RAJASTHAN
LEGISLATIVE ASSEMBLY EX-MEMBERS AND FAMILY PENSIONERS (MEDICAL FACILITIES)
(AMENDMENT) RULES, 2021
PREAMBLE
In exercise of the powers conferred by section 11
read with sub-section (2) of section 4-A of the Rajasthan Legislative Assembly (Officers
and Members Emoluments and Pension) Act, 1956 (Act No. 6 of 1957), the State
Government hereby makes the following rules further to amend the Rajasthan
Legislative Assembly Ex-Members and Family Pensioners (Medical Facilities)
Rules, 2010, namely:-
Rule - 1. Short title and commencement.
(1) These rules may be
called the Rajasthan Legislative Assembly Ex-Members and Family Pensioners
(Medical Facilities) (Amendment) Rules, 2021.
(2) They shall come into
force with immediate effect.
Rule - 2. Amendment of rule 2.
In
rule 2 of the Rajasthan Legislative Assembly Ex-Members and Family Pensioners
(Medical Facilities) Rules, 2010, hereinafter referred to as the said rules,-
(i) after the existing
(c) and before the existing clause (d), the following new clause (c-a) shall be
inserted, namely:-
"(c-a) "e-Pharma stores/Pharma
stores" means the medicine shops run by the CONFED/Rajasthan
SahkariUpbhokta Sangh, Ubhokta wholesale Bhandar, KrayaVikrayaSahkari Samiti,
Jan Ausadhi Kendra or chain of e-pharmacy stores empanelled in the RGHS;";
(ii) in clause (f), the
existing expression 'and', appearing at the end shall be deleted; and
(iii) after the existing
clause (f), so amended and before the existing clause (g), the following new
clause (f-a), (f-b) and (f-c) shall be inserted, namely:-
"(f-a) "Fund" means the
Rajasthan Government Health Scheme Fund;
(f-b) "RGHS" means the Rajasthan
Government Health Scheme;
(f-c) "RGHS Card" means card issued
to the pensioner under the Rajasthan Government Health Scheme; and"
Rule - 3. Substitution of rule 3.
The
existing rule 3 of the said rules shall be substituted by the following,
namely:-
"3. Medical Attendance and Treatment.
An
ex-member and his family and family pensioners shall be provided cashless
medical facilities at Health Care Network Provider (HCNP) i.e. Government
hospitals, Approved Hospitals, Hospitals under Public Private Partnership
arrangement, Referral Hospitals. However, indoor treatment can also be taken in
a private unapproved/unrecognized hospital within or outside the State in case
of emergent circumstances and reimbursement for such treatment shall be
admissible as are admissible to State Government servant under the Rajasthan
Civil Services (Medical Attendance) Rules, 2013 through RGHS portal. These
medical facilities will be subject to following limits:-
(a) Allopathic drugs,
medicines, vaccines, sera, other therapeutic substances not ordinarily
available in Government Hospitals free of charge can be taken from pharma
store/e-pharma store recognized under the RGHS in case of outdoor treatment
upto the cost ceiling of Rs. 20,000/- per annum. The tests (pathological,
bacteriological, radiological and other) can be taken upto Rs. 5000/- per annum
after NAC from Government hospital, if cashless test/lab tests is not available
in Government hospitals:
Provided
that medicines to the indoor patient shall be made available irrespective of
the cost ceiling.
(b) The claim of test
charges shall be submitted online through RGHS portal as per procedure, if Non
Available Certificate from the Government hospital has been obtained or charges
paid in the Government hospital, if any.
(c) No reimbursement will
be allowed to RGHS Card holder, where cashless treatment is available. However,
reimbursement can be taken by the RGHS Card Holder for medical treatment taken
in grave emergency in un-approved hospital and in other exceptional
circumstances. In such circumstances, the claim will be reimbursed only after
submitting the bills through RGHS Portal.
(d) The Ex-member and his
family/family pensioner shall be entitled for the free accommodation and
reimbursement as admissible to class-I officers of the State Government under
rule 13 of the Rajasthan Civil Services (Medical Attendance) Rules, 2013."
Rule - 4. Substitution of rule 4.
The
existing rule 4 of the said rules shall be substituted by the following,
namely:-"4. Relaxation in cost ceiling under rule 3.-
(1) The Secretary may
extend the cost ceiling for medicines specified in rule 3 upto Rs. 1,00,000/-
per annum in all deserving cases and in respect of treatment of cancer, kidney
failure and renal disease upto limit of Rs. 2,00,000/- per annum through RGHS
portal on the recommendation of the committee consisting of the following and
after obtaining second medical opinion where it is felt necessary, namely:-
1.
Secretary
President
2.
Medical
Officer of the Government Hospital of Member the Rajasthan Vidhan Sabha
3.
Financial
Adviser/Chief Accounts Officer/Senior Accounts Officer Member Secretary.
(2) The State Government
may grant further relaxation in cases of severe and persistent diseases through
RGHS portal after being forwarded by the Secretary, Rajasthan Legislative
Assembly."
Rule - 5. Deletion of rule 5.
The
existing rule 5 of the said rules shall be deleted.
Rule - 6. Substitution of rule 6.
The
existing rule 6 of the said rules shall be substituted by the following,
namely:-
"6. Ex-Member's RGHS Card.-
The
RGHS card shall be issued to every Ex-Members/family pensioners through RGHS
portal."
Rule - 7. Substitution of rule 7.
The
existing rule 7 of the said rules shall be substituted by the following,
namely:-
"7. Procedure for claiming cashless
facility or Medical reimbursement.-
(1) Procedure for
claiming cashless facility or medical reimbursement for the treatment taken in
Government Hospital and Approved Hospitals, if cashless facility is not
provided, will be such as provided in the RGHS portal:
Provided
that in grave emergency treatment taken in un approved hospital reimbursement
will be admissible to the RGHS Card holder through RGHS portal for medicines
purchased from outside.
Rule - 8. Substitution of rule 8.
The
existing rule 8 of the said rules shall be substituted by the following,
namely:-
"8. Fixed medical allowance to
Ex-Members/family pensioner.
Where
an ex-member/family pensioner does not want to avail the medical facility under
these rules and opt to take a fix medical allowance amounting to Rs. 300/- per
month an option may be given by such Ex-member/family pensioner either to get
fixed medical allowance for 10 years @ Rs. 300/- x 12 x 10 i.e. Rs. 36,000/- as
life time fix allowance or to get registered under the RGHS for availing the
fixed monthly medical allowance. The option once given shall be final. No
recovery shall be made from life time fixed medical allowance given under this
rule. The Project Director, Rajasthan Government Health Scheme shall make
payment through RGHS Portal after receiving proposal from the Secretary,
Rajasthan Legislative Assembly in this regard."
Rule - 9. Deletion of rule 9.
The
existing rule 9 of the said rules shall be deleted.
Rule - 10. Amendment of rule 10.
The
existing sub-rule (2) of rule 10 of the said rules shall be substituted by the
following, namely:-"(2) The State Government may empanel pharma
stores/e-pharma stores for cashless supply of medicine."
Rule - 11. Substitution of rule 11.
The
existing rule 11 of the said rules shall be substituted by the following,
namely:-
"11. Supply of medicines through pharma
stores/e-pharma stores.-
The
RGHS card holder shall get supply of medicines through pharma stores/e-pharma
stores as per procedure laid down in RGHS portal.
Rule - 12. Substitution of rule 13.
The
existing rule 13 of the said rules shall be substituted by the following,
namely:-
"13. Misuse of RGHS Card.-
(1) In cases where it is
found that a ex-member/Family Pensioner has misused any of the concessions
allowed under the RGHS, he shall be permanently debarred from availing of the
concessions under the RGHS.
(2) If the Speaker of
Rajasthan Legislative Assembly is satisfied that an ex-member/Family Pensioner
has misused the concession allowed under these rules then he shall be competent
to pass an order under sub-rule (1)."
Rule - 13. Insertion of new rule 14A and 14B.
After
the existing rule 14 and before the existing rule 15, the following new rule
14A and 14B shall be inserted, namely:-
"14A. Transitional provision.-
Notwithstanding
any thing contained in these rules, until the RGHS Cards are issued or RGHS
becomes fully operational, the provisions of the Rajasthan Legislative Assembly
Ex-Members and Family Pensioners (Medical Facilities) Rules, 2010, as exists
prior to commencement of the Rajasthan Legislative Assembly Ex-Members and
Family Pensioners (Medical Facilities) (Amendment) Rules, 2021 shall apply to
provide the Medical Attendance to a Ex-Member/Family Pensioner.
14B. Power to remove difficulties.-
If
any difficulty arises in giving effect to the provisions of these rules due to
implementation of the RGHS, the State Government may, by order, make such
provisions as may appear to it necessary for removing such difficulty."
Rule - 14. Deletion of Form-1, Form-2, Form-3, Form-4 and Form-5.
The
existing Form-1, Form-2, Form-3, Form-4 and Form-5 appended to the said rules
shall be deleted.