WBHS: Major Revision in OPD Rules for West Bengal Health Scheme, Ending Patient Hassles

WBHS Corrigendum: A very important amendment has been made to the rules for Out-Patient Department (OPD) treatment under the West Bengal Health Scheme (WBHS). The Medical Cell of the State Government’s Finance Department issued a corrigendum (No. 104-F(MED)WB) on July 2, 2025, to implement this change. This amendment permanently resolves a major problem faced by the beneficiaries of the scheme, who are current and retired state government employees and their dependent family members.

The previous order mentioned the term “Treating Specialist”, which led to many treasury offices raising objections on bills submitted with prescriptions from a General Physician or Medical Officer. They were only accepting prescriptions from specialist doctors, causing extreme hardship for ordinary people. This new change has ended that complication.

What was the Old Rule and the Main Problem?

Last year, on November 6, 2023, the Finance Department issued a notification (No. 164-F(Med) WB). According to that notification, the government would reimburse the full cost of OPD treatment for 17 specified diseases, such as malignant diseases, heart diseases, renal failure, insulin-dependent diabetes, rheumatoid arthritis, etc. The notification also importantly stated that if a beneficiary has one of the listed diseases, the cost of treatment for other co-morbid diseases required for better medical management would also be reimbursed.

However, a problem arose from a specific condition. The order stated that all necessary medicines (including supplements like vitamins, calcium, etc.) must be prescribed by a “Treating Specialist” in a single prescription. This term ‘Specialist’ created major confusion. In many cases, general physicians or medical officers provide the primary treatment, but treasury offices were only accepting prescriptions signed by a specialist doctor. As a result, many legitimate claims were getting stuck, and people were facing unnecessary harassment.

What Does the New Corrigendum Say?

To quickly resolve this practical problem, the state government issued a new corrigendum on July 2, 2025. This amendment makes one very clear and significant change.

The phrase “Treating Specialist” used in the previous notification has been replaced with the term “Treating Doctor“.

This directly means that from now on, a prescription provided by any registered treating doctor—be it a General Physician, Medical Officer, or a Specialist—will be accepted for claim settlement. The obligation to visit a specialist doctor just for a prescription is no longer there.

What Are the Benefits for the Beneficiaries?

This single-word change has brought immense relief to the beneficiaries. The main advantages are:

• End of Harassment: There is no longer a fear of claims being rejected at the treasury office for having a prescription from a general physician.
• Ease of Treatment: Patients can now get treatment from any registered doctor as per their convenience. They will not have to run to a specialist just to get a signature on a prescription.
• Faster Claim Settlement: The process of getting claims passed is now expected to be much simpler and faster.
• Other Rules Remain Unchanged: It is important to remember that all other rules from the original notification remain unchanged. This includes the condition that the benefit applies to the specified list of diseases and that all medicines should be on a single prescription.

This small but very timely step by the state government will greatly benefit thousands of government employees and pensioners. This initiative to understand a real-world problem faced by the public and provide a swift solution is certainly commendable. It will make the benefits of the West Bengal Health Scheme more accessible and effective for the people.