Rajasthan Civil Services (Medical Attendance) Rules, 2008

 

In exercise of the powers conferred by the proviso to Article 309 of the Constitution, the Governor hereby makes the following rules to revise the existing Rajasthan Civil Services (Medical Attendance) Rules, 1970, namely: -

Rule 1. Short Title & Commencement.?

 

(1)     These rules may be called the Rajasthan Civil Services (Medical Attendance) Rules, 2008.

 

(2)     These shall come into force with immediate effect.

Rule 2. Extent of Application.?

 

(1)     These rules shall apply to: -

 

(i)       all Government servants, appointed before 1st January, 2004, including those on foreign service, and whose conditions of service are regulated or deemed to be regulated by the Rajasthan Service Rules;

 

(ii)      all Government servants on deputation from Central / other State Governments unless anything otherwise is provided in their terms of deputation;

 

(2)     These rules shall not apply to: -

 

(i)       Government servants, governed or. covered by the Employees State Insurance Act and Schemes framed thereunder;

 

(ii)      Government servants who are abroad either on leave or deputation;

 

(iii)    work charged, casual and part-time employees, except where these rules are specifically made applicable to them under their service rules;

 

(iv)    persons appointed on contract basis;

 

(v)     officers of All India Services;

 

(vi)    officers of Rajasthan Judicial Service, when governed by specific rules applicable to them;

 

(3)     Nothing contained in these rules shall apply to the Government servants appointed to the civil services of the state on or after the 1st day of January 2004.

Rule 3. Definitions.?

 

In these rules, unless there is anything repugnant in the subject or context, -

(1)     "Authorised Medical Attendant" in respect of a Government servant or class of Government servants at a Station or area, means: -

 

(i)       a Medical Officer of the Rajasthan Medical & Health Department on duty in a hospital or dispensary; or

 

(ii)      a Government Ayurved / Unani / Homeopathy Chikitsa Adhikari on duty in a Government hospital or dispensary; or

 

(iii)     an Ayurved Chikitsa Adhikari on duty in National Institute of Ayurved, Jaipur and attached hospital and in Ayurved Hospital attached to Rajasthan Ayurved University, Jodhpur;

 

(iv)    a Medical Officer/ Ayurved / Unani / Homeopathy Chikitsa Adhikari on duty in a hospital, private or run by Charitable Trust, which has been approved by the Government for the purpose of these rules for treatment of Government employees.

 

(v)      A qualified medical officer, so authorized, by the private or charitable hospital, approved/ recognized under these rules by the Government.

Explanation. - An Authorised Medical Attendant for one spell of illness shall be either a Medical Officer or Ayurved / Unani / Homeopathy Chikitsa Adhikari.

(2)     "State" means the State of Rajasthan.

 

(3)     "Government" means the Government of Rajasthan.

 

(4)     "Director of Medical & Health Services" means the Head of the Medical & Health Department in Rajasthan.

 

(5)     "Director of Ayurved Department" means the Head of the Ayurved Department in Rajasthan.

 

(6)     "Government Hospital" means a Medical/ Ayurvedic/ Unani or Homeopathy Hospital/ Dispensary or institution maintained by the Government of Rajasthan or any organization, owned or controlled by the Government of Rajasthan or by a partner under a Public-Private Partnership arrangement, for the purpose of Medical / Ayurvedic / Unani or Homeopathic treatment and also include hospitals attached to National Institute of Ayurved, Jaipur and Rajasthan Ayurved University, Jodhpur and any other hospital so specified by the Government.

 

(7)     "Approved Hospital" means a private or charitable hospital in Rajasthan, which is included in the Appendix -1 or which is approved by the Government, on the recommendation of the Committee, formed under these rules.

 

(8)     "Referral Hospital" means an approved hospital, in or outside Rajasthan, where a patient is referred for treatment by the Principal of a Medical College or Head of a District Hospital, on the recommendation of the concerned Head of the Department, for such treatment(s), the facility of, which is not available in any Government hospital of the State. List of such hospitals is included in the Appendix - II.

 

(9)     "Health Benefit Advisory Committee" means the Standing Committee constituted under Rule -4.

 

(10)   "Family" means Government servant's wife / husband, children, including children adopted legally and parents, if wholly dependent upon the Government servant. It is not necessary that the members of the family of a Government servant should reside with him at the time of illness.

 

Explanation. ?

 

(i)       For the purpose of this clause the parents do not include step parents.

 

(ii)      For the purpose of this clause, the parents shall be regarded as wholly dependent upon the Government servant if they normally reside with the Government servant at the place of his duty and their total annual income from all sources including recurring income from sources like house rent, rent from land holdings, dividend, equity, shares, interest etc. does not exceed Rs.36000/- per annum. Non-recurring income e.g. Contributory Provident Fund, Gratuity, Government of India's Prize Bonds, Insurance benefits etc. shall not be regarded as income for the purpose of this clause.

 

(iii)     A declaration regarding income and the residence of parents shall be furnished by the Government servant once only from enforcement of these rules.

 

(iv)    Any addition / deletion in dependents due to birth/ demise shall be declared by the Government servant within three months.

 

(11)   "Medical Attendance" means in respect of a Government servant, attendance in a Government and approved hospitals or in the case of illness which compels the patient to be confined to his residence, at the residence of the Government servant by the authorised medical attendant, and includes:

 

(i)       such pathological, bacteriological, radiological or other methods of examination for the purpose of diagnosis as are available in any Government or approved hospital, in the State and are considered necessary by the Authorised Medical Attendant, and

 

(ii)      such consultation with any other medical officer or specialist in the service of the Government or approved hospital, as the authorised medical attendant certifies to be necessary, to such extent and in such manner as the medical officer or the specialist may, in consultation with the Authorised Medical Attendant, determine.

 

(12)   "Patient" means Government servant including family, as defined in Rule 3(10), who has fallen ill and to whom these rules apply.

 

(13)   "Treatment" means the use of medical and surgical facilities for curing the disease, from which the patient suffers, by the Authorised Medical Attendant at Government / approved hospital or at residence of the Government servant, in the case of illness which compels the patient to be confined to his residence, and includes;

 

(i)       the employment of pathological, bacteriological, radiological or any other methods, as are considered necessary by the Authorised Medical Attendant.

 

(ii)      dental treatment where the diagnosis of the pathological or other disease from which a patient is suffering indicates that the teeth are the real source of such disease, but it excludes Surgical operations needed for the removal of Odontomes including the oral surgery of the mouth.

 

(iii)     use of such medicines, vaccines, sera or other therapeutic substances but excluding medicines or other consumables/ non consumables, which are regarded as food, toiletary preparation, tonics having more food value, disinfectants and other similar preparations.

 

(iv)    confinement in Government hospital / approved hospital and pre-natal and post-natal treatment of wife of a Government servant and a female Government servant.

 

(v)      provision of accommodation in Government or approved hospitals on the scale as prescribed in these rules .

 

(vi)    consultation fee charged by the Authorised Medical Attendant from Government servant for attendance at residence of the patient as prescribed in these rules and also fee charged by Compounder/ Nurse for administering injection at the residence of the Government servant as per rates prescribed in these rules

It is however clarified that "treatment" shall not include treatment undertaken for efficiency improvement like growth in height, cosmetic / plastic surgery to shape up some part of body / face, lippo-suction, weight reduction, dentures, use of spectacles/ contact lens etc.

 

It is also clarified that implants, used for improvement of efficiency of any organ or part of the body, from its normal natural state, at the age of the government servant, other than those, which are specifically permitted based on the recommendation of the Advisory Committee, shall also not be included in the "treatment".

(14)   "Pay" for the purpose of these rules, means total of pay in running pay band and grade pay drawn.

Rule 4. Constitution of Health Benefits Advisory Committee.?

 

A standing Health Benefits Advisory Committee, headed by Principal Secretary (Finance) and consisting of Pr. Secretary / Secretary, Medical Education, Principal, S.M.S. Medical College, Jaipur, Principal Medical College, Udaipur, Superintendent, S.M.S. Hospital, Jaipur, Director, Medical & Health Services, Director, Ayurved and an Officer not below the rank of Deputy Secretary nominated by Principal Secretary, Finance, who shall be Member Secretary of the Committee is constituted with following terms of reference: -

(i)       Lay down norms and procedure for approving private/ charitable hospitals, diagnostic centres

 

(ii)      Examine and recommend such hospitals / diagnostic centres for approval by the Government;

 

(iii)     Determine and suggest the extent of reimbursement for treatment undertaken and tests carried out in approved hospitals/ labs;

 

(iv)    Examine, and recommend implants essential for treatment and recommend the amount/extent of reimbursement for such implants;

 

(v)      Determine and suggest the category of ailments for which treatment in private hospitals within the State may be allowed;

 

(vi)    Recommend the negative list of allopathic drugs and medicines, which will not be eligible for reimbursement;

 

(vii)   Recommend the classes or list of Ayurvedic, Unani and Homeopathic Drugs and Medicines and Pharmacists considered necessary for reimbursement;

The Committee may also give recommendation on any other related issues on its own motion or on the issue referred to it by the Government. The Committee may also recommend rates for various treatments / tests and investigations in SMS and other government hospitals.

Rule 5. Provision to opt Mediclaim Insurance Coverage.?

 

A Government servant, who is entitled to avail medical attendance and treatment facilities and reimbursement thereof under these rules, can opt out of the benefits under these rules and avail medical facilities under any mediclaim insurance Scheme, of any insurance provider regulated by the Insurance Regulatory & Development Authority (IRDA). Government will reimburse full premium, including service tax, upto an amount of Rs. 3000 (or so revised by the Government from year to year) per annum for the family. The option can be exercised by filing prescribed form in writing with the Appointing Authority. Such option once exercised shall be final and irrevocable and such Government servant shall not be entitled to avail facility of medical attendance and treatment and reimbursement thereof, under these rules.

Rule 6. Free Medical Attendance and Indoor I Outdoor Treatment to Government servant and his family in a Government Hospital.?

 

(1)     A Government servant and his family, except those who opt for medical insurance, will be provided free medical attendance and treatment, in accordance with provisions of these rules in a Government hospital.

 

(2)     (I) Expenses incurred by a Government servant, while availing medical attendance and treatment in a Government hospital shall, on production of essentiality certificate from the authorised medical attendant or such other authority as prescribed, or upon self certification to, where so prescribed, be reimbursed to him to the extent and in manner provided as under:

(a)      Cost of allopathic drugs and medicines (including sales tax), vaccines, sera or other therapeutic substances not available in the government hospital, except allopathic drugs, medicines, included in Appendix-ill (negative list);

 

(b)      Cost of ayurvedic and yunani drugs of approved preparations only not available in government hospital, as included in the list of drugs and medicines in Appendix-IV

 

(c)      Cost of homeopathic drugs of approved preparation only, not available in government hospitals, from pharmacists included and medicines listed in Appendix-V.

 

(d)      Ambulance charges incurred to carry patient from place of illness to a government hospital, vice versa or from one government hospitals to another for treatment or examination.

 

(e)      Blood transfusion charges.

 

(f)       Cost wholly or partly of hearing aid or artificial limb (including cost of replacing a limb) or calipers. Cost of hearing aid will be reimbursed as under: -

 

(i)       For first time : -

 

 

An example of calculation of cost of reimbursement: - I the cost of hearing aid is Rs.20,000/-, then reimbursable amount will be Rs.5,000/- + Rs.4,000/- + Rs.5,000/- = Rs.14,000/-.

 

(ii)      In case hearing aid equipment is required to be purchased again, in the opinion of the competent Authorised Medical Attendant or earlier equipment is beyond repairs, reimbursement would be limited to 50% of the amount as would have been admissible for first purchase as per rule (i) above.

 

(g)      Consultation fee charged by the authorized medical attendant for treatment at residence of Government servant to the extent and as per scale prescribed in the Rajasthan Medical Officers Fees Rules, 1964 as given in Schedule in Appendix - X of Rajasthan Service Rules, Vol.-II.

 

(h)     Fee paid to compounder / nurse per visit for administering injection at the residence of the Government servant to the extent and on scale laid down in the Rajasthan Medical Officers Fees Rules, 1964 as given in Schedule in Appendix - X of Rajasthan Service Rules, Vol.-II.

 

(i)       Charges paid under auto finance scheme for pathological, bacteriological and radiological tests, x-ray, dialysis and investigations on prescription of authorized medical attendant.

 

(j)       Actual cost of intra-ocular lens implantation and treatment thereto.

 

(k)      Cost of Subcutaneous Infusion Pump - an instrument for use of blood transfusion.

 

(l)       Cost of disposable surgical sundries used during surgical and other operations and which cannot be re-used including items of common surgical materials like gauge, I.V. Set, bandage, Leucoplast, Cotton, Crepe Bandage etc., if not supplied by the hospital.

 

(m)    Charges paid by the Government servants to the Rajasthan Medicare Relief Societies, established in accordance with the government instructions, for pathological, bacteriological and radiological tests, x-ray, dialysis and investigations etc., which are considered necessary by the Authorised medical attendant, (n) Charges paid by the Government servant to the private diagnostic centres / labs etc, installed in Government hospitals through Rajasthan Medicare Relief Societies for pathological, bacteriological and radiological tests, x-ray, MRI, CT-Scan etc., at the rates as may be approved by the Rajasthan Medicare Relief Society from time to time.

 

(n)     Charges paid by the Government servant to the private diagnostic centres / labs etc. for the tests undertaken on advice of Authorised Medial Attendant, under conditions and to the extent as under: -

 

(i)       After obtaining NAC from Government hospital. ?

 

 

(ii)      Without obtaining NAC from Government hospital. ?

 

Note 1: Rates of private diagnostic centers established in the Government hospitals through Rajasthan Medicare Relief Society shall be treated as Government hospital rates for this purpose. In case where such facility is not available in Govt, hospitals outside Jaipur (but within State), but it is available in SMS Hospital, Jaipur then rates of SMS Hospital shall be treated as Government hospitals rates for this purpose.

Note 2: (i) For outdoor patients, MRI, Stress Thallium and other costly tests (charges above Rs. 1500/-) shall be got conducted only after recommendation of the Professor / Unit Head of the concerned department of Medical College.

(ii) ? For Indoor patients in a Government Hospital MRI, Stress Thallium, CT Scan and other costly tests (charges above Rs.1500/-) in case of emergency shall be got conducted on recommendation by the Medical Attendant on duty in the hospital.

(o)      Cost of implants including stents, valves, joints, pacemaker, ICD, Cochlear Implant etc., considered necessary to be implanted in the body of the patient and angioplasty / balloonplasty to the extent as may be prescribed by orders of the Government from time to time, on the advice of Medical Benefits Advisory Committee.

 

(p)      (i) Free of charge accommodation in the Government Hospital as classified below, subject to availability:-

 

 

Note : The above pay slabs are subject to corresponding revision on implementation of Sixth Pay Commission Report.

(ii) ? If the class of accommodation to which a Government servant is entitled to under sub-clause (i) above is not available, accommodation of a higher class may be provided if the admission of patient cannot be delayed without danger to his health. The Superintendent / Principal, Medical & Health Officer of the hospital shall record this fact in the appropriate hospital records.

(q)      Ordinary nursing facilities available in a Government hospital.

 

(r)      Sums actually paid on account of medical attendance and treatment including charges for surgical operations.

Rule 7. Admissibility of traveling allowance to ailing Government servant and Authorised Medical Attendant in certain circumstances.?

 

(1)     If a Government servant falls ill at a place which is not the headquarters of the Authorised Medical Attendant, he shall be entitled to travelling allowance as on tour as per Rajasthan Travelling Allowance Rules, except the daily allowance for the journey to and from such headquarter provided that he does not undertake journey for attendance by a dentist or an oculist. In case the condition of the ailing Government servant is so serious that he cannot be carried to the headquarters of the Authorised Medical Attendant in any conveyance, the Authorised Medical Attendant attending the patient at his residence shall be entitled to Travelling Allowance as on tour for forward and return journey from his headquarters to the place of residence of the ailing Government servant under Travelling Allowance Rules.

 

(2)     If the Authorised Medical Attendant is of opinion that the condition of the patient is so serious or of special nature, as to require medical attendance by a specialist medical officer other than himself, he may I send the patient to the nearest specialist or other medical officer concerned. Such ailing Government servant shall be entitled to Travelling allowance as on tour, except the daily allowance for the forward and return journey from and to the Headquarter of Specialist or other Medical Officer as per Rajasthan Travelling Allowance Rules. Such traveling allowance shall also be admissible for an Attendant, if the Authorised Medical Attendant certifies in writing to this effect.

 

(3)     In case a Government servant travels by air or by Rail in the class higher than his entitlement for this purpose, the travelling allowance shall be limited to Travelling Allowance admissible to him for journey by Rail under Rajasthan Travelling Allowance Rules except the Daily Allowance. Similarly if he travels by Road in the class higher than his entitlement, the travelling allowance shall be limited to Travelling Allowance admissible to him for journey by Road under Rajasthan Travelling Allowance Rules except Daily Allowance.

 

Explanation. - The Authorised Medical Attendant for the purpose of this rule means the Authorised Medical Attendant as referred in Rule 3(1 )(i), (ii) and (iii) only, excluding the Authorised Medical Attendant as referred in Rule 3(1 )(iv).

Rule 8. Medical Attendance and Treatment to Government servant and his family in approved Hospitals, within the State.?

 

(1)     A Government servant and the members of his family shall be entitled to medical attendance and treatment in approved hospital within State to the extent indicated in sub-rule (2) of this rule.

 

(2)     Charges paid by the Government servant on account of medical attendance and treatment in approved hospital shall be reimbursable to the following extent only: -

 

 

(3)     Facility of medical attendance and treatment in the type of cases mentioned in sub rule (1) can be availed at any approved hospital mentioned, at the headquarters of the government servant, -Facility at approved hospitals outside the headquarters of the government servant can be availed upon reference from Government hospital at the headquarter of government servant.

 

(4)     For the purpose of reimbursement, original receipt issued by such hospital and vouchers of medicines etc. shall be countersigned by the Authorised Medical Attendant of that hospital and Essentiality Certificate duly signed by the same Authorised Medical Attendant are to be submitted for reimbursement. Government may also make third party confirmation or confirmation by a team of doctors necessary for treatments taken in approved hospitals. In such a case, reimbursement shall be limited to the amount recommended by such body.

Rule 9. Medical attendance and treatment outside Rajasthan in Government hospitals.?

 

(1)     A Government servant including members of his family posted to a station or sent on duty or spending leave or otherwise at a station outside Rajasthan in India and who falls ill there, shall be entitled to free medical attendance and treatment as an indoor and outdoor patient in any hospital maintained by the Central Government or other State Government on the scale and conditions which would, be admissible to him under these rules, had he been on duty or on leave in Rajasthan.

 

(2)     For the purpose of this rule "Authorized Medical Attendant" in respect of a Government servants or class of Government servant at a station outside Rajasthan shall mean an officer of Medical Department of Central or other State Government (as the case may be) on duty in a Government Hospital or Dispensary at this station.

 

(3)     The charges paid by the Government servants posted at Delhi to the following private hospitals/ clinics for X-ray, Pathological, Bacteriological, Radiological tests and other kind of investigations which are considered necessary by the doctor of the State Government posted in Delhi, shall be reimbursed: -

 

1.        Sunder Lai Jain Charitable Hospital, Ashok Vihar

 

2.        Massonic Charitable Poly Clinic, Janpath, and;

 

3.        Sir Ganga Ram Hospital, Rajendra Nagar.

 

4.        Lai Pathological Lab., New Delhi

 

5.        Dewan Chand Satypal Aggrawal Imaging & Research Centre, New Delhi.

 

6.        Any other hospital / lab so prescribed.

Rule 10. Treatment, including specialised treatment, outside Rajasthan in hospitals other than Government hospitals.?

 

(1)     With advanced medical facilities and treatment of serious diseases now being made available to government servants in Government hospitals and also approved hospitals within State, government servants shall not be provided facility of medical attendance and treatment in hospitals outside the state, without reference.

 

(2)     Government servant and the members of his family suffering from a disease for which treatment is not available in any Government Hospital in the State, including SMS Hospital, Jaipur or any approved hospital within Rajasthan, can be referred for medical attendance and treatment upon certification by the Principal of a Medical College on the basis of opinion of the Medical Board to the effect that the treatment of a particular disease from which the patient is suffering is not available within Rajasthan and it is considered absolutely essential for the recovery of the patient to have treatment in a specific hospital outside the State, where such treatment is available . Upon such reference and treatment being availed of, following charges/ expenses shall be reimbursable: -

 

(i)       Cost of Allopathic Drugs, Medicines, Vaccines, Sera or other therapeutic substances inclusive of taxes paid, if any, reimbursable under these rules.

 

(ii)      Sums actually paid to the Hospital/Institution on account of medical attendance and treatment including charges for surgical operations, nursing facilities and accommodation of entitled class.

 

(iii)     Travelling allowance for journey by rail/road from duty point at the station at which the patient falls ill to the place of treatment outside the State and back to a single fare of the class to which his classification entitles him under Rajasthan Travelling Allowance Rules. Such traveling allowance shall also be admissible for an attendant, 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 the patient to the place of treatment and back.

 

(iv)    In case a Government servant travels by air or by Rail in the class higher than his entitlement for this purpose, the travelling allowance shall be limited to single fare of the class to which his classification entitles him under Rajasthan Travelling Allowance Rules. Similarly if he travels by Road in the class higher than his entitlement, the travelling allowance shall be limited to single fare of the class to which his classification entitles for journey by Road under Rajasthan Travelling Allowance Rules.

 

(v)      For the purpose of reimbursement, the original receipts issued by such Hospital / Institutions and vouchers of medicines etc. shall be signed by the doctor on duty of that hospital or countersigned by the Authorised Medical Attendant of Government Hospital on whose advice the treatment outside the State was undertaken.

 

(3)     If a Government servant undertakes indoor treatment of life threatening disease like kidney, heart and some sudden accident, in. a private hospital outside the State, without reference in case of emergent circumstances, Government may allow reimbursement of the medical expenses incurred upto the cost of treatment, that would have been incurred had the treatment been taken in S.M.S. Hospital, Jaipur and if facility of that treatment is not available in S.M.S. Hospital, Jaipur upto the cost of treatment at AllMS, New Delhi, upon such emergent circumstances being explained satisfactorily. No Travelling Allowance shall be admissible in such cases.

Rule 11. Medical attendance and treatment, where both husband and wife are employed in State Government / Autonomous Body I elsewhere, where procedure for medical reimbursement exists.?

 

(1)     Where both husband and wife are Government servants prior to 01.01.2004, they shall be entitled to medical attendance and treatment under these rules. The claim for reimbursement of medical expenses of spouse and other dependent family members can be preferred by anyone of them provided he / she has exercised an option intimating the Appointing authority that claims of medical reimbursement will be made to Government for the spouse and other dependent family members by him / her. Such option can be revised only with Government approval.

 

(2)     In case the spouse of the Government servant is recruited in State Government service on or after 01.01.2004, his / her claims cannot be reimbursed under these rules.

 

(3)     If the spouse of the Government servant is employed in State Autonomous Body / elsewhere in a body having prescribed procedures for reimbursement of medical expenses shall have option either to claim medical reimbursement under the rules applicable on that body or under these rules provided that the Government servant has exercised an option, intimating the Appointing Authority, that claims of medical reimbursement will be made to Government for the spouse even though his I her spouse is employed elsewhere in a body having prescribed procedures for reimbursement of medical expenses.

Rule 12. Grant of advance for medical attendance and treatment (outside/ within State).?

 

(1)     A Government servant and member(s) of his family, entitled to medical attendance and treatment under these rules, may be granted 75% of the estimated cost of treatment, subject to a maximum of Rs. 2.00 Lacs, as medical advance. The estimated amount of reimbursable expenditure on medical attendance and treatment should invariably be indicated in the certificate to be given as under: -

 

(a)      From Principal / Unit Head of a Medical College, in case the treatment is undertaken in a Government hospital of the State or in a referral hospital outside the State.

 

(b)      From Superintendent / Head of the approved hospital in case the treatment is undertaken in approved hospital.

 

(2)     However, for treatment of Cancer, Bone Marrow transplantation and any other treatment as per sub-rule (1) of this rule, in which the amount considered sufficient for the required medical attendance and treatment is more than Rs.5 lacs, medical advance may be granted Rs.3.00 lacs by the Administrative Secretary.

 

(3)     The advance shall be sanctioned by the Head of Office / Head of Department/ Secretary to Government of concerned Administrative Department, as the case may be, in consultation with the senior most Accounts personnel posted in the Office / Department, keeping in view the estimated amount of expenditure indicated in the certificate or the pecuniary limit mentioned in sub-rule (1) and sub-rule (2), as under: -

 

 

(4)     The advance shall be debited to head of account to which pay and allowance of the Government servant are debited.

 

(5)     ?(i) Once an advance has been sanctioned, further advance shall not be allowed until the medical reimbursement claim(s) to the extent of amount of previous advance has been submitted for adjustment.

(ii) ? Entire amount of advance shall finally be adjusted against the due medical reimbursement claim under these rules not later than the expiry of a period of one month from the date of release of the patient from the hospital, otherwise 12% interest shall be charged.

(iii) Unspent amount of advance, if any, shall invariably be refunded in cash within 15 days from the date of patient returned from the hospital, otherwise 12% interest shall be charged.

(iv) The advance shall be granted only 15 days before the actual date of operation/treatment as fixed by the Authorised Medical Attendant.

(v) ? If as per advice of the Medical Attendant or for any other reason, the patient does not take treatment, the advance shall be refunded by the applicant employee within 15 days from the date on which such a decision is taken, but this shall not apply in cases where the date of treatment has been postponed due to medical reasons by the Authorised Medical Attendant.

(vi) Sanction of advance shall not be treated as concurrence/ sanction for reimbursement. The adjustment of advance/ reimbursement shall be admissible as per provisions of these rules.

(vii) Entire amount of advance shall be remitted through Demand Draft in favour of the hospital.

(viii) Non-compliance of these conditions subject to which this advance is being granted would be treated as misconduct.

Rule 13. Procedure for claiming reimbursement.?

 

The procedure to be followed for claiming reimbursement of expenses incurred by a Government servant on account of medical attendance and treatment under these rules shall be as follows: -

(1)     Every Government servant claiming refund of medical expenses incurred on account of medical attendance and treatment for himself and / or members of his family, shall make an application in duplicate in form given in Appendix-VI. Such claims shall be presented within two years from the date of completion of treatment.

 

(2)     (i) Each form of application referred to in clause (1) shall be accompanied by an Essentiality Certificate from the Authorised Medical Attendant in Form given in Appendix-VII alongwith any other certificate(s) required to be attached under any rule. A duplicate copy of Essentiality Certificate signed by the Authorised Medical Attendant shall be prepared by the concerned Government servant for attaching it with the duplicate coy of the application form referred to in sub-rule (1).

(ii) ? The cash memo attached to the medical bills, for purchase or medicines shall be verified and signed by Authorised Medical Attendant prescribing the medicines.

(iii) A Government servant or member of his family who receives medical attendance and treatment at his residence under rule 6(2)(!)(g) and (h) shall be reimbursed the consultation fee charged by the Authorised Medical Attendant and / or fee paid to Compounder / Nurse for administering injection on production ol a certificate from the Authorised Medical Attendant in the prescribed form given in Form *A' of Appendix-VIII. This Certificate shall be attached with the application for claiming fee paid to Compounder / Nurse for administrating injection at the residence of the Government servant a certificate from the Authorised Medical Attendant in the Form 'B' given ir Appendix-VIII shall be appended to the Application Form.

(iv)? Every Authorised Medical Attendant while signing the Essentiality Certificate shall make an entry in the register in the prescribed form given in Appendix-IX in the serial order ol issue of such certificate or alternatively a copy of the Essentiality Certificate alongwith the form of application shall be retained ir support of the entries shown in Column 3 to 7 of the prescribed register. He shall indicate the Serial number (with date) at which the entry has been made in the aforesaid register on the Essentiality Certificate. The register maintained by the Authorised Medical Attendant shall be available for inspection and check without notice by the District Medical & Health Officer or Superintendent of the Hospital or any other officer authorised by the Government from time to time.

(3)     (i) (a) The bill for Medical expenses shall be drawn in the form prescribed for drawing pay and allowances of Government servants and charged to the budget head to which pay and allowances are debited.

(b) ? Claim for Travelling Allowance admissible to ailing Government servant and / or attendant / escort under Rule 6 of these rules shall be drawn on Travelling Allowance bill form. Such a travelling allowance claims shall be accompanied by a certificate from the Authorised Medical Attendant permitting the Government servant alone or with attendant / escort, where necessary to undertake journey.

(ii) ? The bill shall be countersigned by the authority competent to sign the Travelling Allowance bill of the Government servant concerned.

(4)     A Government servant shall present a consolidated claim for reimbursement of medical expenses not earlier than once in a month in respect of all the members of his family including himself/ herself after the treatment is over. In cases where treatment continues over a long period, a part claim for reimbursement of medical expenses may be presented by the Government servants as follows: -

Rule 14. Reimbursement based on prescription and self certification.?

 

(1)     Claims for reimbursement of medical expenses upto Rs.250/-presented by a Government servant, in case of allopathic medicines purchased for himself and members of his family from other than Cooperative shops in emergent circumstances/ non-availability of Cooperative shops, under these rules shall be paid on the basis of prescription of the Authorised Medical Attendant.

 

Provided that at places where purchases of Allopathic medicines through Co-operative Shops run by the Upbhokta Sahakari Sangh / Bhandar is provided the maximum ceiling for presenting the claim in such cases shall be Rs.500/-.

 

(2)     (i) The procedure for claiming reimbursement in the type of claims referred to in sub-rule (1) of this rule shall be the same as laid down in Rule 13 of these rules except that the provisions of clause (i), (ii) and (iv) of sub-rule (2) of Rule 13 shall not be applicable in such cases.

(ii) ? The prescription of the Authorised Medical Attendant referred to in sub-rule (1) of this rule shall bear O.P.D. registration number and date of the hospital/ dispensary where treatment is undertaken, and the Authorised Medical Attendant shall subscribe his signature on such prescription under his official seal.

Rule 15. Special concessions to Government servants suffering from Tuberculosis and Cancer.?

 

(1)     A Government servant suffering from Tuberculosis and Cancer shall be entitled to the following special concessions: -

 

(i)       Upto Rs.100/- p.m. for non reimbursable medicines i.e. medicines having more food value subject to the condition that the medicines are prescribed by the Authorised Medical Attendant of the Government T.B. Hospital / Sanatorium.

 

(ii)      Upto Rs.150/- p.m. towards the cost of Special diet, if any prescribed by the Authorised medical Attendant subject to the condition that his pay does not exceed Rs. 16500/- per month.

 

(iii)    The Travelling Allowance shall be admissible for any journey undertaken in the circumstances mentioned in Rule 7 of these rules to the extent admissible under the rail concessions allowed to T.B. and Cancer patients by Railways.

 

(2)     The concessions as per sub-rule (1) shall also be admissible to a Government servant who is on leave and is being treated as an outdoor patient on the advice of the Medical Officer Incharge of Government Hospital/ T.B. Sanatorium or Clinic.

 

(3)     Subject to the provisions contained in Rule 8, the concessions laid down in sub-rule (1) of this rule shall also be admissible to the members of family of the Government servants on the conditions on which they are admissible to Government servants themselves provided the treatment is taken as indoor patient and not otherwise.

 

(4)     The members of the family of the Government servant when they are treated as outdoor patient in view of sub-rule (2) & (3) of this rule shall not be entitled to special concessions laid down in sub-rule (1).

Rule 16.

 

Notwithstanding any thing contained in these rules, the Government may issue any direction/ guidelines to regulate the purchase of medicines, the cost ceiling of implants, tests, treatments and approval of hospitals for treatment of State employees etc. and reimbursement procedure under these rules,

Rule 17. Savings.?

 

Nothing in these rules shall be deemed to entitle a Government servant to reimbursement of any cost incurred in respect of medical services obtained by him or to traveling for any journey performed by him otherwise than expressly provided in these rules.

Rule 18.

 

These rules supersede the Rajasthan Civil Services (Medical Attendance) Rules, 1970 and all orders issued thereunder, and shall be applicable for the medical attendance and treatment taken on or after the date these rules are issued. The pending cases and cases in which the treatment has been commenced prior to this date, shall be decided by the provisions of Rajasthan Civil Services (Medical Attendance) Rules, 1970.

 

Appendix -1

List of Approved Hospitals (Private And Charitable Hospitals) in Rajasthan

 

Note- Name of the approved hospitals will be included in the Appendix after approval of the Government on the recommendation of the Committee formed under these rules.

 

Appendix - II

List of Referral Hospitals Within State and Outside the State

 

Note - Name of the Referral Hospitals will be included in the Appendix after approval of the Government on the recommendation of the Committee formed under these rules.

 

Appendix-III

List of Non-Reimbursable Allopathic Drugs And Medicines

Note - All Medicines for Injection purposes are admissible and should be allowed reimbursement under Rajasthan Services {Medical Attendance) Rules, 1958.

List - B

The following preparations are classified as Foods: -

(I) Baby Foods, Milk Foods and Invalid Foods, other than those indicated below: -

^^izksVhUl ,oa mlds mRikn QkeZwys'ku tks nokbZ;ksa dh Js.kh esa Hkh vkrs gS] muesa lhji] VscysVl] dSilwy] ikmM+j ,oa fcLdqV] izksVhu ds lkFk vU; rRo tSls dkcksZgkbM~sV] feujYl vkfnA*

LIST - C

Preparations normally used for Toilet purpose -

Appendix-IV

List of Reimbursable Ayrvdic and Yunani Drugs of Approved Prepararions

 

 

 

izfriwfrZ;ksX; vk;qosZfnd vkS"kf/k;ksa ds dz; gsrq jkT; ljdkj }kjk ekU;rk izkIr jlk;u'kkykvksa dh lwph%&

Appendix - V

List of Homeopathic Medicines and Pharmacists For Reimbursement

Group 'B': Homeopathic Mother Tinctures & Externals

Group 'C': Biochemic Medicines and Biochemic Combinations

Group *D': Homoeopathic Triturations

Group 'E': Homoeopathic Ointments

Group F': Homoeopathic Special Items

Name of the Homoeopathic Pharmacists

 

1.        Messrs L.R. Bhandari & Sons, Hanging Bridge, Daryaganj Chowk, Delhi-6

 

2.        Ramakrishna Pharmaceuticals, 2-2-647/125, Bag Amberpet, Hyderabad (A.P.)

 

3.        Father Mullers Charitable Institutions, 17-804, Father Muller Road, Kankanady, Mangalore-3

 

4.        St. George's Homeopathic Pharmacy, 16-139-A, Balmatta, Kankanady, Mangalore-2 (Mysore).

 

5.        Economic Homoeo Pharmacy, 89, Netaji Subhash Road (Ground Floor) Calcutta-1

 

6.        Hahnemann Publishing Co. (P) Ltd., 169, B.B. Ganguly Street, Calcutta-12

 

7.        M. Bhattacharya & Co. (P) Ltd., 73, Netaji Subhash Chander Road, Calcutta-12.

 

8.        National Homoeo Laboratory, 110, Acharya Jagdish Bohra Road, Calcutta-14

 

9.        Sunder Homoeo Sadan, 113, Netaji Subhash Road, Calcutta-1

 

10.     Ganapathi Homoeo Stores & Laboratory, D.No.9-2-9th Block Marutery, West Godavari Dt.

 

11.     New Indian Pharmaceuticals, No. 17-2-1136/2. Madannapet, Hyderabad.

 

Foreign Pharmacists

 

1.        Messrs Willnian Schivabo (West Germany).

 

2.        Messrs Boorioke and Tafel (U.S.A.)

 

3.        Messrs Dr. Madaus & Co. (West Germany).

 

Appendix-VI

Form of Application for claiming refund of Medical expenses incurred in connection with Medical Attendance and / or Treatment of Government servants and their families.

N.B. - Separate form should be used for each patient.

I hereby declare that the statement in this application are true to the best of my knowledge and belief and that the person for whom medical expenses were incurred is wholly dependent upon me.

I also declare that the claim for these medicines purchased by me has not been presented and drawn in the past.

Date..........................................

Signature and Designation of the

Government Servant and

Office to which attached

Appendix. VII

Essentiality Certificate

I certify that Mrs./ Mr. / Miss.............................wife/ son/ daughter of Mr. ............................ employed in the office ..................... has been under treatment at the Hospital/ Indoor / Outdoor in my consulting room and that the undermentioned medicines prescribed by me in this connection are essential for the recovery / prevention of serious deterioration in the condition of the patient.

These medicines are not stocked in the ........................................... for supply to private patient and do not include proprietary preparations for which cheaper substances of equal therapeutic value are available for preparations which are primarily foods, toilets or disinfectants.

Signature and Designation of the Authorised

Medical Attendant.

Signature of the Medical Officer l/c of the case in the Hospital

2. Certified that the patient is/ was suffering from ............................ disease and is / was under my treatment from.....................to...............it is further certified that the disease mentioned above does not come under veneral disease, Delirium / Tremens.

3. The patient did not require / required hospitalisations. The case is / was definitely not/ one of prolonged treatment.

4. Certified that the treatment is over/continuing.

Entered at S. No......................... in Hospital / Dispensary Register on ................(Date).

Signature of the Authorised Medical Attendant.

Place

Date..........................................................

Signature of the Medical Officer

l/c of the case in the Hospital

Appendix-VIII

Form 'A'

Certificate

Certify that Shri / Smt. / Kumari....................................................................... Son/ wife/ daughter/ husband of Shri / Smt.............................................. of the Department of age was suffering from !. (disease) since................ and was under my treatment. I paid visit / visits to his/ her house on ............... at time............as his / her condition was serious and his / her removal to the hospital would have been dangerous or injurious to his / her life. ! charged Rs................for my visits.

Signature and Designation of the Authorised

Medical Attendant.

Countersigned

Signature & Designation of the Superior

Medical Officer

Note. -1. Countersignature by a Superior Medical Officer is not necessary if one of the following officers acts as Authorised Medical Attendant.

Note. - 2. Medical Officer in receipt of non-practising allowance are not allowed to undertake private and cannot charge consultation fee as Authorised Medical Attendant of Government servants vide Finance Department Order No. F.9(60)FD(Rules)/68 dated 04.06.1969.

Form 'B'

Certify that Shri / Smt. / Kumari.................................................... Son/ wife/ daughter/ husband of Shri / Smt.............................................of the Department of .................... age was suffering from.......................... (disease) since...............and I...................paid visit / visits to his/her house on ..............at time............ for administrating the injection as prescribed by the Authorised Medical Attendant of................his Hospital / Dispensary and he /she was not in a position to attend the Hospital / Dispensary for the same. I charged Rs...................as fee for injecting the injections.

Signature and Designation of Compounder / Nurse.

Countersigned

Signature & Designation of the Authorised Medical Attendant

Appendix - IX

Form of Register