Tuesday 29 May 2018

RELAXATION OF RULES FOR CONSIDERATION OF REIMBURSEMENT IN EXCESS OF THE APPROVED RATES PERTAINING TO MEDICAL CLAIMS


Government of India
Ministry of Health and Family Welfare
Department of Health & Family Welfare
EHS Section

No: Z.15025/38/2018/DIR/CGHS/EHS 
Nirman Bhawan, New Delhi
Dated the 22nd May, 2018

OFFICE MEMORANDUM

Subject: - Relaxation of Rules for consideration of reimbursement in excess of           the approved rates pertaining to medical claims

            With reference to the above mentioned subject the undersigned is directed to draw attention to the Office Memorandum No. 4-18/2005- C&P [Vo]. l-Pt (1)], dated the 20th February 2009 and to state that it has now been decided to modify the Para 3 (2) of the above referred Office Memorandum as per the details given under the succeeding paragraphs.

a) The requests for full reimbursement which fall under the following defined criteria shall be examined by Directorate General of CGHS and submitted to AS&DG (CGHS) for consideration of approval. After the recommendation of AS&DG (CGHS), the concurrence of Internal Finance Division and approval of Secretary, Ministry of Health & Family Welfare are required for reimbursement in excess of CGHS rates:

1) Treatment was obtained in a private unrecognized hospital under emergency and the patient was admitted by others when the beneficiary was unconscious or severely incapacitated and was hospitalized for a prolonged period.

2) Treatment was obtained in a private unrecognized hospital under emergency and was admitted for prolonged period for treatment of Head Injury, Coma , Septicemia, Multi-organ failure , etc.

3) Treatment was obtained in a private unrecognized hospital under emergency for treatment of advanced malignancy

4) Treatment was taken under emergency in higher type of accommodation as rooms as per his/her entitlement are not available during that period.

5) Treatment was taken in higher type of accommodation under specific conditions for isolation of patients to avoid contacting infections

6) Treatment was obtained in a private unrecognized hospital under emergency when there is a strike in Govt. hospitals.

7) Treatment was obtained in a private unrecognized hospital under emergency while on official tour to non-CGHS covered area.

b) The requests from CGHS beneficiaries. having a valid CGHS Card at the time of treatment, in respect of the following conditions shall be considered by a High Powered Committee constituted by Ministry of Health & Family Welfare:

(i) Settlement of medical claims in relaxation of rules

(ii) Approval for air-fare with or without attendant on the advice of treating doctor for treatment in another city even though he/she is not eligible for air travel treatment facilities are available in city of residence

(iii) Representations from CGHS beneficiaries seeking full reimbursements under special Circumstances, which are not notified.

c) The other terms and conditions mentioned in the OM No. 4-18/2005- C&P[Vol. l-Pt(1)] dated the 20 February 2009 shall remain unchanged. 
Sd/-
(Rajeev Attri)
Under Secretary to Government of India

Thursday 10 May 2018

SPONSORSHIP OF DRTC FOR B.Tech / M.Sc

DHRD decided that  "Sponsorship of DRTC personnel for B.Tech / M.Sc is not permissible being minimum qualification for DRDS entry level."

AIDTOA denounces the decision of DRDO Hqrs to close the point and appeals to all Federations & Associations to pursue the issue of Sponsorship for higher qualification of DRTC personnel.

Regarding the demand of AIDTOA & others for DRTC Awards, only two number of awards were agreed by DRDO Hqrs.

Wednesday 9 May 2018

PROFESSIONAL UPDATE ALLOWANCE FOR DRTC

All India DRDO Technical Officers Association (AIDTOA) & CCGGOO protest against turning down the case for Professional Update Allowance for DRTC by the Government.

The Government has not agreed to grant Professional Update Allowance for DRTC as given to DRDS personnel.

Instead of taking up the Case again by strengthening the justification, DRDO Hqrs has arbitrarily closed the point.

AIDTOA appeals to all the Federations & Associations to pursue the matter until the benefits given to employees of Dept.of Atomic Energy / ISRO are extended to DRTC personnel.