for continuity of treatment
will be issued by the hospital.
ii. No nutritional supplements, tonic, cough syrup, vitamins injections
will be issued by the hospital. These are not allowed.
iii. No non drug items/equipments/appliances will be issued.
iv. Total cost of such medicines issued by the hospital must not exceed
Rs. 2,000/- in any case.

2. DURATION OF AGREEMENT

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 The Agreement shall remain in force for a period of 02 years or till it is modified or revoked,
whichever is earlier. The Agreement may be extended annually subject to fulfillment of all the
terms and conditions of this Agreement and with mutual consent of both parties.

Note: In case the hospital is derecognized by CGHS or the recognition is not extended for any
reason then, unless and until specifically allowed by Railway, the Railway empanelment under
this agreement shall also be withdrawn. Patient already admitted to the hospital during currency
of MoU will however, be continued to be provided treatment, which shall be paid by Railway as
per this MoU.

3. CONDITIONS FOR PROVIDING TREATMENT/SERVICES

A. GENERAL CONDITIONS
The hospitals shall be empanelled for all facilities/services available in the health care
organization as approved by CGHS and shall not be empanelled for selected
specialties/facilities.

The Hospital shall investigate / treat the Railway beneficiaries only for the emergency condition
for which the patient has reported to them. Likewise, the Railway beneficiaries referred by the
railway hospital shall be treated / investigated only for the condition referred. No undue/
unnecessary investigation shall be done by the hospital.

It is agreed that Railway beneficiaries shall be attended to on priority.

IRHS has the right to monitor the treatment provided in the private hospital.

B. ADDITIONAL PROCEDURES / INVESTIGATIONS

The hospital has been empanelled for treatment /investigation of the Railway beneficiaries. For
any material / additional procedure / investigation other than the emergency condition for which
the authorization was initially given, would require the permission of the competent authority.
Likewise, if IRHS refers a patient, the treatment given should be confined to the condition for
which the patient has been referred by the Railway. `
C. PROCEDURE WHERE A RAILWAY BENEFICIARY REPORTING IN EMERGENCY
NEEDS TREATMENT IN A SPECIALTY (s) WHICH ARE NOT AVAILABLE IN THE
HOSPITAL
The Hospital shall not undertake treatment of cases, reporting to them, in specialties which are
not available in the hospital. But it will provide necessary treatment to stabilize the patient and
transport the patient safely to nearest recognized hospital under intimation to Railway authorities
However in such cases the Hospital will charge as per the CGHS rates only for the treatment
provided.
D. CHANGES IN INFRASTRUCTURE / STAFF TO BE NOTIFIED TO RAILWAY
The hospital shall immediately communicate to Railway about any change in the
infrastructure/shifting of premises of the hospital. The empanelment will be temporarily withheld
in case of shifting of the hospital facility to any other location without prior permission of
Railway.
E. ANNUAL REPORT
The Hospital will submit an annual report regarding number of admitted Railway beneficiaries,
bills submitted to the Railway and payment received. Similar report for the referred patients
treated by the hospital may also be submitted. Annual audit report of the hospitals will also be
submitted along with the statement. The Hospital shall submit all the medical records in digital
format.
I. MEETINGS
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 Authorized signatory / representative of the empanelled hospital shall attend the periodic
meetings held by Railway required in connection with improvement of working conditions and
for redressal of grievances.
J. INSPECTIONS
During the visit by Railway officials, the empanelled hospital’s authorities will cooperate in
carrying out the inspection.
L. NO COMMERCIAL PUBLICITY
The Hospital will not make any commercial publicity projecting the name of Railway or
Government of India. However, the fact of empanelment under IRHS shall be displayed at the
premises of the empanelled hospital indicating that the charges will be as per CGHS approved
rates.

4. TREATMENT IN EMERGENCY

The following ailments may be treated as emergency which is illustrative only and not
exhaustive depending on the condition of the patient and if any changes done by CGHS will
apply for Railway too:
 Acute Coronary Syndromes (Coronary Artery Bye-pass Graft / Percutaneous, Transluminal
Coronary Angioplasty) including Myocardial Infarction. Unstable Angina, Ventricular
Arrhythmias Paroxysmal Supra Ventricular Tachycardia, Cardiac Tamponade, Acute Left
Ventricular Failure /Severe Congestive Cardiac Failure, Accelerated Hypertension,
Complete Heart Block and Stoke Adam attack, Acute Aortic Dissection.
 Acute limb Ischemia, Rupture of Aneurysm Medical and Surgical shock and peripheral
circulatory failure.
 Cerebra-Vascular attack-Stokes, Sudden unconsciousness, Head injury Respiratory failure,
Decompensated lung disease. Cerebra- Meningeal Infections, Convulsions Acute Paralysis,
Acute Visual Loss.
 Acute Abdomen pain,
 Road Traffic Accidents / with injuries including fall.
 Severe Hemorrhage due to any cause.
 Acute poisoning.
 Acute Renal Failure.
 Acute abdomen pain in female including acute Obstetrical and Gynecological emergencies.
 Electric shock. Any other life-threatening condition.

In emergency the hospital will not refuse admission or demand an advance payment from the
Railway beneficiary or his family member and will provide credit facilities to the patient whether
the patient is a serving employee of Railway or a pensioner availing facilities, on production of a
valid Railway Medical Identity card (UMID etc.). The refusal to provide the treatment to
bonafide Railway Beneficiaries in emergency cases on credit basis, without valid ground, would
attract disqualification for continuation of empanelment.
The Hospital will intimate all instances of Railway Beneficiaries admitted as
emergencies without prior permission to the Railway authorities through mutually accepted means to
Railway authorities at the earliest and within 24 hours and Railway will revert within next 24 hours,
otherwise it will be treated as deemed approved. The empanelled hospital will clearly mention/
certify the emergency condition as per MoU.

If Railway finds that patient is not suffering from emergency, in such case the hospital bill upto
the stage of such determination will be paid by Railway directly to the hospital. However, the

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 patient can continue to avail treatment at the empanelled hospital, if so desired by paying CGHS
rates or hospital rates whichever is less on the patients cost thereafter.

5. ENTITLEMENTS FOR VARIOUS TYPES OF WARDS

Railway beneficiaries are entitled to facilities of private, semi-private or general ward depending
on their pay drawn in pay band / pension. These entitlements are amended from time to time and
the latest order in this regard needs to be followed. The entitlement at present is as follows:

Sl. No. Corresponding basic pay drawn by the Entitlement

officer in 7th CPC per month
1. Up-to Rs. 47,600 /- General Ward
2. Rs. 47,601/- to 63,100/- Semi-Private Ward
3. Rs.63,101/- and above Private Ward

The Card will have the entitlement of the patient endorsed. For the patients referred by railway
the entitlement of ward shall be endorsed on the referral letter itself.

a. Private ward is defined as a hospital room where single patient is accommodated and
which has an attached toilet (lavatory and bath). The room should have furnishings like
wardrobe, dressing table, bed- side table, sofa set, carpet, etc., as well as a bed for
attendant. The room has to be air- conditioned.
b. Semi Private Ward is defined as a hospital room where two to three patients are
accommodated and which has attached toilet facilities and necessary furnishing.
c. General wards is defined as a hall that accommodates four to ten patients.
Treatment in higher Category of accommodation than the entitled category is not permissible for
payment by Railway or reimbursable. If the patient or his/her attendant opts for a higher class than
admissible under extent rules mentioned above (Para 5), as modified from time to time, the difference
in cost of treatment including room charges, procedure and treatment cost investigations etc would
have to be borne by patient’s representative. A written declaration to the effect should be taken
before such change is carried out and it can be collected from the patient or his / her representative
directly by the hospital. This should be indicated distinctly in the bill raised in the interest of
transparency.
6. APPROVED RATES TO BE CHARGED
6.1 The empanelled Hospital shall charge from the Railway beneficiary as per the rates for a
particular procedure / package deal as prescribed by the CGHS or mutually accepted rates by
Railways where rates are not available for CGHS or in case of Government of India
undertaking hospitals or mutually accepted rates where no CGHS hospital exist and attached
as Annexure (rate list) which shall be an integral part of this Agreement. The rates notified by
CGHS shall also be available on web site of Ministry of Health & F.W at
http://msotransparent. nic. in/cghsnew/index,asp.
6.2 The package rate will be calculated as specified in the tender document. No additional charge
on account of extended period of stay shall be allowed if, that extension is due to infection as
a consequence of surgical procedure or due to any improper procedure and is not justified.
The decision of Railway will be final in this regard.
6.3 The procedure and package rates for any diagnostic investigation, surgical procedure and
other medical treatment for Railway beneficiary under this Agreement shall be as per the
latest CGHS rate applicable for the city of Bangalore, during the validity period of this
Agreement. The empanelled hospital agrees that during the in-patient treatment of the
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 Railway beneficiary, the Hospital will not ask the beneficiary or his attendant to purchase
separately the medicines / sundries /equipment or accessories from outside and will provide
the treatment within the package deal rate fixed by the CGHS which includes the cost of all
items Appropriate action, including removal from RAILWAY empanelment and / or
termination of this Agreement may be initiated on the basis of a complaint medical audit or
inspections carried out by Railway teams. The hospital shall agree to charge CGHS rates to
Railway Employees / Pensioners on production of valid I-Card / Documentary proof, even
though treatment is not sought as Railway beneficiary.

7. MODE OF PAYMENT FOR TREATMENT OF BENEFICIARIES

There shall be three classes of patients

I. Railway Beneficiaries referred by Railway Hospitals to the empanelled hospital

II. Railway Beneficiaries reporting to Hospital directly in emergency.
III. Railway beneficiary directly reporting to empanelled hospital without any emergency or
referral letter and paying on their own for OPD/IPD/Investigations for which empanelled
hospital shall charge CGHS rate or hospital rate, whichever is less.
IV. RELHS beneficiaries aged 75 years and above (having valid UMID cards and Not getting
FMA) seeking direct OPD consultation (not including issue of medicine) from specialists of
Private Hospitals empanelled by Railway, without referral from Railway Hospital/Health
Unit under which beneficiary is registered.
Railway beneficiaries coming under Serial No. 7 (I), will be attending the hospital with referral
letter from Railways, the bill should be submitted to the office of the concerned Railway hospital
with whom they have the MoU.
Railway beneficiaries coming under Serial No. 7 (II) above – Emergency as in para 4
treatment / procedures, the services shall be undertaken and provided on credit. No payment
shall be sought from them and information sent to Railway hospital through mutually agreed
means and authorization be sought from the concerned Railway hospital with whom then have
MOU with. Situation may arise where Railway hospital, after scrutinizing admission report
submitted be empanelled hospital, finds that the patient is not suffering from emergency. In such
cases, the hospital bills upto the stage of such determination (para 4) shall be paid be Railway
directly to hospital. However, the patients can continue to avail treatment at the empanelled
hospital, if so desired, paying CGHS rates or hospital rates, whichever is less on the patient’s
cost, thereafter.

For railway patients coming under Serial No.7(III) above, empanelled hospital has to collect
payment from the Railway patients directly at the rate as decided already. That is empanelled
hospitals will provide necessary treatment in OPD or otherwise to Railway Beneficiaries at the
CGHS approved rates or hospital rates, whichever is less for the treatment in non- referral and
non- emergency case at Railway Medical Beneficiary’s own cost.

For Railway patients coming under serial no.7 (IV), this facility will be subject to the following:-
(a) This facility will be available for only those aged 75 years & above RELHS
beneficiaries (having valid UMID card) who are eligible for OPD consultation at
Railway Hospitals/Health Units. This Facility is not available to beneficiaries having
UMID card with FMA.
(b) If any CGHS listed investigation /procedures is advised by the treating doctor at
railway empanelled hospital and is required to be undertaken in emergency, no other
authorization will be required, and the same may be undertaken from empanelled
hospital at CGHS rates for that city/or as per MOU with Railway in cashless
procedure.
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 (c) In non-emergency cases, approval of competent authority from Railways will be
required for undertaking (a) CGHS non-listed investigations/planned procedures; and
(b) those CGHS listed investigations, which cost above Rs. 10000/- whenever advised
by specialist of an empanelled hospital.
(d) Medicines prescribed by a specialist doctor of private Railway empanelled Hospital
will NOT be issued by the private hospital. It will be issued by concerned Railway
hospitals/Health Units on authorization of available railway doctor.
(e) Private Hospitals empanelled shall submit the bill to the Railways for payment along
with copy of UMID card, Copy of prescription/Reports and declaration form (enclosed
Annexure I) signed by the beneficiary and duly endorsed by the competent authority
of empanelled hospital.
(f) This is a Pilot Project only for one year i.e. 01.11.2023 to 31.10.2024.
(g) Railway will provide access of HMIS portal to Empanelled hospitals so that data is
captured efficiently and can be retrieved whenever required. Same will be started as
soon as the portal for same is ready.

Note- for para IV- As per terms & conditions mentioned in Board’s letter no.
2023/H/28/1/RELHS/Empanelled (CGHS) dated 19.09.2023 as a pilot project for one year
from 01.11.2023 to 31.10.2024

8. NOTIFICATION OF NODAL OFFICERS

Empanelled hospital shall notify concerned Railway hospital authority about admission of
Railway beneficiaries in emergency clarifying the nature of emergency as pointed out in para 4.
Empanelled hospital will mark a counter for Railway beneficiary and also display the names and
the contact no of person dealing with railway for that empanelled hospital as being done for
CGHS beneficiary. Concerned Railway hospital will appoint two senior doctors for acting as
administrative nodal officer for empanelled hospital and for Railway beneficiaries.

9. INFORMATION TO BE PROVIDED TO BY HOSPITALS OF EMERGENCY

ADMISSIONS

The Hospital will intimate all instances of Railway beneficiaries admitted as emergencies
without prior permission to the Railway authorities through mutually accepted means at the
earliest and within 24 hours and Railway will revert within next 24 hours, otherwise it will be
treated as deemed approved. The empanelled hospital will clearly mention/clarify condition as
per MOU.
If Railway finds that patient is not suffering from emergency, in such case the hospital bill up
to the stage of such determination will be paid by Railway directly to the hospital. However, the
patient can continue to avail treatment at the empanelled hospital, if so desired by paying CGHS
rates or hospital rates, whichever is less on the patient’s own cost thereafter.
Treatment in no case would be delayed or denied for the reason that authorization by Railway
is not forthcoming.
10. SUBMISSION OF BILLS
Empanelled hospitals shall submit the physical bill to the concerned CMS/MD office for
processing of bills. However, no claims of empanelled hospitals after a period of six months from
the date of completion of treatment/ date of discharge of Railway beneficiaries shall be accepted
by Railway authority.

11. PROCESSING OF CLAIMS

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 The Hospital shall be expected to upload the bill, on the website, for a particular episode
within 7 days of the discharge of the patient.
Railway hospital shall put up a scrutinized statement of the bill within 15 days of submission
of the bill by the hospital, as per the extant rules, raising objections if any, if the hospital has
anything to state on the scrutinized statement then it will do so within 02 days, otherwise it will
be presumed that hospital agrees with scrutinized statement.

After approval MD/CMS/CMO office shall submit the bill to associate Accounts Department
(within 15 days of clearing of last query). Account Department will pass the bills and make the
payment to the hospital within 15 working days.
Note:- The patient may be from railway unit other than the agreement signing unit but the bill
shall be paid be the Railway Unit which had empanelled the hospital, without making any
reference or debit etc. to the Railway Unit to which beneficiary may belong.
Railway reserves the right to make recoveries. If any, from future bills of hospitals as the case
may be. Railway hospital will examine in the bill in terms of:
a) Appropriateness of treatment including screening of patients records to identify unnecessary
admissions and unwarranted treatments.
b) Whether the planned treatment is shown as emergency treatment.
c) Whether the diagnostic, medical or surgical, procedures that were not required were conducted
by hospital including unnecessary investigations.
d) Whether the treatment procedures have been provided as per the approved rates and the
packages.
e) Whether procedures performed were only those for which permission had been granted or the
patient was referred.
f) Empanelled hospital will provide established & approved treatment protocol to Railway
beneficiaries. Therapies which are not approved or experimental in the nature are not permitted.
12. MEDICAL AUDIT OF BILLS
There shall be a continuous Medical Audit of the services provided by the empanelled Private
Hospital by railway or its nominated agency.

13. DUTIES AND RESPONSIBILITIES OF EMPANELLED HOSPITAL.

It shall be the duty and responsibility of the empanelled Hospital at all times, to obtain, maintain
and sustain the valid registration, recognition and high quality and standard of its services and
healthcare and to have all statutory / mandatory licenses, permits or approvals of the concerned
authorities under or as per the existing laws.

14. NON-ASSIGNMENT
The empanelled Hospital shall not assign, in whole or in part, its obligations to perform under the
agreement, except with the Railway’s prior written consent at its Sole discretions and on such
terms and conditions as deemed fit by the Railway. Any such assignment shall not relieve the
Hospital from any liability or obligation under this agreement.
15. EMPANELLED HOSPITAL’S INTEGRITY AND OBLIGATIONS DURING AGREEMENT
PERIOD
The empanelled Hospital is responsible for and obliged to conduct all contracted activities in
accordance with the Agreement using state-of-the-art methods and economic principles and
exercising all means available to achieve the performance specified in the Agreement. The
Hospital is obliged to act within its own authority and abide by the directives issued by the
Railway. The Hospital is responsible for managing the activities of its personnel and will hold
itself responsible for their misdemeanors, negligence, misconduct or deficiency in services, if
any.
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16. PERFORMANCE BANK GUARANTEE (PBG)
(it should be in favor of - Senior Divisional Finance Manager, S.W.Railways,
Bangalore).

Health care Organizations that are recommended for empanelment after the initial assessment
shall also have to furnish a performance Bank Guarantee (PBG) as per given below:

(a) For CGHS covered cities / areas, the rate will be :-

(i) Hospital / Cancer Units: Rupees 10 Lakhs
(ii) Eye Center / Single Specialty Hospital/Dental Clinic/Diagnostic Center: Rupees 02 Lakh;
and

(b) For Non-CGHS covered cities / areas, the rates will be:
(i) Hospital / Cancer Units: Rupees 02 Lakhs
(ii) Eye Center / Single Specialty Hospital/Dental Clinic/Diagnostic Center: Rupees 0.5 Lakh;

Note: PBG for Charitable Hospitals / Organizations would be 50% (fifty percent) of above
amount.

PBG will be valid for a period of 30 months /18 months i.e six months beyond empanelment period to
ensure efficient service and to safeguard against any default. If they have given the same to one
Railway then they need not give to other Railway since if one hospital is empanelled with a particular
Railway then it is deemed empanelled by the other Railway too and other Railways can simply sign
the MoU with them in same term and conditions for beneficiaries from their Railways.

PBG No………………………………………..…………Dated………………for Rs. 10,00,000/-

(In Words - Ten Lakh’s only) Name of the Bank…………………….…..…………..……………
Branch………………………………………………..Valid from…..……………to…..…..………..

17. FORFEITURE OF PERFORMANCE BANK GUARANTEE AND REMOVAL FROM LIST

OF EMPANELLED ORGANIZATIONS
In case of any violation of the provisions of the MOA by the hospital empanelled under Railway such
as:
1. Refusal of service,
2. Undertaking unnecessary procedures,
3. Prescribing unnecessary drugs/tests
4. Over billing,
5. Reduction in staff/ infrastructure/ equipment etc., after the hospital/ has been empanelled
6. Non submission of the report, habitual late submission or submission of incorrect data in the report
7. Refusal of credit to eligible beneficiaries and direct charging from them.
8. If not recommended by NABH/NABL/QCI at any stage
9. Discrimination against Railway beneficiary’s vis-a-vis general patients
10. De-empanelment by CGHS/ECHS/ESI.
The amount of performance Bank Guarantee will be forfeited and the Railway shall have the right to
de-recognize the hospital as the case may be. Such action could be initiated on the basis of a
complaint, medical audit or inspections carried out by Railway teams at random. The decision of the
Railway will be final.

18. LIQUIDATED DAMAGES

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  The Hospital shall provide the services as per the requirements specified by the Railway in
terms of the provisions of this Agreement. In case of initial violation of the provisions of the
Agreement by the Hospital such as refusal of service or direct charging from the Railway
beneficiaries (and referred patients) or defective service and negligence, the amount
equivalent to 15% of the amount of Performance Bank Guarantee will be charged as agreed
Liquidated Damages by the Railway, however, the total amount of the Performance Bank
Guarantee will be maintained intact being a revolving Guarantee.

 In case of repeated defaults by the Hospital the total amount of Performance Bank Guarantee
will be forfeited and action will be taken for removing the Hospital from the empanelment of
Railway as well as termination of this Agreement.
 For over-billing and unnecessary procedures, the extra amount so charged will be deducted
from the pending / future bills of the Hospital and the Railway shall have the right to issue a
written warning to the Hospital not to do so in future. The recurrence, if any, will lead to De-
recognition from Railway.

19. TERMINATION FOR DEFAULT

The Railway may, without prejudice to any other remedy for breach of Agreement, by written
notice of default sent to the Hospital terminate the Agreement in whole or part:
19.1 If the empanelled Hospital fails to provide any or all of the services for which it has been
empanelled within the periods(s) specified in the Agreement or within any extension thereof if
granted by the Railway Pursuant to condition of Agreement or if the Health care organization
fails to perform any other obligation(s) under the Agreement.
19.2 If the Hospital in the judgment of the Railway has engaged in corrupt or fraudulent practices in
competing for or in executing the Agreement.
19.3 In case of any wrong doings as specified in Memorandum of Agreement by one hospital Railway
reserves the right to remove all empanelled hospitals of that particular group from its empanelled
list of hospital.

20. INDEMNITY
The empanelled Hospital shall at all times, indemnify and keep indemnified Railway / the
Government and against all actions, suits, claims and demands brought or made against it in respect
of anything done or purported to be done by the Health Care Organization in execution of or in
connection with the services under this Agreement and against any loss or damage to Railway / the
Government in consequence to any action or suit being bought against the Railway / the
Government, along with (or otherwise), Health Care Organization as a party for anything done or
purported to be done in the course of the execution of this Agreement. The Health Care Organization
will at all times abide by the job safety measures and other statutory requirements prevalent in India
and will keep free and indemnify the Railway from all demands or responsibilities arising from
accidents or loss of life, the cause or result of which is the Hospital negligence or misconduct.

The Hospital will pay all indemnities arising from such incidents without any extra cost to
Railway and will not hold the Railway responsible or obligated. Railway / the Government may at its
discretion and shall always be entirely at the cost of the Health Care Organization defend such suit,
either jointly with the Health Care Organization enter or singly in case the latter chooses not to
defend the case.

21. ARBITRATION
If any dispute or difference of any kind whatsoever (the decision whereof is not herein otherwise
provided for) shall arise between the Railway and the Hospital, upon or in relation to or in
connection with or arising out of the Agreement, shall be referred to for arbitration by the
CMD/CMO of the unit who will give written award of his decision to the parties. The decision of the
CMD/CMO will be final and binding. The provisions of the Arbitration and conciliation Act, 1996

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 shall apply to the arbitration proceedings. The venue of the arbitration proceedings shall be at the
city of CMD/CMO office.

22. MISCELLANEOUS

22.1 Nothing under this Agreement shall be constructed as establishing or creating between the parties
any relationship of Master and servant or Principal and Agent between Railway and the Hospital.
The Health care Organization shall work or perform their duties under this Agreement or
otherwise.
22.2 The Hospital agrees that any liability arising due to any default or negligence in not represent or
hold itself out as agent of the Railway.
22.3 The Railway will not be responsible in any way for any negligence or misconduct of the Hospital
and its employees for any accident, injury or damage sustained or suffered by any Railway
beneficiary or any third party resulting from or by any operation conducted by and on behalf of
the Hospital or in the course of doing its performance of the medical services shall be borne
exclusively by the hospital who shall alone be responsible for the defect and / or deficiencies in
rendering such services.
22.4 The Hospital shall notify the Government of any material change in their status and their
shareholdings or that of any Guarantor of the in particular where such change would have an
impact on the performance of obligation under this Agreement.
22.5 This Agreement can be modified or altered only on written agreement signed by both the parties.
22.6 Should the Hospital get wound up or partnership is dissolved the RAILWAY shall have the right
to terminate the Agreement. The termination of Agreement shall not relieve the hospital or their
heirs and legal representatives from the liability in respect of the services provided by the
Hospital during the period when the Agreement was in force
22.7 The hospital shall bear all expenses incidental to the preparation and stamping of this agreement.

23. OTHER SERVICES TO BE PROVIDED

The empanelled Hospital will, on the request of RAILWAY, agree to provide training to
RAILWAY medical, para-medical and nursing staff.
24. EXIT FROM THE PANEL
The Rates fixed by the CGHS for the city of Bangalore shall continue to hold good unless revised by
CGHS. In case the notified rates are not acceptable to the empanelled health care Organization, or
for any other reason, the health care Organization no longer wishes to continue on the list under
Railways, it can apply for exclusion from the panel by giving one-month notice. Patients already
admitted shall continue to be treated as per agreed rates between the two parties.
25. NOTICES

25.1 Any notice given by one party to the other pursuant to this Agreement shall be sent to other party
in writing by registered post or by facsimile and confirmed by original copy by post to the other
party’s address as below.

Railway: CHIEF MEDICAL SUPERINTENDENT, S.W. Railways, BANBALORE

Hospital: ………..(Name of the Hospital with Address)

25.2 A notice shall be effective when served or on the notice’s effective date, whichever is later.
Registered communication shall be deemed to have been served even if it returned with remarks
like refused, left, premises locked, etc.

26.1 Under the powers of DRM/SBC as delegated by Railway Board vide letter No: 2017/Trans/01/
Policy/Pt.01 dated 30.11.2017 has sanctioned for empanelment of
………………………………………………………..(Name of the Hospital with Address) as a
referral hospital for super specialties for Railway beneficiaries at NABH 2014 Bangalore rates/
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 hospital rates whichever is less for a period of 02 years with effect from ….../..…/……... to
….../………/………...

26.2 Cancer Surgical Package will be done as per O.O No. S-11045/36/2012-CGHS(HEC) Dt.
07/09/2015.
1. For cases on chemotherapy where referral is given for one month original signature from patients
or patient’s relatives may be taken during every chemotherapy visit on the copy of referral letter
along with mobile number.
2. With each chemotherapy billing the drug utilized to be mentioned
3. In case, if the patient is advised any Non- cancer surgery. The CGHS 2014 rates for surgical
package to be follow.

26.3 Terms and conditions for Pharmacy, implants and other services

a. 10% discount on hospital rates, for those services/investigations/treatment modalities,

which are not listed in CGHS rates - Un- Coded items.
b. Hospital has agreed to provide free Ambulance service for all the referral
patients.

26.4 26.4 CMS/SBC will sign the MOU on behalf of SWR, Bangalore, for Railway beneficiary and
bills will be paid as per the conditions laid in this MOU through associate finance.

26.5 The NABH accreditation of this hospital is valid up to 25/09/2025 and hospital has given for
renewal. The hospital has to ensure accreditation after this period. In case of NABH accreditation is not
extended, the rate applicable to Non- NABH rate will be paid.

26.6 No upward revision of rates for Non-CGHS / Hospital rates is permitted during this contract.

IN WITNESSES WHEREOF, the parties have caused this Agreement to be signed and executed on
the day, month and the year first above mentioned.

CMS/SBC ON BEHALF OF SOUTH WESTERN RAILWAY

For and on behalf of The President of India

In the Presence of (Witnesses)

1.

2.
Signed By

FOR AND ON BEHALF OF (Name of the Hospital)

Duly authorized vide Resolution No…………….. dated…………………..

In the Presence of (Witnesses)

1.

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2.

Annexure I

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