CGHS administrative sanctions for life-saving procedures must be initiated through the designated Wellness Centre.

The Applicant, a Senior Store Assistant at DESIDOC, DRDO, filed an application under Section 19 of the Administrative Tribunals Act, 1985, seeking directions for administrative sanction of a life-saving medical procedure (CLIPP) for his mother.

The Applicant’s mother suffers from "Recurrent Acute Decompensated Heart failure" and is a beneficiary of the Central Government Health Scheme (CGHS).

The Applicant alleged that despite providing a medical summary from Max Hospital, Vaishali, the respondents failed to act upon his requests for administrative sanction.

The respondents contended that the Applicant failed to follow the proper protocol, citing a communication dated 09.04.2025, which required the Applicant to approach the CGHS Wellness Centre first rather than the CGHS Headquarters directly.

1. Whether the respondents are liable to accord administrative sanction for the life-saving medical procedure for the Applicant's mother.

2. Whether the Applicant followed the prescribed administrative procedure for seeking such medical sanction under the CGHS.

The Tribunal exercised its jurisdiction under Section 19 of the Administrative Tribunals Act, 1985.

The core legal principle applied was the adherence to established administrative protocols for CGHS sanctions, specifically the requirement that beneficiaries must route permission requests through the designated CGHS Wellness Centre before processing by the Additional Director or Headquarters.

The court also emphasized the duty of the administration to decide on life-saving medical grievances within a reasonable timeframe.

The Tribunal analyzed the communication from the Additional Director (RH) CGHS (HQ) dated 09.04.2025, which explicitly informed the Applicant that permissions for such procedures are not processed at the Headquarters level and must be initiated through the CGHS Wellness Centre.

The Tribunal noted that the Applicant's direct approach to the Headquarters and the Ministry was procedurally premature.

Recognizing the urgency of the "life-saving procedure," the Tribunal avoided a dismissal on technical grounds.

Instead, it harmonized the procedural requirements with the Applicant's medical exigency by directing the Applicant to follow the correct administrative channel (the Wellness Centre) while simultaneously imposing a time-bound mandate on the respondents to ensure the life-saving treatment was not delayed by administrative lethargy.

It directed the Applicant to approach the CGHS Wellness Centre in accordance with the communication dated 09.04.2025.

Respondent No. 3 was specifically directed to consider the Applicant’s grievance and the request for administrative sanction in accordance with the law as expeditiously as possible, preferably within two weeks from the date of receipt of the order.

No order as to costs was issued.