THE ALL INDIA SERVICES
(MEDICAL ATTENDANCE) RULES, 1954
MISCELLANEOUS EXECUTIVE
INSTRUCTION/ORDERS ISSUED BY THE GOVERNMENT OF INDIA UNDER THE ALL INDIA
SERVICES (MEDICAL ATTENDANCE) RULES, 1954
1. Claims for reimbursement
of medical expenses - Procedure for drawal of -
The form of application and
the various certificates prescribed for the Central Government servants under
the Central Services (Medical Attendance) Rules, 1944, as amended by the
Ministry of Health from time to time, shall, with necessary modifications, be
used for claiming refund of medical expenses incurred in connection with
medical attendance and/or treatment of members of the All India Services and
their families.
[G.I. M.H.A. letter
No.31/16/56-AIS (II), dated 17th November, 1956.]
2. Reimbursement of medical
expenses - Preferring of claims -Fixing of time limits.-
The Government of India
have decided that claims for reimbursement of medical expenses of Central
Government servants should invariably be preferred within six months from the
date of completion of treatment as shown in the essentiality certificate of the
authorised medical attendant/medical officer concerned. The bills for
reimbursement of charges on account of medical attendance and treatment should
be countersigned by the controlling authorities, who are empowered to
countersign the travelling allowance bills of the officers concerned. In the
case of members of the Service who are their own controlling officers regard to
travelling allowance bills, medical bills concerning them and members of their
families shall be countersigned by the members themselves. Specific sanction to
the reimbursement of medical charges is not ordinarily necessary. If, however,
a claim for reimbursement of medical charges is not countersigned and
preferred, within six months/one year of the date of completion of treatment
should be subject to investigation by the Accountant General in accordance with
the provisions of rules 123 and 124 of the General Financial Rules, Volume I,
respectively. If a special sanction is accorded for reimbursement of any
charges in relation of the rules that sanction should be deemed to be operative
from the date of its issue and the period of six-months/one year will count
from that date.
2. If the State Government
has no objection, the same procedure and time limit may also be prescribed in
the case of All India Service officers preferring claims under the All India
Service (Medical Attendance) Rules, 1954.
[G.I. M.H.A. letter No.
31/3/57-AIS (i), dated 13th March, 1957 read with letter No. 6/6/59-AIS (III),
dated 12th May, 1959 and 7/22/60-AIS (III), dated 25th October, 1960.]
3. Delegation of powers to
Head of Departments.-
Letter No. 8/8/66-AIS
(III), 14-07-1966 11023/5/75-AIS (III), 19th January, 1976, 11023/16/76
AIS(III), 14th Dec., 1977, 11023/5/76-AIS(II), 19th Aug., 1976. [Annexure-I]
4. Concessions regarding
treatment of tuberculosis or leprosy.-
In exercises of the powers
conferred under clause (ii) of rule 14 of the All India Services (Medical
Attendance) Rule, 1954, the administrative Ministry in respect of All India
Services officers working in connection with the affairs of the Union and the
State Government in respect of officers working in connection with the affairs
of the States, may reimburse expenses incurred by the officers in the following
cases:-
(i) Post treatment
check-up: a member of the Service who has suffered from tuberculosis or leprosy
and who has obtained treatment in accordance with the relevant rules and orders
will be entitled to reimbursement of fee for obtaining the certificate of
fitness for return to duty. If he is required to undergo post-treatment
check-up with specialist, he will also be entitled to reimbursement of fees for
medical examinations during such periodical check-up as well as travelling
allowance from his place of duty to the headquarters of the specialist and
back. Post-treatment follow-up should, however, be done by a recognised T.B
specialist/Institution, stationed at or nearest to the place of the ex-T.B.
patient. The specialist if necessary may call for the complete records of the
ex-patient from the institution where he was treated originally.
(ii) Ambulance charges:
Reimbursement of ambulance charges will also be allowed even if the ambulance
used belongs to a social service organisation such as the Red Cross Society.
[G.I. M.H.A. letter No.
6/1/58-AIS (III), dated 16th April, 1958, read with O.M. No. 6/1/58-AIS (III),
dated 30th August, 1958.]
5. Medical attendance and
treatment in the St. George’s Nursing Home Bombay - Reimbursement of charges.-
The Government of India
have decided that the Nursing Home at the St. George’s Hospital, Bombay should
be treated as a recognised institution for purpose of medical attendance and
treatment of the All India Service officers serving in connection with the
affairs of the Union and stationed in Bombay State, who are in receipt of a pay
of over Rs.500 per mensem and the members of their families. In view, however,
of the fact that the charges levied by the Nursing Home for the professional
services rendered by the attending doctors are high, reimbursement of charges
incurred by officers on their own treatment and/or on the treatment of members
of their families in the Nursing Home will be allowed subject to the following
conditions.
(i) The treatment should be
received only at the hands of Government doctors of the hospitals and not at
the hands of private doctors and private specialists who are allowed to treat
patients at the Nursing Home.
(ii) The reimbursement of
visiting fees of the doctors in the case of persons drawing a pay of Rs. 1,000
per mensem would be restricted to a maximum of Rs. 16 for the first visit and
Rs. 10 for subsequent visit.
(iii) the reimbursement of
anaesthetist’s charges would be restricted to a maximum of Rs. 50 for a minor
operation and Rs. 100 for a major operation.
(iv) The reimbursement of
operation charges would be made in full at the rates prescribed by the
Government of Bombay.
(v) The reimbursement of
surgeon’s charges would be restricted to a maximum of Rs. 500 in the case of a
major operation and a maximum of Rs. 130 in the case of a minor operation. This
will be in addition to the other usual hospital charges.
(2) The Government of
Bombay may extend the above concession to All India Services officers serving
in connection with the affairs of the State in exercise of the powers vested in
them by rule 2(d) and rule 14(ii) of the All India Services (Medical
Attendance) Rule, 1954.
[G.I. M.H.A. letter No.
7/3/60-AIS (II), dated 19th March, 1960.]
6. Reimbursement of fees
paid to Honorary Specialists in the State of Bombay.-
The Government of India
have decided that, since there are no Government specialists in the State of
Bombay Honorary specialists attached to Government hospitals should be regarded
as Government specialist in respect of All India Service Officers, serving in
connection with the affairs of the Union and stationed in Bombay State, and the
fees paid to them for consultations in their private consulting rooms reimbursed
to the officers in accordance with the rates prescribed for Government
specialists. The honorary specialists should, however, be consulted on the
advise of the authorised medical attendant and with the prior approval of the
Surgeon General with the Government of Bombay. The consultation with the
honorary specialist at their private consulting rooms will be permissible only
in emergent cases and in all other cases such consultation should be had at the
hospitals without payment of any fees.
(2) The Government of
Bombay may extend the above concessions to All India Services Officers serving
in connection with the affairs of the State in exercise of the powers vested in
them by the rule 2(d) and rule 14(ii) of the All India Service (Medical
Attendance) Rules, 1954.
[G.I. M.H.A. letter No.
7/3/60-AIS (III), dated 19th March 1969.]
7. Concessions regarding
treatment of members suffering from tuberculosis, cancer and poliomyelitis.-
The Government of India
have decided that the following concessions which are admissible to the Central
Government servants under the Central Services (Medical Attendance) Rules,
1944, should be extended to members of the All India Services serving in
connection with the affairs of the Union. The State Government may extend these
concessions to members of the All India Service serving in connection with the
affairs of the State also.
TUBERCULOSIS
(i) Consultation: If a
Government specialist in tuberculosis diseases is not available, consultation
on the advise of the authorised medical attendant with a specialist in T.B.
diseases recognised as such by the State Administrative Medical Officers
concerned will be admissible. Where the authorised medical attendant proposes
to advise a member to consult a specialist in T.B. diseases, the approval of
the Chief Administrative Medical Officer of the State concerned shall be
obtained. The specialist consulted should, as far as possible, be a medical
officer equal in status to the authorised medical attendant and if such a
specialist is in Government service, he should charge fees at the following
rates:-
In respect of consultation
with specialists, who are not in the service of the Government, the fees paid
to them for consultations should be reimbursed to the members concerned to the
extent of the rates indicated above.
(ii) Treatment in a
Sanatorium: If the specialist in T.B. diseases certifies that treatment in a
T.B. Sanatorium is necessary, the member concerned will be entitled to
treatment at a recognised sanatorium, located at or nearest to the place of
duty, which can, in the opinion of the T.B. specialist, provide the necessary
and suitable treatment and where accommodation for him is available. A list of
T.B. institutions recognised for the purpose is given in Appendix I. Where in the
opinion of the T.B. Specialist, the member concerned does not require treatment
in a T.B. Sanatorium; he will be entitled to receive treatment in a hospital in
the State, which can provided the necessary treatment. These concessions are
admissible to members of their families also.
Members of the Service and
the members of their families, who fail to get accommodation in a recognised
T.B. institution or for whom treatment as an in-patient in a Government
hospital and/or a recognised T.B. institution is not considered necessary, may,
on the advise of the authorised medical attendant, be allowed to receive
treatment at the outpatient department of a Government hospital and/or a
recognised T.B. institution at or near the place where they fall ill or at the consulting
room of a T.B. specialist, subject to the following conditions:-
(i) that a certificate
signed by the authorised medical attendant or the government recognised
specialist is submitted to the effect that the patient was advised to receive
treatment as an out-door patient at the consulting room of the T.B. Specialist,
as they failed to get necessary accommodation at the recognised T.B.
institution or treatment as in patient in a recognised T.B. institution was not
considered necessary; and
(ii) that a certificate
from the authorised medical attendant and/or the Government recognised T.B.
specialist is submitted to the effect that the patient had reasonable chances
of recovery if treated otherwise than as an inpatient in a recognised T.B.
institution.
Reimbursement of
consultation fees paid to the authorised medical attendant and for a Government
recognised specialist for treatment at his consulting room will be allowed in
full at the prescribed rates for the first consultation and at two-thirds for each
subsequent consultation. The cost of medicines, which will include the cost of
drugs injected but not with professional fees for administering the injections,
will be reimbursable in full, if otherwise admissible under the Rules.
(iii) Travelling allowance:
A member of the Service and the members of his family sent to a recognised
sanatorium for treatment under the advice of the authorised medical attendant
or the T. B. Specialist consulted, will be entitled to travelling allowance for
the journeys performed by rail and road to and from the place of treatment.
Travelling allowance will
not be admissible for journeys performed by air. If the T.B. Specialist
consulted certifies in writing that it is unsafe for the patient to travel
unattended and that an attendant is necessary to accompany him to the place of
treatment, then the attendant may draw T.A for the outward and return journeys.
A member of the Service
will be entitled to travelling allowance at tour rate for the rail and road
journey; but no halting allowance will be paid.
A member of his family
referred for treatment, will be entitled to the actual single railway fare for
the class of accommodation to which the member of the Service is entitled, or
of any lower class, by which the patient travels for the rail journey and
actual cost of transit not exceeding the travelling allowance admissible to the
member of the Service for journey by road. An attendant accompanying a patient
will be granted actual single railway fare for the appropriate class in which
the patient travels, or by a lower class, by which the attendant actually
travels, for the rail journey, and actual cost of the transit not exceeding the
travelling allowance admissible to the member concerned for journey by road.
The outward journey will be
deemed to have commenced from the headquarters of the member of the Service or
from the place, from which the patient actually travels, whichever is nearer to
the sanatorium. Likewise, the return journey will be deemed to have ended at
the headquarters or at the place, to which the patient actually travels,
whichever is nearer.
For purpose of
reimbursement of travelling allowance for the return journey, a certificate
testifying to the actual performance of the journey from the Medical
Superintendent of the sanatorium or any other doctor-in-charge of the case in
the sanatorium, who for all practical purposes is the authorised medical
attendant of the patient while at the sanatorium, will be acceptable.
CANCER
(i) Treatment: A member of
the Service or a member of his family may receive treatment for cancer at the
nearest recognised hospitals providing such treatment, subject to the
conditions that such treatment is recommended by the authorised medical
attendant and that the prior approval of the State Administrative Medical
officer concerned is obtained. A list of the hospitals recognised for this
purpose is given in Appendix II. If the Medical Superintendent of the
recognised hospital to whom the patient was sent for treatment by the
authorised medical attendant considers that special treatment is necessary, he
may refer the patient to the Tata Memorial Hospital, Bombay or the Cancer
Institute, Madras.
(ii) Travelling Allowance:
A member of the Service and the members of his family sent to a recognised hospital
for treatment of cancer under the advise of the authorised medical attendant
will be entitled to travelling allowance for the journeys performed by rail and
road to and from the place of treatment. Travelling allowance will not be
admissible for journeys performed by air or by Air-conditioned accommodation on
trains.
If the authorised medical
attendant certifies in writing that it is unsafe for the patient to travel
unattendant and that attendant is necessary to accompany him to the place of
treatment he may draw travelling allowance for the onward and return journeys.
A member of the Service
will be entitled to travelling allowance at tour rates for the rail and road
journey but no halting allowance will be paid. A member of his family, referred
for treatment will be entitled to the actual single railway fare for the class
of accommodation to which the member of the Service entitled, or of any lower
class, by which the patient travels for the rail journey, and cost of transit
not exceeding the travelling allowance admissible to the member of the Service
for journey by road.
An attendant accompanying
the patient will be granted actual single railway fare of the appropriate class
by which the patient travels or by a lower class by which the attendant actually
travels for the rail journey and actual cost of transit not exceeding the
travelling allowance admissible to the member concerned for journey by road.
The outward journey will be
deemed to have commenced from the headquarters of the Government servant or
from the place, from which the patient actually travels, whichever is nearer to
the hospital. Likewise, the return journey will be deemed to have ended at the
headquarters at the place, to which the patient actually travels, whichever is
nearer.
(iii) Post-treatment
check-up: A member of the Service, who has suffered from cancer and who has
obtained treatment in accordance with the relevant rules and orders, will be
entitled to reimbursement of fees for obtaining the certificate of fitness for
return to duty. If he is required to undergo post-treatment check-up with a
specialist, he will be entitled to reimbursement of fees for medical
examinations during such periodical check-up as well as travelling allowance by
rail and road from his place of duty to the headquarters of the specialist and
back. Post treatment follow up should however, be done by a recognised cancer
specialist/institution stationed at or nearest to the place of duty of the
ex-patient. The Specialist, if necessary, may call for the complete records of
the ex-patient from the institution where he was treated originally.
(iv) Ambulance charges:
Reimbursement of ambulance charges will also be allowed even if the ambulance
used belongs to a social service organisation such as the Red Cross Society
etc.
POLIOMYELITIS:
(i) Treatment: A member of
the Service or a member of his family may receive treatment for poliomyelitis
at the nearest recognised hospital providing such treatment, subject to the
conditions that such treatment is recommended by the authorised medical
attendant and that the prior approval of the State Administrative Medical
Officer concerned is obtained. A list of hospitals recognised for this purpose
is given in Appendix III.
(ii) Travelling Allowance:
A member of the Service and the members of his family sent to a recognised
hospital for treatment of poliomyelitis under the advise of the authorised
medical attendant will be entitled to travelling allowance for the journeys
performed by rail and road to and from the place of treatment. Travelling
allowance will not be admissible for journeys performed by air or by
Air-conditioned accommodation on trains.
If the authorised medical
attendant certifies in writing that it is unsafe for the patient to travel
unattended and that an attendant is necessary to accompany him to the place of
treatment, he may draw travelling allowance for the onward and return journey.
A member of the Service
will be entitled to travelling allowance at tour rates for the rail and road
journey, but no halting allowance will be paid.
A member of his family,
referred for treatment will be entitled to the actual single railway fare for
the class of accommodation to which the member of the Service is entitled or of
any lower class by which the patient travels, for the rail journey and actual
cost of transit not exceeding the travelling allowance admissible to the member
of the Service for journey by road.
An attendant accompanying
the patient will be granted actual single railway fare of the appropriate class
by which the patient travels, or by a lower class, by which the attendant
actually travels, for the rail travelling allowance admissible to the member
concerned for journey by road.
The out ward journey will
be deemed to have commenced from the headquarters of the Government servant or
from the place from which the patient actually travels whichever is nearer to
the hospital. Likewise, the return journey will be deemed to have ended at the
headquarters or at the place to which the patient actually travels, whichever
is nearer.
MENTAL DISEASES:
(i) Treatment: A member of
the Service may receive consultation and/or treatment for mental disease in the
nearest Government Recognised Mental Hospital on the advise of the authorised
medical attendant and with the prior approval of the Chief Administrative
Medical Officer of the State, subject to the condition that the duration of the
treatment, for which reimbursement of medical expenses will be admissible to
the member concerned, should not exceed six months unless the Medical
Superintendent of the Mental Hospital concerned certifies that treatment for a
reasonable period upto six months beyond the six-month limit is likely to lead
to complete recovery of the patient. A list of recognised mental hospitals is
given in Appendix IV.
(ii) Travelling Allowance:
A member of the Service suffering from mental disease will be entitled to
travelling allowance (by rail and road and not by air) for the outward and
return journeys in the manner indicated below when sent for consultation/treatment
in a Mental Hospital.
(a) for the rail journeys
in question, actual fare for the entitled or lower, class by which the patient
may actually travel; and
(b) for the road portion of
the journey or for journeys between stations connected by road only travelling
allowance at half the rate of the road mileage admissible under the All India
Services (Travelling Allowance) Rules, 1954.
If the authorised medical
attendant certifies in writing that it is unsafe for the patient to travel
unattended and that an attendant is necessary to accompany him to the place of
consultation/treatment, the attendant accompanying the patient will be entitled
to actual single railway fare, both ways, of the appropriate class, in which
the patient is entitled to travel or of a lower class, by which the attendant
actually travels.
Journey by air or by
Air-Conditioned accommodation on trains are not permissible.
The outward journey should
be deemed to have commenced from the headquarters of the members of the Service
or from the place, from which the patient actually travels, whichever is nearer
to the place of consultation/treatment. Likewise, the return journey will be
deemed to have ended at the headquarters or at the place, at which the patient
actually travels, whichever is nearer.
For the road portion of the
journey, the attendant will be allowed the actual cost of transit not exceeding
the travelling allowance admissible to the member of the Service concerned:
(iii) The concessions
mentioned in (i) and (ii) above will also be admissible to the members of the
family of a member of the Service provided the treatment for such diseases is
taken in a Government Mental Hospital.
8. Reimbursement of
expenses on purchase/replacement/repair/adjustment of Hearing Aid instrument:-
The undersigned is directed
to invite attention to this Ministry’s O.M. No. 14025/32/83-MS dated 5th March
1984 according to which the reimbursement of cost of Hearing Aid to Central
Govt. Employees and members of their families is admissible on the recommendations
of the Director General of Health Services. Representations are being received
in this Ministry for the reimbursement of expenses for the purchase of Hearing
Aid to the Central Govt. employees and members of their families under the CS
(MA) Rules, 1944. After careful consideration, it has now been decided that the
reimbursement of cost of Hearing Aid to Central Govt. employees and their
family members, will be made on the recommendation of the ENT Specialist of
Govt./recognized hospital and on the basis of the Audiogram given by him/her,
identifying the degree and the nature of the deafness. The payment would be
made by the Administrative Authority direct to the Supplying Agency and not to
the Govt. Servant concerned.
2. In view of the procedure
indicated above, it is no more necessary to obtain the concurrence of the
Director General of Health Services for the reimbursement of expenditure
incurred by the Deptt./Office concerned for their employees.
3. This issues with the
concurrence of the Deptt. of Pension & P.W. vide their U.O. PPW No. 570/87
P&PW dated 31.08.1987.
4. In so far as persons
serving in the Indian Audit and Accounts Departments are concerned, there
orders issue after consultation with the Comptroller and Auditor General of
India.
5. These orders also apply
to the Central Govt. employees who are beneficiaries of Central Govt. Health
Scheme. The payment will be made from the ‘Service Head’ of the beneficiary.
[G.I. MH & FW O.M. No.
14025/48/96-MS dated 20.11.1987 read with DP&T Circular letter
No.11023/6/92-AIS(III) dated 11.11.1994.]
APPENDIX I
APPENDIX II
APPENDIX III
APPENDIX IV
9. Instructions of the Ministry of Finance Govt. of India regarding
reimbursement of medical claims of Central Government Officers in emergent
circumstances not conversed under the Central rules: Instruction to the State
Government for adoption:-
Instructions have been
issued by M/O Finance vide OM. No. F. 49(15)- EV/59 dated 21-05-1959 and
21(2)-EV(B)/62, dated 17-04-1963 regarding reimbursement of medical expenses
incurred by the Central Government servants and the All India Services Officers
serving in connection with the affairs of the Union, on having medical
attendance/treatment in emergent circumstances from sources other than those
from when it is permissible under the relevant Medical Attendance Rules. The
State Govt. may adopt these orders in respect of All India Services Officers
serving in connection with the affairs of State delegating the powers of
allowing the State Govt. The medical attendance and treatment will include the
cost of all facilities mentioned in clause (f) and (k) of rule 2 of the AIS
(M.A.) Rules, 1954 including cost of medicines, fees for administration of
injections and visiting fees, charged by the Medical Officers and Private Practitioners
who are not authorised Medical Attendants of the officers in question.
[No. 8/8/66-AIS (III),
dated 14th July, 1966.]
(i) Copy of Min. of Finance
(Exp.) O.M. No. F. 49(15)-EV/59, dated 21st May, 1959.
1. At present all cases
where Central Government servants & members of their families receive
medical attendance/treatment in emergent circumstances from sources other than
those from whom it is permissible under the relevant Medical Attendance Rules,
are referred to the Ministries of Finance/Health for allowing reimbursement of
the Medical expenses by special sanction. Such cases are referred to the
Ministries of Finance/Health irrespective of the amount involved. In the past
it has been noticed that in the majority of such cases medical attendance
and/or treatment were received either from Railway/Military/Factory/Local Board
(District and Municipal Boards, Local Funds and Panchayats) hospital or from
doctors attached thereto, or from private practitioners, due to the
non-existence of any Government/recognised hospital within a reasonable
distance from the place where the patient fell ill. With a view to cutting out
delays in the settlement of such cases caused by frequent references to the
Ministries of Finance and Health, the President has been pleased to delegate
powers to all Ministries/Head of Departments to allow refund of medical
expenses upto a maximum limit of Rs. 50/- in each case where they are satisfied
that although refund is not permissible under the strict application of the
various Medical Attendance Rules, the circumstances of the case warranted
medical attendance/treatment being had from hospitals and doctors mentioned
above, in the absence of Government/recognised hospital or doctors within a
reasonable distance from the place where the patient fell ill. The
reasonableness of the distance may be determined with reference to the nature
and severity of the ailment in each case. Further, refunds as above may be
allowed only to the extent admissible under the relevant Medical Attendance Rules
and subject to the general spirit of those rules being observed. Doubtful cases
should continue to be referred to the Ministries of Finance/Health.
(ii) Copy of Min. of
Finance (Exp.) O.M. No. F. 21(2) EV (B)/62, dated 17th April, 1963.
1. In modification of the
orders contained in this Ministry’s Office Memorandum No. F.49 (15)-EV/59 dated
21st May, 1959 (Copy enclosed for ready reference) on the above subject, the
President has been pleased to decided that the existing limit of Rs. 50/- laid
down in the above orders shall be raised to Rs. 100/- in each case.
2. Ministries and Head of
Departments may henceforth allow refund of medical expenses upto Rs. 100/- in
each case in relaxation of the relevant Medical Attendance Rules subject to the
consideration and conditions set out in the aforesaid orders.
3. The powers referred to
above may also be exercised in cases where medical attendance and treatment is
received in a private hospital, as a result of serious accident, or on the
advice of the Authorised Medical Attendant.
4. These powers can also be
exercised in cases where medical attendance and treatment is received from
Government doctors other than the Authorised Medical Attendant, or in
Government recognised hospitals or institutions without following the
prescribed procedure of obtaining prior approval of the Authorised Medical
Attendant, Chief Administrative Medical Officer of the State etc. and in cases
where medical tests like X-ray, Blood examination etc. are got done in private
clinics due to absence of facilities in Government hospitals/institutions or
due to severity of ailment which confines the patient to bed.
5. Doubtful cases should,
however, be referred to the Ministry of Health for their advice, who would
consult the Ministry of Finance, if necessary.
6. It has also been decided
that in the types of cases referred to above, where the amount exceeds Rs. 100
refund may be allowed by the Ministries and Head of Departments in relaxation
of various Medical Attendance Rules and orders issued thereunder in
consultation with the Ministry of Health only. (That Ministry will be free to
consult the Ministry of Finance in cases of doubt).
7. It has further been
decided that:
(a) in cases where medical
attendance/treatment is received in State/State-aided hospital in Calcutta,
which has not been specifically recognised by the Government of India for
medical attendance/treatment of Central Government employees and members of
their families i.e. in respect of which Schedule of Charges has not been published
by the Ministry of Health, reimbursement of medical expenses to the extent
otherwise admissible may be allowed by the Ministries/Heads of Departments,
where necessary and justified, in direct consultation with the Director of
Health Services, West Bengal, Calcutta. The Director of Health Services, West
Bengal will be deemed to be the final authority to decide whether the charges
on account of accommodation and other expenses recovered from a Central
Government employee in such a hospital are reasonable and suited to the status
of the Government servant concerned. The same procedure may be adopted in the
case of hospitals in respect of which the Schedules of Charges have been
published by the Government of India but such Schedules have undergone changes,
till such charges are communicated to all concerned by the Government of India,
Ministry of Health.
Such cases need not be
referred to the Ministries of Health and Finance.
(b) in cases where
artificial appliances have to be purchased (e.g. for diseases like polio, T.B.
etc. or in cases requiring surgical operations etc.) reimbursement of expenses
incurred in connection with the procurement of such artificial appliances (e.g.
travelling expenses, hospitalisation charges etc. if any) including the actual
cost of appliance, may, where necessary and justified, be allowed by the
Ministries/Heads of Departments, in consultation with the Ministry of Health
direct. Such cases need not be referred to the Ministry of Finance.
8. The powers referred to
in these orders shall not be exercised by the Heads of the Departments in their
own cases. In such cases sanction of the higher authority should be obtained.
9. These orders also apply
to Central Government employees who are beneficiaries of the Contributory
Health Service Scheme mutatis mutandis.
10. Pending cases may be
decided in the light of these orders.
11. In their application to
persons serving in the Indian Audit and Accounts Department, these orders issue
after consultation with the Comptroller and Auditor General of India.
10. Instructions of the
Ministry of Finance Govt. of India regarding reimbursement of indoor medical
treatment in private hospitals Central Government: Instruction to the State
Government for adoption:-
I am directed to refer to
the Ministry of Home Affairs letter No. 8/8/66-AIS(III), dated the 14th July,
1966 and forward herewith a copy of a Ministry of Finance O.M. No. F. 26
(10)-EV(B)/74 dated the 16th July, 1974. It is requested that the State
Government may adopt the orders contained therein in respect of members of the
All India Services working under them.
[DP & AR Letter No.
11023/5/75-AIS(III), dated 19th January, 1976.]
(i) Copy of Min. of Finance
(Exp.) O.M.26(10)EV-B/74 of 16-07-1974.
1. The question of
reimbursement of indoor medical treatment in private hospitals was raised by
the staff in the National Council of the J.C.M. and on the basis of the
decision taken in the National Council; the President is pleased to decide that
in partial modification of the orders contained in Finance Ministry’s Office
Memorandum No. F. 21(2)E.V.(B) 62 dated the 17th April, 1963 the ceiling of Rs.
100/- upto which Ministries/Heads of departments were at present delegated
powers for sanctioning reimbursement in each case where treatment was received
in private hospitals as a result of serious accidents or on the advise of the
authorised medical attendants mentioned therein, would be raised to Rs. 250/-
where Ministries and Heads of departments consider claims in respect of their
own staff and to Rs. 500/- where they consider claims in respect of the
employees of their subordinate and lower formations. In other cases as at
present, the claims in respect of reimbursement for treatment in private
hospitals would be examined on merits by the Ministry of Health.
2. The other conditions
mentioned in this Ministry’s Office Memorandum No. F. 49 (15)/59 dated 21st
May, 1959 and Office Memorandum No. F. 21(2)-E.V.(B)/62 dated the 17th April,
1963 will, however, continue to be observed.
3. In their application to
the persons serving in the Indian Audit and Accounts Department, these orders
issue after consultation with Comptroller and Auditor General of India.
(ii) Copy of DP & AR
letter No. 11023/16/76-AIS(III), dated 14th December, 1977.
1. I am directed to enclose
a copy of the Ministry of Finance (Department of Expenditure) Office Memorandum
No. 22(3)-EV(B)/76, dated the 18th June, 1976 regarding reimbursement of the
cost of Heart Pace Maker and its replacement. In accordance with these orders,
the reimbursement of the cost of Heart Pace Maker and the replacement of its
pulse generator has been brought within the purview of the delegated powers in
terms of their earlier Office Memorandum No. F. 21(2)-EV(B)/62 dated the 17th
April, 1963.
2. Attention in this
connection is invited to the Ministry of Home Affairs letter
No.8/8/66-AIS(III), dated the 14th July, 1966 (copy enclosed with its
enclosures) under which the instructions contained in the Ministry of Finance
(Deptt. of Exp.) O.M. dated 17th April, 1963 were adopted in respect of All
India Services Officers serving in connection with Affairs of the State,
directing further that powers allowing refund in such cases may be delegated to
the Heads of Departments under the State Government.
3. It has also been decided
that the orders contained in the Ministry of Finance (Department of Exp.) O.M.
No. F.22(3)-EV(B)/76, dated the 18th June, 1976 may also be adopted in respect
of the members of All India Services and the powers of reimbursement of the
cost of Heart Pace Maker and the replacement of its pulse generator may also be
delegated to the Heads of Departments of the State Government.
The initial supply of the
Heart Pace Maker as well as the replacement of the pulse generator will in all
cases be made only on the recommendation of the Department of Health of the
State concerned.
4. Wherever the supply is
approved by the Department of Health of the State concerned, the administrative
authority would make payment direct to the supplying agency and not direct to
the member of the All India Service concerned.
5. These orders also apply
to the members of the All India Services serving in connection with the affairs
of the Union and who are beneficiaries of Central Government Health Scheme.
(iii) Copy of Ministry of
Finance (Exp.) O.M. No. F. 22(3)-EV(B), dated 18th June, 1976.
1. The undersigned is
directed to say that a question has been raised whether the reimbursement of
the expenses incurred on the purchase of Heart Pace Maker or its replacement is
covered by the power delegated to Ministries/Heads of Departments in terms of
para 7(b) of this Ministry’s Office Memorandum No. F.21(2)-EV(B)/62, dated 17th
April, 1963. The matter has been considered carefully and the President has
been pleased to decide that the reimbursement of the cost of Heart Pace Maker
and the replacement of its pulse generator should also be brought within the
purview of the delegated powers in terms of the above mentioned para 7(b). But
the initial supply of the Heart Pace Maker as well as the replacement of the
pulse generator will in all cases be made only on the recommendation of the
Director General of Health Services and not as a matter of course.
2. Wherever the supply is
approved by DGHS, the administrative authority would make the payment direct to
the supplying agency and not direct to the Government servant concerned.
3. These orders also apply
to Central Government employees who are beneficiaries of Central Government
Health Scheme.
4. In so far as persons
serving in the Indian Audit and Accounts Department are concerned, these orders
have been issued after consultation with the Comptroller and Auditor General of
India.
11. Sanctioning authorities
of medical reimbursement in respect of member of Service serving at the
headquarters and places outside the headquarters in the State Government: -
A question was raised as to
who would be the sanctioning authority for allowing medical reimbursement of
Rs. 250/- and Rs. 500/- to members of the All India Services serving at the
headquarters of the State Governments and those serving at places outside the
State Governments Hqrs. The matter has been considered in consultation with the
Ministry of Finance and the position is clarified as under:-
(i) In respect of All India
Services officer serving at the headquarters in the Ministries/Departments of
the State Governments viz., State Government’s Capital such as Bombay,
Calcutta, Lucknow etc., the Heads of Departments viz., Secretary, Special
Secretary, Chairman, Board of Revenue, Commissioner and Secretary and the other
officers of equivalent status who are Heads of the Ministries/Departments would
be empowered to sanction amounts upto Rs. 250/- in each case; and
(ii) In respect of members
of the All India Services serving outside the State Government’s headquarters
viz., outside the capital of the State Governments the Heads of Departments
viz., Secretary, Special Secretary, Chairman, Board of Revenue, Commissioner
and Secretary and other officers of equivalent status who are Heads of
Ministries/Departments would be empowered to sanction amounts upto Rs. 500/- in
each case.
2. In case the amounts
mentioned at (i) and (ii) above are exceeded, the matter shall be decided by
the cadre authority (e.g. Appointment department, Department of Personnel etc.)
in consultation with the Health Department of the State Government concerned.
(This disposes Government
of Rajasthan letter No. 3/8/(1)-1/68, dated the 10th March, 1976).
[DP & AR letter No.
11023/5/76-AIS (III), dated 19th August 1976.]
12. Instructions of the
Ministry of Finance Govt. of India regarding the reimbursement of the cost of
replacement of diseased heart valves: Delegation of powers: Instruction to the
State Government for adoption:-
I am directed to enclose a
copy of the Ministry of Finance (Department of Expenditure) O.M. No. F.
23(5)-EV(B)/77 dated the 18th Sept., 1978, regarding the reimbursement of the
cost of replacement of diseased heart valves. In accordance with these orders,
the reimbursement of the cost of heart valves has been brought within the
purview of the delegated powers of their earlier O.M. No. F. 21(2)-EV/(B)/62
dated 17th April, 1963, a copy of which is attached to this Department’s letter
No. 11023/16/76-AIS(III), dated 14th December, 1977.
2. It has been decided that
the orders contained in the Ministry of Finance O.M. No. F. 23(5)-EV(B)/77
dated 18th Sept., 1978 may be adopted in respect of member of All India
Services and the powers of reimbursement of the Cost of replacement of diseased
heart valves may be delegated to the Heads of Department of the State
Government.
The initial supply of the
heart valves will, however, in all cases be made only on the recommendation of
the Department of Health of the State concerned.
3. Wherever the supply is
approved by the Deptt. of Health of the State concerned, the administrative
authority would make payment direct to the supplying agency and not direct to
the member of the All India Service, concerned. These orders also apply to the
members of the All India Services serving in connection with the affairs of the
Union and who are beneficiaries of the Central Government Health Scheme.
[DP & AR letter No.
11023/14/78-AIS(III), dated 6th January, 1979.]
(i) Copy of Ministry of
Finance (Exp.) O.M. No. F.23(5)EV (B)/77 Dated 18.09.1978.
1. The undersigned is
directed to say that a question has been raised whether the reimbursement of
the cost of the replacement of diseased Heart Valves is covered by the powers
delegated to the Ministries/Heads of Departments in terms of para 7(b) of this Ministry’s
Office Memorandum No. F.21(2)EV(B)/62 dated the 17th April, 1963. The matter
has been considered carefully and the President has been pleased to decide that
the reimbursement of the cost of replacement of diseased Heart Valves should
also be brought within the purview of the delegated powers in terms of the
above mentioned para 7(b). The initial supply of the Heart Valves will,
however, in all cases be made only on the recommendation of the Director
General of Health Services.
2. Wherever the supply is
approved by D.G.H.S. the Administrative authorities would make the payment
direct to the supplying agency and not direct to the Government servant
concerned.
3. These orders also apply
to Central Government employees who are beneficiaries of Central Government
Health Scheme.
4. In so far as persons
serving in the Indian Audit and Accounts Department are concerned these orders
have been issued after consultation with the Comptroller and Auditor General of
India.
[Copy of letter No.
11023/4/76-AIS(III), dated 21st January, 1977.]
13. Instruction of the
Ministry of Health, Govt. of India on the procedure to be followed regarding
medical treatment under Indian System of Medicine and Homoeopathy in respect of
Central Government servants: Instructions to the State Governments for
adoption: -
I am directed to say that
in accordance with the Government of India decision No. 13 below Rule 2 of the
All India Services (Medical Attendance) Rules, 1954, the State Governments are
competent to recognise Unani or Ayurvedic Hospitals for the purpose of
treatment of All India Services Officers serving in connection with the Affairs
of the State. The Government of India (Ministry of Health and Family Planning)
have issued orders/instructions regarding the procedure to be followed
regarding medical treatment under Indian System of Medicine and Homoeopathy in
respect of Central Government servants vide their O.M. No.29/16/71-MA dated
14-09-1972 (copy enclosed).
2. It has been decided that
the provisions contained in the Deptt. of Health’s O.M. referred to in para 1
above may also be adopted in respect of the members of All India Services.
3. The authorised Medical
Attendant in respect of members of the AIS will have the same meaning as
mentioned in para 2(i) (a) of the Ministry of Health and Family Planning O.M.
No. 29-16/71-MA, dated 14-09-1972, referred to in para 1 above, and also under
rule 2(a) of the AIS (Medical Attendance) Rules, 1954.
4. I am to request that the
contents of this letter may be brought to the notice of the members of the
Service working under the State Government.
(i) Copy of Deptt. of
Health letter No. 29-16/71MA, dated 14th September, 1972.
1. Reference is invited to
this Ministry’s Office Memorandum No.F. 28-26/61-HI, dated the 6th November,
1961 reproduced as Government of India decision No. 5 at page 11 of the
Compilation of Central Services (Medical Attendance) Rules, 1944 and orders
(1964 edition). It was clarified under para 2 that under the Medical Attendance
Rules, modern system of medicine only is recognised and other systems of
medicines such as Ayurvedic, Unani, Homoeopathy amount covered by these rules,
and that Ayurvedic etc., hospitals are not recognised for the purpose of
aforesaid orders even though some of the State Governments have recognised such
hospitals for the treatment of their own employees. This decision was based on
the policy of Government according to which Allopathic (Modern) scientific
medicine should continue to be the basis for the development of the National
Health Services in the country. The above mentioned policy decision has
recently undergone modification according to which the Union and State
Governments have been directed that Allopathic, Indian and Homoeopathic Systems
of medicine should contribute towards the development of the National Health
Services in the country.
2. The question of giving
effect to the aforesaid revised policy decision in so far as medical attendance
and treatment of Central Government servants and members of their families are
concerned under the provisions of the Central Services (Medical Attendance)
Rules have been under the consideration of the Government for some time past.
It has now been decided as follows:-
(i) Authorised medical
attendant for the purposes of these orders within the meaning of Rule 2 of the
Central Services (Medical Attendance) Rules, 1944, will mean -
(a) In respect of a
Government servant who belongs to a Central Service Class I, or whose pay is
not less than Rs. 500 per mensem, Class I officers belonging to Ayurveda, Unani,
Sidha and Homoeopathic Medical Services of the State/or Central Government or
any other qualified medical officer, appointed by the Government, to attend its
officers in the district;
(b) In respect of a
Government servant not belonging to a Central Service, Class I whose pay is
less than Rs. 500 per mensem, but more than Rs. 150/- per mensem, a Class II
Gazetted Officer of the Department of Indian Medicine or Homoeopathy of a State
or Central Government, or any other qualified Medical Officer, appointed by the
Government to attend its officers in the station;
(c) In respect of any other
Government servant, the physicians-in-charge of Government, Government aided
Municipal and Panchayati dispensaries of Ayurveda, Sidha, Unani and
Homoeopathic systems of medicines and/or any other qualified medical officer,
similarly appointed.
N.B.: The term ‘qualified’
would mean in the case of Ayurveda, Unani and Sidha, persons possessing
recognised medical qualifications as included in the II, III and IV Schedules of
the Indian Medicines Central Council Act, 1970. As far as Homoeopathy is
concerned, it would include the recognised medical qualifications as notified
in the II Schedule of the Homoeopathy Central Council Bill, 1971.
(ii) Rates of fees for
purposes of re-imbursement:
(a) Class I Officers
belonging to Ayurveda, Unani, Sidha and Homoeopathic Medical Services of the
State or Central Government of any other medical officers of equivalent status
appointed by the Government....................Rs. 16
(b) Class II Officers of
the Departments of Indian Medicine and Homoeopathy of a State or Central
Government or any other medical officer of an equivalent status appointed by
the Government........... Rs. 3.
(c)
Others.....................Rs 3.
Provided that in respect of
medical officers of State Governments who are not allowed to receive any
payment, no fees would be reimbursable.
NOTE:- The fees prescribed
in clause (a) and (b) above will be payable for consultation at the consulting
room of the authorised medical attendant or at the residence of the patient.
(iii) List of admissible
medicines for the purpose of reimbursement: Ayurveda, Sidha, Unani and
Homeopathy.
The list of medicines in
these systems approved for the purposes of reimbursement with indication of maximum
prices against each medicine is given in Annexure I. In this Annexure, lists of
medicines have been drawn up in three categories viz.
(a) Costly medicines and
treatment like panchakarma therapy which may be prescribed only by class I
officers or a doctor of equivalent rank;
(b) General medicines which
may be prescribed by all authorized medical attendants, and
(c)
Restricted medicines which may be deemed t
For General Information
THE ALL INDIA SERVICES
(MEDICAL ATTENDANCE) RULES, 1954
MISCELLANEOUS EXECUTIVE
INSTRUCTION/ORDERS ISSUED BY THE GOVERNMENT OF INDIA UNDER THE ALL INDIA
SERVICES (MEDICAL ATTENDANCE) RULES, 1954
1. Claims for reimbursement
of medical expenses - Procedure for drawal of -
The form of application and
the various certificates prescribed for the Central Government servants under
the Central Services (Medical Attendance) Rules, 1944, as amended by the
Ministry of Health from time to time, shall, with necessary modifications, be
used for claiming refund of medical expenses incurred in connection with
medical attendance and/or treatment of members of the All India Services and
their families.
[G.I. M.H.A. letter
No.31/16/56-AIS (II), dated 17th November, 1956.]
2. Reimbursement of medical
expenses - Preferring of claims -Fixing of time limits.-
The Government of India
have decided that claims for reimbursement of medical expenses of Central
Government servants should invariably be preferred within six months from the
date of completion of treatment as shown in the essentiality certificate of the
authorised medical attendant/medical officer concerned. The bills for
reimbursement of charges on account of medical attendance and treatment should
be countersigned by the controlling authorities, who are empowered to
countersign the travelling allowance bills of the officers concerned. In the
case of members of the Service who are their own controlling officers regard to
travelling allowance bills, medical bills concerning them and members of their
families shall be countersigned by the members themselves. Specific sanction to
the reimbursement of medical charges is not ordinarily necessary. If, however,
a claim for reimbursement of medical charges is not countersigned and
preferred, within six months/one year of the date of completion of treatment
should be subject to investigation by the Accountant General in accordance with
the provisions of rules 123 and 124 of the General Financial Rules, Volume I,
respectively. If a special sanction is accorded for reimbursement of any
charges in relation of the rules that sanction should be deemed to be operative
from the date of its issue and the period of six-months/one year will count
from that date.
2. If the State Government
has no objection, the same procedure and time limit may also be prescribed in the
case of All India Service officers preferring claims under the All India
Service (Medical Attendance) Rules, 1954.
[G.I. M.H.A. letter No.
31/3/57-AIS (i), dated 13th March, 1957 read with letter No. 6/6/59-AIS (III),
dated 12th May, 1959 and 7/22/60-AIS (III), dated 25th October, 1960.]
3. Delegation of powers to
Head of Departments.-
Letter No. 8/8/66-AIS
(III), 14-07-1966 11023/5/75-AIS (III), 19th January, 1976, 11023/16/76
AIS(III), 14th Dec., 1977, 11023/5/76-AIS(II), 19th Aug., 1976. [Annexure-I]
4. Concessions regarding
treatment of tuberculosis or leprosy.-
In exercises of the powers
conferred under clause (ii) of rule 14 of the All India Services (Medical
Attendance) Rule, 1954, the administrative Ministry in respect of All India
Services officers working in connection with the affairs of the Union and the
State Government in respect of officers working in connection with the affairs
of the States, may reimburse expenses incurred by the officers in the following
cases:-
(i) Post treatment check-up:
a member of the Service who has suffered from tuberculosis or leprosy and who
has obtained treatment in accordance with the relevant rules and orders will be
entitled to reimbursement of fee for obtaining the certificate of fitness for
return to duty. If he is required to undergo post-treatment check-up with
specialist, he will also be entitled to reimbursement of fees for medical
examinations during such periodical check-up as well as travelling allowance
from his place of duty to the headquarters of the specialist and back.
Post-treatment follow-up should, however, be done by a recognised T.B
specialist/Institution, stationed at or nearest to the place of the ex-T.B.
patient. The specialist if necessary may call for the complete records of the
ex-patient from the institution where he was treated originally.
(ii) Ambulance charges:
Reimbursement of ambulance charges will also be allowed even if the ambulance
used belongs to a social service organisation such as the Red Cross Society.
[G.I. M.H.A. letter No.
6/1/58-AIS (III), dated 16th April, 1958, read with O.M. No. 6/1/58-AIS (III),
dated 30th August, 1958.]
5. Medical attendance and
treatment in the St. George’s Nursing Home Bombay - Reimbursement of charges.-
The Government of India
have decided that the Nursing Home at the St. George’s Hospital, Bombay should
be treated as a recognised institution for purpose of medical attendance and
treatment of the All India Service officers serving in connection with the
affairs of the Union and stationed in Bombay State, who are in receipt of a pay
of over Rs.500 per mensem and the members of their families. In view, however,
of the fact that the charges levied by the Nursing Home for the professional
services rendered by the attending doctors are high, reimbursement of charges
incurred by officers on their own treatment and/or on the treatment of members
of their families in the Nursing Home will be allowed subject to the following
conditions.
(i) The treatment should be
received only at the hands of Government doctors of the hospitals and not at
the hands of private doctors and private specialists who are allowed to treat
patients at the Nursing Home.
(ii) The reimbursement of
visiting fees of the doctors in the case of persons drawing a pay of Rs. 1,000
per mensem would be restricted to a maximum of Rs. 16 for the first visit and
Rs. 10 for subsequent visit.
(iii) the reimbursement of
anaesthetist’s charges would be restricted to a maximum of Rs. 50 for a minor
operation and Rs. 100 for a major operation.
(iv) The reimbursement of
operation charges would be made in full at the rates prescribed by the
Government of Bombay.
(v) The reimbursement of
surgeon’s charges would be restricted to a maximum of Rs. 500 in the case of a
major operation and a maximum of Rs. 130 in the case of a minor operation. This
will be in addition to the other usual hospital charges.
(2) The Government of
Bombay may extend the above concession to All India Services officers serving
in connection with the affairs of the State in exercise of the powers vested in
them by rule 2(d) and rule 14(ii) of the All India Services (Medical
Attendance) Rule, 1954.
[G.I. M.H.A. letter No.
7/3/60-AIS (II), dated 19th March, 1960.]
6. Reimbursement of fees
paid to Honorary Specialists in the State of Bombay.-
The Government of India
have decided that, since there are no Government specialists in the State of
Bombay Honorary specialists attached to Government hospitals should be regarded
as Government specialist in respect of All India Service Officers, serving in
connection with the affairs of the Union and stationed in Bombay State, and the
fees paid to them for consultations in their private consulting rooms
reimbursed to the officers in accordance with the rates prescribed for
Government specialists. The honorary specialists should, however, be consulted
on the advise of the authorised medical attendant and with the prior approval
of the Surgeon General with the Government of Bombay. The consultation with the
honorary specialist at their private consulting rooms will be permissible only
in emergent cases and in all other cases such consultation should be had at the
hospitals without payment of any fees.
(2) The Government of
Bombay may extend the above concessions to All India Services Officers serving
in connection with the affairs of the State in exercise of the powers vested in
them by the rule 2(d) and rule 14(ii) of the All India Service (Medical
Attendance) Rules, 1954.
[G.I. M.H.A. letter No.
7/3/60-AIS (III), dated 19th March 1969.]
7. Concessions regarding
treatment of members suffering from tuberculosis, cancer and poliomyelitis.-
The Government of India
have decided that the following concessions which are admissible to the Central
Government servants under the Central Services (Medical Attendance) Rules,
1944, should be extended to members of the All India Services serving in
connection with the affairs of the Union. The State Government may extend these
concessions to members of the All India Service serving in connection with the
affairs of the State also.
TUBERCULOSIS
(i) Consultation: If a
Government specialist in tuberculosis diseases is not available, consultation
on the advise of the authorised medical attendant with a specialist in T.B.
diseases recognised as such by the State Administrative Medical Officers
concerned will be admissible. Where the authorised medical attendant proposes
to advise a member to consult a specialist in T.B. diseases, the approval of
the Chief Administrative Medical Officer of the State concerned shall be
obtained. The specialist consulted should, as far as possible, be a medical
officer equal in status to the authorised medical attendant and if such a
specialist is in Government service, he should charge fees at the following
rates:-
In respect of consultation
with specialists, who are not in the service of the Government, the fees paid
to them for consultations should be reimbursed to the members concerned to the
extent of the rates indicated above.
(ii) Treatment in a
Sanatorium: If the specialist in T.B. diseases certifies that treatment in a
T.B. Sanatorium is necessary, the member concerned will be entitled to
treatment at a recognised sanatorium, located at or nearest to the place of
duty, which can, in the opinion of the T.B. specialist, provide the necessary and
suitable treatment and where accommodation for him is available. A list of T.B.
institutions recognised for the purpose is given in Appendix I. Where in the
opinion of the T.B. Specialist, the member concerned does not require treatment
in a T.B. Sanatorium; he will be entitled to receive treatment in a hospital in
the State, which can provided the necessary treatment. These concessions are
admissible to members of their families also.
Members of the Service and
the members of their families, who fail to get accommodation in a recognised
T.B. institution or for whom treatment as an in-patient in a Government
hospital and/or a recognised T.B. institution is not considered necessary, may,
on the advise of the authorised medical attendant, be allowed to receive
treatment at the outpatient department of a Government hospital and/or a
recognised T.B. institution at or near the place where they fall ill or at the
consulting room of a T.B. specialist, subject to the following conditions:-
(i) that a certificate signed
by the authorised medical attendant or the government recognised specialist is
submitted to the effect that the patient was advised to receive treatment as an
out-door patient at the consulting room of the T.B. Specialist, as they failed
to get necessary accommodation at the recognised T.B. institution or treatment
as in patient in a recognised T.B. institution was not considered necessary;
and
(ii) that a certificate
from the authorised medical attendant and/or the Government recognised T.B.
specialist is submitted to the effect that the patient had reasonable chances
of recovery if treated otherwise than as an inpatient in a recognised T.B.
institution.
Reimbursement of
consultation fees paid to the authorised medical attendant and for a Government
recognised specialist for treatment at his consulting room will be allowed in
full at the prescribed rates for the first consultation and at two-thirds for
each subsequent consultation. The cost of medicines, which will include the
cost of drugs injected but not with professional fees for administering the
injections, will be reimbursable in full, if otherwise admissible under the
Rules.
(iii) Travelling allowance:
A member of the Service and the members of his family sent to a recognised
sanatorium for treatment under the advice of the authorised medical attendant
or the T. B. Specialist consulted, will be entitled to travelling allowance for
the journeys performed by rail and road to and from the place of treatment.
Travelling allowance will
not be admissible for journeys performed by air. If the T.B. Specialist
consulted certifies in writing that it is unsafe for the patient to travel
unattended and that an attendant is necessary to accompany him to the place of
treatment, then the attendant may draw T.A for the outward and return journeys.
A member of the Service
will be entitled to travelling allowance at tour rate for the rail and road
journey; but no halting allowance will be paid.
A member of his family
referred for treatment, will be entitled to the actual single railway fare for
the class of accommodation to which the member of the Service is entitled, or
of any lower class, by which the patient travels for the rail journey and
actual cost of transit not exceeding the travelling allowance admissible to the
member of the Service for journey by road. An attendant accompanying a patient
will be granted actual single railway fare for the appropriate class in which
the patient travels, or by a lower class, by which the attendant actually
travels, for the rail journey, and actual cost of the transit not exceeding the
travelling allowance admissible to the member concerned for journey by road.
The outward journey will be
deemed to have commenced from the headquarters of the member of the Service or
from the place, from which the patient actually travels, whichever is nearer to
the sanatorium. Likewise, the return journey will be deemed to have ended at
the headquarters or at the place, to which the patient actually travels,
whichever is nearer.
For purpose of reimbursement
of travelling allowance for the return journey, a certificate testifying to the
actual performance of the journey from the Medical Superintendent of the
sanatorium or any other doctor-in-charge of the case in the sanatorium, who for
all practical purposes is the authorised medical attendant of the patient while
at the sanatorium, will be acceptable.
CANCER
(i) Treatment: A member of
the Service or a member of his family may receive treatment for cancer at the
nearest recognised hospitals providing such treatment, subject to the
conditions that such treatment is recommended by the authorised medical
attendant and that the prior approval of the State Administrative Medical
officer concerned is obtained. A list of the hospitals recognised for this
purpose is given in Appendix II. If the Medical Superintendent of the
recognised hospital to whom the patient was sent for treatment by the
authorised medical attendant considers that special treatment is necessary, he
may refer the patient to the Tata Memorial Hospital, Bombay or the Cancer
Institute, Madras.
(ii) Travelling Allowance:
A member of the Service and the members of his family sent to a recognised
hospital for treatment of cancer under the advise of the authorised medical
attendant will be entitled to travelling allowance for the journeys performed
by rail and road to and from the place of treatment. Travelling allowance will
not be admissible for journeys performed by air or by Air-conditioned
accommodation on trains.
If the authorised medical
attendant certifies in writing that it is unsafe for the patient to travel
unattendant and that attendant is necessary to accompany him to the place of
treatment he may draw travelling allowance for the onward and return journeys.
A member of the Service will
be entitled to travelling allowance at tour rates for the rail and road journey
but no halting allowance will be paid. A member of his family, referred for
treatment will be entitled to the actual single railway fare for the class of
accommodation to which the member of the Service entitled, or of any lower
class, by which the patient travels for the rail journey, and cost of transit
not exceeding the travelling allowance admissible to the member of the Service
for journey by road.
An attendant accompanying
the patient will be granted actual single railway fare of the appropriate class
by which the patient travels or by a lower class by which the attendant
actually travels for the rail journey and actual cost of transit not exceeding
the travelling allowance admissible to the member concerned for journey by
road.
The outward journey will be
deemed to have commenced from the headquarters of the Government servant or
from the place, from which the patient actually travels, whichever is nearer to
the hospital. Likewise, the return journey will be deemed to have ended at the
headquarters at the place, to which the patient actually travels, whichever is
nearer.
(iii) Post-treatment
check-up: A member of the Service, who has suffered from cancer and who has obtained
treatment in accordance with the relevant rules and orders, will be entitled to
reimbursement of fees for obtaining the certificate of fitness for return to
duty. If he is required to undergo post-treatment check-up with a specialist,
he will be entitled to reimbursement of fees for medical examinations during
such periodical check-up as well as travelling allowance by rail and road from
his place of duty to the headquarters of the specialist and back. Post
treatment follow up should however, be done by a recognised cancer
specialist/institution stationed at or nearest to the place of duty of the
ex-patient. The Specialist, if necessary, may call for the complete records of
the ex-patient from the institution where he was treated originally.
(iv) Ambulance charges:
Reimbursement of ambulance charges will also be allowed even if the ambulance
used belongs to a social service organisation such as the Red Cross Society
etc.
POLIOMYELITIS:
(i) Treatment: A member of
the Service or a member of his family may receive treatment for poliomyelitis
at the nearest recognised hospital providing such treatment, subject to the
conditions that such treatment is recommended by the authorised medical
attendant and that the prior approval of the State Administrative Medical
Officer concerned is obtained. A list of hospitals recognised for this purpose
is given in Appendix III.
(ii) Travelling Allowance:
A member of the Service and the members of his family sent to a recognised
hospital for treatment of poliomyelitis under the advise of the authorised
medical attendant will be entitled to travelling allowance for the journeys
performed by rail and road to and from the place of treatment. Travelling
allowance will not be admissible for journeys performed by air or by Air-conditioned
accommodation on trains.
If the authorised medical
attendant certifies in writing that it is unsafe for the patient to travel
unattended and that an attendant is necessary to accompany him to the place of
treatment, he may draw travelling allowance for the onward and return journey.
A member of the Service
will be entitled to travelling allowance at tour rates for the rail and road
journey, but no halting allowance will be paid.
A member of his family,
referred for treatment will be entitled to the actual single railway fare for
the class of accommodation to which the member of the Service is entitled or of
any lower class by which the patient travels, for the rail journey and actual
cost of transit not exceeding the travelling allowance admissible to the member
of the Service for journey by road.
An attendant accompanying
the patient will be granted actual single railway fare of the appropriate class
by which the patient travels, or by a lower class, by which the attendant
actually travels, for the rail travelling allowance admissible to the member
concerned for journey by road.
The out ward journey will
be deemed to have commenced from the headquarters of the Government servant or
from the place from which the patient actually travels whichever is nearer to
the hospital. Likewise, the return journey will be deemed to have ended at the
headquarters or at the place to which the patient actually travels, whichever
is nearer.
MENTAL DISEASES:
(i) Treatment: A member of
the Service may receive consultation and/or treatment for mental disease in the
nearest Government Recognised Mental Hospital on the advise of the authorised
medical attendant and with the prior approval of the Chief Administrative
Medical Officer of the State, subject to the condition that the duration of the
treatment, for which reimbursement of medical expenses will be admissible to
the member concerned, should not exceed six months unless the Medical
Superintendent of the Mental Hospital concerned certifies that treatment for a
reasonable period upto six months beyond the six-month limit is likely to lead
to complete recovery of the patient. A list of recognised mental hospitals is
given in Appendix IV.
(ii) Travelling Allowance:
A member of the Service suffering from mental disease will be entitled to
travelling allowance (by rail and road and not by air) for the outward and
return journeys in the manner indicated below when sent for
consultation/treatment in a Mental Hospital.
(a) for the rail journeys
in question, actual fare for the entitled or lower, class by which the patient
may actually travel; and
(b) for the road portion of
the journey or for journeys between stations connected by road only travelling
allowance at half the rate of the road mileage admissible under the All India
Services (Travelling Allowance) Rules, 1954.
If the authorised medical
attendant certifies in writing that it is unsafe for the patient to travel
unattended and that an attendant is necessary to accompany him to the place of
consultation/treatment, the attendant accompanying the patient will be entitled
to actual single railway fare, both ways, of the appropriate class, in which
the patient is entitled to travel or of a lower class, by which the attendant
actually travels.
Journey by air or by
Air-Conditioned accommodation on trains are not permissible.
The outward journey should
be deemed to have commenced from the headquarters of the members of the Service
or from the place, from which the patient actually travels, whichever is nearer
to the place of consultation/treatment. Likewise, the return journey will be
deemed to have ended at the headquarters or at the place, at which the patient
actually travels, whichever is nearer.
For the road portion of the
journey, the attendant will be allowed the actual cost of transit not exceeding
the travelling allowance admissible to the member of the Service concerned:
(iii) The concessions
mentioned in (i) and (ii) above will also be admissible to the members of the
family of a member of the Service provided the treatment for such diseases is
taken in a Government Mental Hospital.
8. Reimbursement of
expenses on purchase/replacement/repair/adjustment of Hearing Aid instrument:-
The undersigned is directed
to invite attention to this Ministry’s O.M. No. 14025/32/83-MS dated 5th March
1984 according to which the reimbursement of cost of Hearing Aid to Central
Govt. Employees and members of their families is admissible on the
recommendations of the Director General of Health Services. Representations are
being received in this Ministry for the reimbursement of expenses for the
purchase of Hearing Aid to the Central Govt. employees and members of their
families under the CS (MA) Rules, 1944. After careful consideration, it has now
been decided that the reimbursement of cost of Hearing Aid to Central Govt.
employees and their family members, will be made on the recommendation of the
ENT Specialist of Govt./recognized hospital and on the basis of the Audiogram
given by him/her, identifying the degree and the nature of the deafness. The
payment would be made by the Administrative Authority direct to the Supplying
Agency and not to the Govt. Servant concerned.
2. In view of the procedure
indicated above, it is no more necessary to obtain the concurrence of the
Director General of Health Services for the reimbursement of expenditure
incurred by the Deptt./Office concerned for their employees.
3. This issues with the
concurrence of the Deptt. of Pension & P.W. vide their U.O. PPW No. 570/87
P&PW dated 31.08.1987.
4. In so far as persons serving
in the Indian Audit and Accounts Departments are concerned, there orders issue
after consultation with the Comptroller and Auditor General of India.
5. These orders also apply
to the Central Govt. employees who are beneficiaries of Central Govt. Health
Scheme. The payment will be made from the ‘Service Head’ of the beneficiary.
[G.I. MH & FW O.M. No.
14025/48/96-MS dated 20.11.1987 read with DP&T Circular letter
No.11023/6/92-AIS(III) dated 11.11.1994.]
APPENDIX I
APPENDIX II
APPENDIX III
APPENDIX IV
9. Instructions of the Ministry of Finance Govt. of India regarding
reimbursement of medical claims of Central Government Officers in emergent
circumstances not conversed under the Central rules: Instruction to the State
Government for adoption:-
Instructions have been
issued by M/O Finance vide OM. No. F. 49(15)- EV/59 dated 21-05-1959 and
21(2)-EV(B)/62, dated 17-04-1963 regarding reimbursement of medical expenses
incurred by the Central Government servants and the All India Services Officers
serving in connection with the affairs of the Union, on having medical
attendance/treatment in emergent circumstances from sources other than those
from when it is permissible under the relevant Medical Attendance Rules. The
State Govt. may adopt these orders in respect of All India Services Officers
serving in connection with the affairs of State delegating the powers of
allowing the State Govt. The medical attendance and treatment will include the
cost of all facilities mentioned in clause (f) and (k) of rule 2 of the AIS
(M.A.) Rules, 1954 including cost of medicines, fees for administration of
injections and visiting fees, charged by the Medical Officers and Private
Practitioners who are not authorised Medical Attendants of the officers in
question.
[No. 8/8/66-AIS (III),
dated 14th July, 1966.]
(i) Copy of Min. of Finance
(Exp.) O.M. No. F. 49(15)-EV/59, dated 21st May, 1959.
1. At present all cases
where Central Government servants & members of their families receive
medical attendance/treatment in emergent circumstances from sources other than
those from whom it is permissible under the relevant Medical Attendance Rules,
are referred to the Ministries of Finance/Health for allowing reimbursement of
the Medical expenses by special sanction. Such cases are referred to the
Ministries of Finance/Health irrespective of the amount involved. In the past
it has been noticed that in the majority of such cases medical attendance
and/or treatment were received either from Railway/Military/Factory/Local Board
(District and Municipal Boards, Local Funds and Panchayats) hospital or from
doctors attached thereto, or from private practitioners, due to the
non-existence of any Government/recognised hospital within a reasonable
distance from the place where the patient fell ill. With a view to cutting out
delays in the settlement of such cases caused by frequent references to the
Ministries of Finance and Health, the President has been pleased to delegate
powers to all Ministries/Head of Departments to allow refund of medical expenses
upto a maximum limit of Rs. 50/- in each case where they are satisfied that
although refund is not permissible under the strict application of the various
Medical Attendance Rules, the circumstances of the case warranted medical
attendance/treatment being had from hospitals and doctors mentioned above, in
the absence of Government/recognised hospital or doctors within a reasonable
distance from the place where the patient fell ill. The reasonableness of the
distance may be determined with reference to the nature and severity of the
ailment in each case. Further, refunds as above may be allowed only to the
extent admissible under the relevant Medical Attendance Rules and subject to
the general spirit of those rules being observed. Doubtful cases should continue
to be referred to the Ministries of Finance/Health.
(ii) Copy of Min. of
Finance (Exp.) O.M. No. F. 21(2) EV (B)/62, dated 17th April, 1963.
1. In modification of the
orders contained in this Ministry’s Office Memorandum No. F.49 (15)-EV/59 dated
21st May, 1959 (Copy enclosed for ready reference) on the above subject, the
President has been pleased to decided that the existing limit of Rs. 50/- laid
down in the above orders shall be raised to Rs. 100/- in each case.
2. Ministries and Head of
Departments may henceforth allow refund of medical expenses upto Rs. 100/- in
each case in relaxation of the relevant Medical Attendance Rules subject to the
consideration and conditions set out in the aforesaid orders.
3. The powers referred to
above may also be exercised in cases where medical attendance and treatment is
received in a private hospital, as a result of serious accident, or on the
advice of the Authorised Medical Attendant.
4. These powers can also be
exercised in cases where medical attendance and treatment is received from
Government doctors other than the Authorised Medical Attendant, or in
Government recognised hospitals or institutions without following the
prescribed procedure of obtaining prior approval of the Authorised Medical
Attendant, Chief Administrative Medical Officer of the State etc. and in cases
where medical tests like X-ray, Blood examination etc. are got done in private
clinics due to absence of facilities in Government hospitals/institutions or
due to severity of ailment which confines the patient to bed.
5. Doubtful cases should,
however, be referred to the Ministry of Health for their advice, who would
consult the Ministry of Finance, if necessary.
6. It has also been decided
that in the types of cases referred to above, where the amount exceeds Rs. 100
refund may be allowed by the Ministries and Head of Departments in relaxation
of various Medical Attendance Rules and orders issued thereunder in
consultation with the Ministry of Health only. (That Ministry will be free to
consult the Ministry of Finance in cases of doubt).
7. It has further been
decided that:
(a) in cases where medical
attendance/treatment is received in State/State-aided hospital in Calcutta,
which has not been specifically recognised by the Government of India for
medical attendance/treatment of Central Government employees and members of
their families i.e. in respect of which Schedule of Charges has not been
published by the Ministry of Health, reimbursement of medical expenses to the
extent otherwise admissible may be allowed by the Ministries/Heads of
Departments, where necessary and justified, in direct consultation with the
Director of Health Services, West Bengal, Calcutta. The Director of Health
Services, West Bengal will be deemed to be the final authority to decide
whether the charges on account of accommodation and other expenses recovered
from a Central Government employee in such a hospital are reasonable and suited
to the status of the Government servant concerned. The same procedure may be
adopted in the case of hospitals in respect of which the Schedules of Charges
have been published by the Government of India but such Schedules have
undergone changes, till such charges are communicated to all concerned by the
Government of India, Ministry of Health.
Such cases need not be
referred to the Ministries of Health and Finance.
(b) in cases where
artificial appliances have to be purchased (e.g. for diseases like polio, T.B.
etc. or in cases requiring surgical operations etc.) reimbursement of expenses
incurred in connection with the procurement of such artificial appliances (e.g.
travelling expenses, hospitalisation charges etc. if any) including the actual
cost of appliance, may, where necessary and justified, be allowed by the
Ministries/Heads of Departments, in consultation with the Ministry of Health
direct. Such cases need not be referred to the Ministry of Finance.
8. The powers referred to
in these orders shall not be exercised by the Heads of the Departments in their
own cases. In such cases sanction of the higher authority should be obtained.
9. These orders also apply
to Central Government employees who are beneficiaries of the Contributory
Health Service Scheme mutatis mutandis.
10. Pending cases may be
decided in the light of these orders.
11. In their application to
persons serving in the Indian Audit and Accounts Department, these orders issue
after consultation with the Comptroller and Auditor General of India.
10. Instructions of the
Ministry of Finance Govt. of India regarding reimbursement of indoor medical
treatment in private hospitals Central Government: Instruction to the State
Government for adoption:-
I am directed to refer to
the Ministry of Home Affairs letter No. 8/8/66-AIS(III), dated the 14th July,
1966 and forward herewith a copy of a Ministry of Finance O.M. No. F. 26
(10)-EV(B)/74 dated the 16th July, 1974. It is requested that the State
Government may adopt the orders contained therein in respect of members of the
All India Services working under them.
[DP & AR Letter No.
11023/5/75-AIS(III), dated 19th January, 1976.]
(i) Copy of Min. of Finance
(Exp.) O.M.26(10)EV-B/74 of 16-07-1974.
1. The question of
reimbursement of indoor medical treatment in private hospitals was raised by
the staff in the National Council of the J.C.M. and on the basis of the
decision taken in the National Council; the President is pleased to decide that
in partial modification of the orders contained in Finance Ministry’s Office
Memorandum No. F. 21(2)E.V.(B) 62 dated the 17th April, 1963 the ceiling of Rs.
100/- upto which Ministries/Heads of departments were at present delegated
powers for sanctioning reimbursement in each case where treatment was received
in private hospitals as a result of serious accidents or on the advise of the
authorised medical attendants mentioned therein, would be raised to Rs. 250/-
where Ministries and Heads of departments consider claims in respect of their
own staff and to Rs. 500/- where they consider claims in respect of the
employees of their subordinate and lower formations. In other cases as at
present, the claims in respect of reimbursement for treatment in private
hospitals would be examined on merits by the Ministry of Health.
2. The other conditions
mentioned in this Ministry’s Office Memorandum No. F. 49 (15)/59 dated 21st
May, 1959 and Office Memorandum No. F. 21(2)-E.V.(B)/62 dated the 17th April,
1963 will, however, continue to be observed.
3. In their application to
the persons serving in the Indian Audit and Accounts Department, these orders
issue after consultation with Comptroller and Auditor General of India.
(ii) Copy of DP & AR
letter No. 11023/16/76-AIS(III), dated 14th December, 1977.
1. I am directed to enclose
a copy of the Ministry of Finance (Department of Expenditure) Office Memorandum
No. 22(3)-EV(B)/76, dated the 18th June, 1976 regarding reimbursement of the
cost of Heart Pace Maker and its replacement. In accordance with these orders,
the reimbursement of the cost of Heart Pace Maker and the replacement of its
pulse generator has been brought within the purview of the delegated powers in
terms of their earlier Office Memorandum No. F. 21(2)-EV(B)/62 dated the 17th
April, 1963.
2. Attention in this
connection is invited to the Ministry of Home Affairs letter
No.8/8/66-AIS(III), dated the 14th July, 1966 (copy enclosed with its
enclosures) under which the instructions contained in the Ministry of Finance
(Deptt. of Exp.) O.M. dated 17th April, 1963 were adopted in respect of All
India Services Officers serving in connection with Affairs of the State, directing
further that powers allowing refund in such cases may be delegated to the Heads
of Departments under the State Government.
3. It has also been decided
that the orders contained in the Ministry of Finance (Department of Exp.) O.M.
No. F.22(3)-EV(B)/76, dated the 18th June, 1976 may also be adopted in respect
of the members of All India Services and the powers of reimbursement of the
cost of Heart Pace Maker and the replacement of its pulse generator may also be
delegated to the Heads of Departments of the State Government.
The initial supply of the
Heart Pace Maker as well as the replacement of the pulse generator will in all
cases be made only on the recommendation of the Department of Health of the
State concerned.
4. Wherever the supply is
approved by the Department of Health of the State concerned, the administrative
authority would make payment direct to the supplying agency and not direct to
the member of the All India Service concerned.
5. These orders also apply
to the members of the All India Services serving in connection with the affairs
of the Union and who are beneficiaries of Central Government Health Scheme.
(iii) Copy of Ministry of
Finance (Exp.) O.M. No. F. 22(3)-EV(B), dated 18th June, 1976.
1. The undersigned is
directed to say that a question has been raised whether the reimbursement of
the expenses incurred on the purchase of Heart Pace Maker or its replacement is
covered by the power delegated to Ministries/Heads of Departments in terms of
para 7(b) of this Ministry’s Office Memorandum No. F.21(2)-EV(B)/62, dated 17th
April, 1963. The matter has been considered carefully and the President has
been pleased to decide that the reimbursement of the cost of Heart Pace Maker
and the replacement of its pulse generator should also be brought within the
purview of the delegated powers in terms of the above mentioned para 7(b). But
the initial supply of the Heart Pace Maker as well as the replacement of the
pulse generator will in all cases be made only on the recommendation of the
Director General of Health Services and not as a matter of course.
2. Wherever the supply is
approved by DGHS, the administrative authority would make the payment direct to
the supplying agency and not direct to the Government servant concerned.
3. These orders also apply
to Central Government employees who are beneficiaries of Central Government
Health Scheme.
4. In so far as persons
serving in the Indian Audit and Accounts Department are concerned, these orders
have been issued after consultation with the Comptroller and Auditor General of
India.
11. Sanctioning authorities
of medical reimbursement in respect of member of Service serving at the
headquarters and places outside the headquarters in the State Government: -
A question was raised as to
who would be the sanctioning authority for allowing medical reimbursement of
Rs. 250/- and Rs. 500/- to members of the All India Services serving at the
headquarters of the State Governments and those serving at places outside the
State Governments Hqrs. The matter has been considered in consultation with the
Ministry of Finance and the position is clarified as under:-
(i) In respect of All India
Services officer serving at the headquarters in the Ministries/Departments of
the State Governments viz., State Government’s Capital such as Bombay,
Calcutta, Lucknow etc., the Heads of Departments viz., Secretary, Special
Secretary, Chairman, Board of Revenue, Commissioner and Secretary and the other
officers of equivalent status who are Heads of the Ministries/Departments would
be empowered to sanction amounts upto Rs. 250/- in each case; and
(ii) In respect of members
of the All India Services serving outside the State Government’s headquarters
viz., outside the capital of the State Governments the Heads of Departments
viz., Secretary, Special Secretary, Chairman, Board of Revenue, Commissioner
and Secretary and other officers of equivalent status who are Heads of
Ministries/Departments would be empowered to sanction amounts upto Rs. 500/- in
each case.
2. In case the amounts
mentioned at (i) and (ii) above are exceeded, the matter shall be decided by
the cadre authority (e.g. Appointment department, Department of Personnel etc.)
in consultation with the Health Department of the State Government concerned.
(This disposes Government
of Rajasthan letter No. 3/8/(1)-1/68, dated the 10th March, 1976).
[DP & AR letter No.
11023/5/76-AIS (III), dated 19th August 1976.]
12. Instructions of the
Ministry of Finance Govt. of India regarding the reimbursement of the cost of
replacement of diseased heart valves: Delegation of powers: Instruction to the
State Government for adoption:-
I am directed to enclose a
copy of the Ministry of Finance (Department of Expenditure) O.M. No. F.
23(5)-EV(B)/77 dated the 18th Sept., 1978, regarding the reimbursement of the
cost of replacement of diseased heart valves. In accordance with these orders,
the reimbursement of the cost of heart valves has been brought within the
purview of the delegated powers of their earlier O.M. No. F. 21(2)-EV/(B)/62
dated 17th April, 1963, a copy of which is attached to this Department’s letter
No. 11023/16/76-AIS(III), dated 14th December, 1977.
2. It has been decided that
the orders contained in the Ministry of Finance O.M. No. F. 23(5)-EV(B)/77
dated 18th Sept., 1978 may be adopted in respect of member of All India
Services and the powers of reimbursement of the Cost of replacement of diseased
heart valves may be delegated to the Heads of Department of the State
Government.
The initial supply of the
heart valves will, however, in all cases be made only on the recommendation of
the Department of Health of the State concerned.
3. Wherever the supply is
approved by the Deptt. of Health of the State concerned, the administrative
authority would make payment direct to the supplying agency and not direct to
the member of the All India Service, concerned. These orders also apply to the
members of the All India Services serving in connection with the affairs of the
Union and who are beneficiaries of the Central Government Health Scheme.
[DP & AR letter No.
11023/14/78-AIS(III), dated 6th January, 1979.]
(i) Copy of Ministry of
Finance (Exp.) O.M. No. F.23(5)EV (B)/77 Dated 18.09.1978.
1. The undersigned is
directed to say that a question has been raised whether the reimbursement of
the cost of the replacement of diseased Heart Valves is covered by the powers
delegated to the Ministries/Heads of Departments in terms of para 7(b) of this
Ministry’s Office Memorandum No. F.21(2)EV(B)/62 dated the 17th April, 1963.
The matter has been considered carefully and the President has been pleased to
decide that the reimbursement of the cost of replacement of diseased Heart
Valves should also be brought within the purview of the delegated powers in
terms of the above mentioned para 7(b). The initial supply of the Heart Valves
will, however, in all cases be made only on the recommendation of the Director
General of Health Services.
2. Wherever the supply is
approved by D.G.H.S. the Administrative authorities would make the payment
direct to the supplying agency and not direct to the Government servant
concerned.
3. These orders also apply
to Central Government employees who are beneficiaries of Central Government
Health Scheme.
4. In so far as persons
serving in the Indian Audit and Accounts Department are concerned these orders
have been issued after consultation with the Comptroller and Auditor General of
India.
[Copy of letter No.
11023/4/76-AIS(III), dated 21st January, 1977.]
13. Instruction of the
Ministry of Health, Govt. of India on the procedure to be followed regarding
medical treatment under Indian System of Medicine and Homoeopathy in respect of
Central Government servants: Instructions to the State Governments for
adoption: -
I am directed to say that
in accordance with the Government of India decision No. 13 below Rule 2 of the
All India Services (Medical Attendance) Rules, 1954, the State Governments are
competent to recognise Unani or Ayurvedic Hospitals for the purpose of
treatment of All India Services Officers serving in connection with the Affairs
of the State. The Government of India (Ministry of Health and Family Planning)
have issued orders/instructions regarding the procedure to be followed
regarding medical treatment under Indian System of Medicine and Homoeopathy in
respect of Central Government servants vide their O.M. No.29/16/71-MA dated
14-09-1972 (copy enclosed).
2. It has been decided that
the provisions contained in the Deptt. of Health’s O.M. referred to in para 1
above may also be adopted in respect of the members of All India Services.
3. The authorised Medical
Attendant in respect of members of the AIS will have the same meaning as
mentioned in para 2(i) (a) of the Ministry of Health and Family Planning O.M.
No. 29-16/71-MA, dated 14-09-1972, referred to in para 1 above, and also under
rule 2(a) of the AIS (Medical Attendance) Rules, 1954.
4. I am to request that the
contents of this letter may be brought to the notice of the members of the
Service working under the State Government.
(i) Copy of Deptt. of
Health letter No. 29-16/71MA, dated 14th September, 1972.
1. Reference is invited to
this Ministry’s Office Memorandum No.F. 28-26/61-HI, dated the 6th November,
1961 reproduced as Government of India decision No. 5 at page 11 of the
Compilation of Central Services (Medical Attendance) Rules, 1944 and orders
(1964 edition). It was clarified under para 2 that under the Medical Attendance
Rules, modern system of medicine only is recognised and other systems of
medicines such as Ayurvedic, Unani, Homoeopathy amount covered by these rules,
and that Ayurvedic etc., hospitals are not recognised for the purpose of
aforesaid orders even though some of the State Governments have recognised such
hospitals for the treatment of their own employees. This decision was based on
the policy of Government according to which Allopathic (Modern) scientific
medicine should continue to be the basis for the development of the National
Health Services in the country. The above mentioned policy decision has
recently undergone modification according to which the Union and State
Governments have been directed that Allopathic, Indian and Homoeopathic Systems
of medicine should contribute towards the development of the National Health
Services in the country.
2. The question of giving
effect to the aforesaid revised policy decision in so far as medical attendance
and treatment of Central Government servants and members of their families are
concerned under the provisions of the Central Services (Medical Attendance)
Rules have been under the consideration of the Government for some time past.
It has now been decided as follows:-
(i) Authorised medical
attendant for the purposes of these orders within the meaning of Rule 2 of the
Central Services (Medical Attendance) Rules, 1944, will mean -
(a) In respect of a Government
servant who belongs to a Central Service Class I, or whose pay is not less than
Rs. 500 per mensem, Class I officers belonging to Ayurveda, Unani, Sidha and
Homoeopathic Medical Services of the State/or Central Government or any other
qualified medical officer, appointed by the Government, to attend its officers
in the district;
(b) In respect of a
Government servant not belonging to a Central Service, Class I whose pay is
less than Rs. 500 per mensem, but more than Rs. 150/- per mensem, a Class II
Gazetted Officer of the Department of Indian Medicine or Homoeopathy of a State
or Central Government, or any other qualified Medical Officer, appointed by the
Government to attend its officers in the station;
(c) In respect of any other
Government servant, the physicians-in-charge of Government, Government aided
Municipal and Panchayati dispensaries of Ayurveda, Sidha, Unani and
Homoeopathic systems of medicines and/or any other qualified medical officer,
similarly appointed.
N.B.: The term ‘qualified’
would mean in the case of Ayurveda, Unani and Sidha, persons possessing
recognised medical qualifications as included in the II, III and IV Schedules
of the Indian Medicines Central Council Act, 1970. As far as Homoeopathy is
concerned, it would include the recognised medical qualifications as notified
in the II Schedule of the Homoeopathy Central Council Bill, 1971.
(ii) Rates of fees for
purposes of re-imbursement:
(a) Class I Officers
belonging to Ayurveda, Unani, Sidha and Homoeopathic Medical Services of the
State or Central Government of any other medical officers of equivalent status
appointed by the Government....................Rs. 16
(b) Class II Officers of
the Departments of Indian Medicine and Homoeopathy of a State or Central
Government or any other medical officer of an equivalent status appointed by
the Government........... Rs. 3.
(c)
Others.....................Rs 3.
Provided that in respect of
medical officers of State Governments who are not allowed to receive any
payment, no fees would be reimbursable.
NOTE:- The fees prescribed
in clause (a) and (b) above will be payable for consultation at the consulting
room of the authorised medical attendant or at the residence of the patient.
(iii) List of admissible
medicines for the purpose of reimbursement: Ayurveda, Sidha, Unani and
Homeopathy.
The list of medicines in
these systems approved for the purposes of reimbursement with indication of
maximum prices against each medicine is given in Annexure I. In this Annexure,
lists of medicines have been drawn up in three categories viz.
(a) Costly medicines and
treatment like panchakarma therapy which may be prescribed only by class I officers
or a doctor of equivalent rank;
(b) General medicines which
may be prescribed by all authorized medical attendants, and
(c)
Restricted medicines which may be deemed t
