The Rajasthan government, led by Chief Minister Bhajanlal Sharma, has introduced significant modifications to the Rajasthan Government Health Scheme (RGHS). These changes specifically target the process of conducting medical investigations and tests under the Outpatient Department (OPD) services. The primary objective behind these new guidelines is to enhance transparency and accelerate the approval process for beneficiaries seeking medical care. According to the official circular issued by the Rajasthan State Health Assurance Agency, which operates under the Department of Medical and Health, the new system will redefine how diagnostic tests are authorized and processed across the state.
New Financial Threshold for Medical Tests
Under the revised framework, a financial threshold has been established for medical tests. For any diagnostic investigation where the cost is up to 2000 rupees, patients and hospitals will no longer be required to seek any prior permission from the authorities. This move is expected to reduce the administrative burden on both the healthcare providers and the beneficiaries for routine and low-cost tests. However, for any medical investigation that exceeds the cost of 2000 rupees, the hospital must mandatory obtain pre-authorization through the dedicated RGHS portal. This new regulatory arrangement is scheduled to come into effect from July 13, 2026.
Protocols for Emergency and Urgent Cases
The government has also laid out specific protocols for emergency situations to ensure that patient care isn't compromised by administrative procedures. In cases classified as emergencies, the requirement for pre-authorization will be waived. This allows doctors to proceed with necessary investigations immediately based on the patient's clinical condition. Despite this exemption, the hospital or the treating physician is required to later upload all relevant clinical documents and a detailed justification for the tests on the RGHS portal to maintain a record of the emergency intervention.
Documentation and Approval Timelines
For non-emergency cases where the cost exceeds 2000 rupees, the application for pre-authorization must be comprehensive. The hospital is required to upload the following documents:
- OPD prescription from the treating doctor
- Complete medical history of the patient
- Previous investigation reports
- Clear clinical justification explaining the necessity of the proposed test