THE ANDHRA PRADESH INTEGRATED MEDICAL ATTENDANCE RULES, 1972

 

Rule - 1. Short title.

These rules may be called the "Andhra Pradesh Medical Attendance Rules, 1972".

Rule - 2. Extent of Application.

(1)     They shall extend to the whole of the State of Andhra Pradesh.

(2)     These rules also apply to persons who are entitled to medical attendance under the Secretary of State Services (Medical Attendance) Rules. 1938. the All India Services (Medical Attendance) Rules, 1954 and also to the Andhra Pradesh State Higher Judicial Officers who are to be treated on par with the I.A.S. and I.P.S. Officers, but only to the extent to which they are not inconsistent with these rules.

Rule - 3. Definitions.

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

(1)     "Government Servant'' means a whole time Government Servant employed under the Government of Andhra Pradesh and includes such servants employed under State Governments with whom reciprocal agreements in respect of medical attendance have been entered into, but does not include part time or honorary workers ;

(2)     "Hospital'' means a Government Hospital and includes any Special Hospital in the State or any other Medical Institution recognised by the Government.

(3)     "Registered Medical Practitioner" means a person registered under the Madras Medical Registration Act, 1914 adopted to Andhra State; and the Andhra Ayurvedic and Homoeopathic Medical Practitioners' Registration Act, 1956 and the Medical Act No. 1 of 1312 Fasli of the erstwhile Hyderabad Government;

(4)     "Authorised Medical Attendant" means a Medical Officer attached to the Government Hospital or Dispensary in the State who has been nominated by the Government, from time to time, to serve as Authorised Medical Attendant for the State Government Servants ;

[1][A list of Authorised Medical Attendants, appointed by the Government is given in Appendix I to these Rules.]

(5)     "Patient" means a Government Servant or any member of his family and to whom these rales apply and who has fallen ill ;

(6)     "Station'' means the town or place in which the Government Servant and other entitled person falls ill ;

(7)     "Family".

(a)      In the case of a male Government Servant, family means his parents, wife, legitimate children including an adopted son and step Children residing with and wholly dependent on him ;

(b)      In the case of a woman Government Servant it means her parents, husband and children residing with and wholly dependent on her.

(i)       The word "wife' includes more than one wife.

(ii)      The claims for reimbursement of expenses in respect of parents should be accompanied by declaration in the proforma given below.

Proforma

I,.................................................. (full name and designation) hereby declare that my father/mother..................... has no property or income of his/her own and that he/she is wholly dependent on me.

Signature and date.

(iii)     A married daughter who is under the protection of her husband does not come within the definition of "family' for purposes of these rules.

(iv)    The deserted, divorced, or widowed daughters who are residing with entirely dependent on the Government Servants and Employees of local bodies drawing salaries not exceeding Rs. 300 per month are eligible for medical concessions allowed to Government Servants under these rules.

(v)      Their family for purpose of these rules will include adoptive parents who are wholly dependent on the Government Servants but does not include the real parents, though they are wholly dependant on the Government Servants once the adoption is effected].

[2][(vi) Medical reimbursement bills of the Member of the State Legislature can be presented directly to the District Treasury or Sub-treasury as the case may be, from which they are authorised to draw their salaries; on the basis of essentiality certificate issued by the Authorised Medical Attendant without insisting for the countersignature of the District Medical and Health Officer, or Superintendent as the case may be.]

(8)     "Well-to-do-person" means a person who is in receipt of an annual income of Rs. 1,200 or more or who is a member of the family of such a person and acuially dependent on him.

Rule - 4. Medical Attendance.

(1)     Medical Attendance in respect of a Government Servant whose pay is not less than Rs. 500 p.m. means.

(i)       Attendance in a hospital or at the consulting room of the Authorised Medical Attendant or at the residence of the Govt. Senvant ;

(ii)      All pathological, bacteriological, radiological and other methods of examination for the purpose of diagnosis, as are available in any Government Hospital within the State and are considered necessary by the Authorised Medical Attendant ;

(iii)     Any consultation with a Specialist in Government employ within the State or other Medical Officer similarly in Government employ within the State or that the Authorised Medical Attendant may certify to be necessary to such extent and in such manner as the Specialist or Medical Officer in consultation with the Authorised Medical Attendant, determine.

(2)     Medical Attendance in respect of any other Government Servant, means

(i)       Attendance at a Government Hospital or at the consulting room of the Authorised Medical Attendant or in case of illness which compels the patient to be confined to his residence, at the residence of the Government Servant;

(ii)      All methods of examination for purposes of diagnosis that are available in the nearest Government Hospital.

(iii)     Any consultation with a Specialist or other Medical Officer stationed in the State that the Authorised Medical Attendant may certify to be necessary, to such extent and in such manner as the Special Officer may, in consultation with the Authorised Medical Attendant, determine ;

(3)     There will be cases of not infrequent occurrence in which, it will be proper for the medical officer to visit the Government Servant in receipt of salaries under Rupees one hundred at their residences. The Government trust to the good sense and good feeling of the medical profession in preference to laying down any precise rules for such cases.

(4)     It should be distinctly understood that a medical officer will not be expected to attend a Government Servant at his residence unless the patient is unable to wait upon the medical officer either at the latter's residence or his consulting room or till such time as may be appointed by the Medical Officer for the purpose ;

(5)     Medical Officers who are Authorised Medical Attendants to the Government Servants, should not charge any consultation or other fees from the Government Servants for the Medical Attendance rendered to them.

Rule - 5. Medical Treatment.

Medical Treatment means use of all medical and surgical facilities available at the Government Hospital in which the patient is treated and includes.

(1)     Employment of such pathological, bacteriological, radiological or other methods of investigation, etc., as are considered necessary by the Authorised Medical Attendant ;

(2)     Supply of such medicines, special or ordinary vaccines, sera or other therapeutic substances as are ordinarily available in Government Hospitals in the State ;

(3)     Supply of such medicines, vaccines, sera or other therapeutic substances as are not ordinarily available in Government Hospitals as the Authorised Medical Attendant may certify in writing to be essential for the recovery or for the prevention of deterioration in the condition of the patient.

(i)       The refund of the cost of preparations which are not medicines but are primarily foods, tonics, toilet preparations or disinfectants is not admissible under the rules. Prescription of expensive drugs, ionics, laxatives or other elegant and proprietary preparations for the use of Govt. Servants and members of their families when drugs of equal therapeutic value are available in hospital and dispensaries is prohibited. List of items for which refund is not admissible under the Medical Attendance Rules are given in Appendix II.

(ii)      Sales Tax paid by Government Servants while purchasing special medicines from the market is refundable under the Rules. Packing and postage charges paid by Government Servants for purchasing special medicines from out-stations are not refundable.

(iii)     All claims for refund of expenses incurred on account of the purchase of the special medicines should be preferred in the manner indicated in Appendix III.

(4)     Treatment of confinement cases of a Government Servant and includes prenatal and post-natal treatment.

(5)     Such accommodation as is ordinarily provided in the Hospital and is suited to the status of a Government Servant with reference to his pay as indicated below.

(6)     Such nursing as is ordinarily available provided in the hospital and is suited to his status and includes such special nursing as the Authorised Medical Attendant may certify in writing to be essential for the recovery or for the prevention of serious deterioration in the condition of the Government Servant.

If at all a Government Servant requires extra nursing he may engage an attendant at his own cost.

(7)     Such diet as is ordinarily provided to other patients in the hospital.

(8)     Blood transfusion service.

(9)     Provision of ambulance service wherever necessary for the transport of the patient to the Hospital.

Rule - 6. Persons entitled to free medical treatment.

(i)       The following persons are entitled to free medical attendance.

(a)      All Government Servants under the rule making powers of the Government of Andhra Pradesh subject to the conditions specified in these rules, Government Servants are entitled to free medical attendance irrespective of whether they are on duty or on leave, anywhere in the State.

(b)      Employees of the Local Bodies (Zilla Parishads, Municipalities, Panchayat Samithis and Panchayats) drawing salaries not exceeding Rs. 300/- p.m.

The Employees of Zilla Grandhalaya Samsthas drawing pay not exceeding Rs. 300/ - p.m. are eligible for free medical attendance in the Government Hospitals in the State.

(c)      Members of the State Legislature.

(d)      Village Officers and Servants.

(e)      Officers of the Hind Kusht Nivaran Sangh working in Government Medical Institutions.

(f)       Honorary Medical Officers, House Surgeons and House Physicians employed in Government Hospitals in the State, Students of Government Medical Colleges in the State, Nurse Pupils, Auxiliary Nurse-Midwives and Health Visitors undergoing training and Gramsevak Trainees.

(g)      Persons appointed under emergency provisions in the posts carrying a fixed or time scale of pay, only so long as they continue in service during the period of their treatment in a Government Medical Institution.

(h)     Retired and re-employed pensioners (Gazetted and Non-Gazetted).

[3][(h) (a) Family pensioners, after expiring of the pensioner. Provided that the dependent of Family pensioners shall not be eligible for these facilities.]

(i)       Government Servants under suspension.

(j)       Menials in the service of both the Government and Local Bodies who are paid from contingencies on monthly basis.

(k)      The work-charged establishment of all departments.

(l)       The staff employed in the Office of the State Welfare Advisory Board, Hyderabad and the Welfare Extension Projects in the districts drawing a pay not exceeding Rs. 300 p.m. and their families will be given the same privileges in respect of medical attendance, treatment and accommodation including the diet charges and administration of special and expensive drugs as are allowed to the employees of local bodies drawing pay not exceeding Rs. 300 p.m.

(m)    The disabled personnel from the Defence Services will be given free treatment including diet and specialised treatment in the general wards of Government Hospitals irrespective of their income.

(n)     Sportsmen representing the State of Andhra Pradesh in Inter-State tournaments at Government expenses, shall be entitled to the privileges under Rule 10 of the Chapter on par with State Government Servants.

(a)      Telangana System of giving free treatment to the patients in General wards is extended to all Government Hospitals in the State.

(b)      All Freedom Fighters who are drawing pension either from State Government/Central Government/Union Territory Administration in respect of their income and their dependants are eligible for free medical treatment and accommodation in Government Hospitals on par with members of the Legislature.

(ii)      Rulers of the Merged States and their families and their personal staff.

(a)      The rulers of the Merged States and their families will be treated on par with the members of the Secretary of State Services for urposes of free medical attendance and treatment and the provisions of the Secretary of State Services (M.A.) Rules, 1938 except those relating to travelling allowance and reimbursement of any cost incurred in respect of the medical advice obtained by them will apply to them.

(b)      The personal staff of the Rulers of the Merged States and their families will be given the same privileges in respect of medical attendance, treatment and accommodation as are allowed to Government Servants under the rule-making powers of the Government.

Rule - 7. Arrangements for Free Medical Attendance.

(1)     All Government Servants and other entitled personnel are eligible for free medical attendance in the Government Hospitals in the State and to the extent specified in Rule 4 above.

(2)     Persons entitled to treatment free of charge in any hospital, shall produce before the hospital authorities an identification certificate signed by the Department or by a Gazetted Officer dealing with establishment matters or by the Head of the Office in which they are working in the following form.

GOVERNMENT OF ANDHRA PRADESH

Identification Certificare

Name of the Officer/Official..................,............................................................... 

Designation.................................................................................................................

Accommodation to which the

Officer/Official is entitled

in Government Hospital...............................,....................

In emergency cases the above certificate will not be insisted upon at the time of admission, but the same should be produced within a period of one week.

(3)     In any station where there may be an Assistant Surgeon and where there may not be proper hospital accommodation, the duty of such officer should be to attend at their own residence. The Upper subordinate grades of Government Servants including clerks whose appointments are not gazetted the latter paying conveyance hire should they reside more than two miles from the official residence of the medical attendant. If the distance is such as to entitle the medical officer to travelling allowance, the amount is payable by the Government. Should the case be reported as serious the Civil Surgeon will visit the patient.

(4)     The Medical Officer employed in the following classes of Institutions should render free medical attendance to Government Servants at the stations where there are no Government Medical Institutions

(i)       Local Fund and Municipal Institutions for which a percentage contribution is given towards the pay of medical officers employed therein.

(ii)      Local Fund and Municipal Medical Institutions in respect of which the Government meet one half of the annual maintenance charges.

(iii)     Local Fund and Municipal Taluk Headquarters Medical Institutions in respect of which the Government meet the entire or a portion of the salaries of Government Medical Officers employed in them.

(iv)    In places where there are no Government Hospitals, but where there are local fund or private hospitals, or dispensaries, the Non-Gazetted Officers and Employees of the Local Bodies drawing less than Rs. 300/- per mensem and their families may take treatment stratightaway in such institutions and that the expenditure as incurred by them in that connection including the cost of special and expensive drugs purchased by them on the prescription of the doctor in charge of the institution, be reimbursed subject to the production of relevant vouchers and subject to the scrutiny of the relative bills by the authorised medical attendant.

At places where there are no Government or Non-Government Medical Institutions, Non-Gazetted Officers and Employees of Local Bodies drawing less than Rs. 300/- per mensem and their families may avail themselves of the services of local private doctor in emergencies where there is no sufficient time for them to go to the nearest Government Medical Institution. The expenditure incurred by them in that connection will be reimbursed to them subject to the production of relevant vouchers and subject to the relative bills by the District Medical Officer concerned and to his certifying that the amount claimed is reasonable and expenditure incurred was necessary. In non-emergent cases, the entitled personnel serving in places where there are neither Government Medical Institutions nor Non-Government Medical Institutions should go to the Government Medical Institution or the Non-Government Medical Institution at the nearest station for treatment.

(v)      (a) The N.G.Os. and the Employees of Local Bodies in stations where there are no Government or Non-Government Medical Institutions who seek treatment in an emergency, under Local Private doctors should in addition to the essentiality certificate from the private doctors produce a certificate in the form given hereunder from the nearest authorised medical attendant immediately after they are in a fit condition to travel to the nearest authorised medical attendant who will judge whether the essentially certificate issued by the local private doctor in such cases is a genuine one or not.

"I certify that there are no Government or Non-Government Medical Institutions available in the village............................of.......................Taluk". 

"I also certify that I examined the patient (Name)......................... (Designation)........................ (Department).................. and consider that the case in v question is an emergency one requiring immediate treatment under a local private doctor."

Signature of authorised Medical Attendant.

(b) The local private Registered Medical Practitioner should prescribe the drugs contained in the lists in Appendix IV as far as possible.

Rule - 8. Free of charges.

(1)     A Govt. Servant shall be entitled free of charges.

(i)       to treatment

(a)      in such Government Hospital, at or near the place where he falls ill as can in the opinion of the authorised medical attendant, provide the necessary and suitable treatment, or

(b)      if there be no such hospital as is referred to in sub-clause (a), in such hospital, other than a Government Hospital, at or near that place as can, in the opinion of the authorised medical attendant, provide the necessary and suitable treatment,

(ii)      to anti-rabic treatment at the nearest Government Hospital providing such treatment.

(2)     Where a Government Servant is entitled under sub-rule(l) free of charge, no treatment in any hospital any amount paid by him on account of such treatment shall on production of a certificate in writing by authorised medical attendant in this behalf be reimbursed to him by the Government.

Rule - 9.

(1)     If the authorised medical attendant is of the opinion that owing to the absence or remoteness of a suitable hospital or to the severity of the illness, a Government Servant cannot be given treatment as provided in clause (1) of Rule 6, the Government Servant may receive treatment at his residence.

(2)     A Government Servant receiving treatment at his residence under sub-rule (1), shall be entitled to receive towards the cost of such treatment as he would have been entitled, free of charge, to receive under these rules; if he had not been treated at his residence.

(3)     Claims for sums admissible under sub-rule (2), shall be accompanied by a Certificate in writing by the authorised medical attendant stating(a) his reasons for the opinion referred to in sub-rule (1) ; (b) the cost of similar treatment referred to in sub-rule (2).

Rule - 10. Treatment outside the State but within India.

(1)     A Government Servant and other entitled personnel in or travelling on duty, or on leave, in any place in the territory of India outside Andhra Pradesh receives any medical attendance for himself or for the members of his family, any reasonable amount paid by him on account of such treatment shall, on production of a certificate in writing of the medical attendant, be reimbursed to him by the Government.

(2)     The Government Servants of this State [4][and their families] residing outside the State on official work and falling ill or otherwise requiring medical attention should consult and be treated by the "Medical Attendants" authorised to treat the officers of equal rank of that State. For the purpose of these rules, such medical attendants shall be the Authorised Medical Attendants of the State. 

(3)     For receiving treatment outside the State but in a Government medical institution of that State (on the advice of the Authorised Medical Attendant) prior permission of the Director of Medical and Health Services should be obtained.

(4)     For receiving treatment outside the State but in an institution other than a Government Hospital of that State (on the advice of the Authorised Medical Attendant) prior permission of the Government should be obtained.

Rule - 10A. Treatment for Kidney transplantation and Coronary By-pass Surgery by private hospitals within the State.

(1)     The Government servants and other entitled personnel for treatment under the Rules shall be permitted by the Director of Medical Education to undergo Kidney transplantation operation in the Mahaveer Hospital, Hyderabad and Coronary By-pass Surgery in the Durgabai Deshmukh Hospital, Andhra Mahila Sabha, Hyderabad on the letter of advice given by the Authorised Medical Attendant in the Osmania General Hospital, Hyderabad or the Nizam's Institute of Orthopaedics and Specialities, Hyderabad, respectively where the above operations are done.

(2)     The Authorised Medical Attendant in the Government Hospitals mentioned in sub-rule (1) will issue letter of advice only if the said hospital cannot cope with the work load and the treatment of the patients cannot wait till the operations could be performed in the said Government Hospital; and

(3)     Those who obtain prior permission of the Director of Medical Education and get admitted to the private hospitals mentioned in sub-rule(l) for Kidney transplantation and Coronary By-pass Surgery will be eligible for reimbursement of all admissible expenditure including charges for accommodation and also for an advance as per the estimates given by the concerned hospital undertaking the operation".

Rule - 11. Consultations with Specialists or Colleagues.

(1)     If the authorised medical attendant is of opinion that the case of the patient is of such serious or special nature as to require medical attendance by some person other than himself or that the patient requires anti-rabic treatment, he may with the approval of the Director of Medical Services (which shall be obtained before-hand unless the delay involved entails danger to the health of the patients)

(a)      send the patient to the nearest Specialist or other Medical Officer as provided in clause (c) of Rule 2 by whom, in his opinion medical attendance is required for the patient or in the case of anti-rabic treatment, to the nearest place where such treatment is available ; or

(b)      if the patient is too ill to travel, summon such specialist or other Medical Officer to attend upon the patient.

(2)     A patient sent under clause (a) of sub-rule (1) shall on production of a certificate in writing by the authorised medical attendant in this behalf, be entitled to travelling allowance for the journeys to and from the headquarters, of the Specialist or other Medical Officer or the place where he is sent for anti-rabic treatment.

(3)     A Specialist or other Medical Officer summoned under sub-rule (1), shall on production of a certificate in writing by the Authorised Medical Attendant in this behalf, be entitled to travelling allowance for the journey to and from the place where the patient is and also daily allowance according to rules.

Rule - 12. Travelling Allowance.

(1)     T.A. for journeys undertaken under Rule 10 shall be at the rates admissible to a Government Servant when on tour.

(2)     A member of the family of a Government Servant shall be entitled to travel by a class by which the Government Servant himself is entitled to travel.

Rule - 13. Medical Attendance Charges.

(1)     Charges for services rendered in connection with but not included in medical attendance on, or treatment of a patient entitled to free medical attendance or treatment under these rules, shall be determined by the authorised medical attendant and paid by the patient.

(2)     If any question arises as to whether any service is included in Medical attendance or treatment, it shall be referred to the Government ; the decision of the Government shall be final.

Rule - 14. Treatment under Indian System of Medicines.

The following procedure is prescribed for getting re-imbursement of cost of medicine purchased by the persons entitled to free medical attendance or treatment including State Gazetted Officers when treatment is taken under the indigenous system of medicine either in the Government Institutions or under private doctors :

(1)     The bills relating to the modern medicine, if any, prescribed by the Medical Officer in private or local fund institutions or by the private practitioner will be scrutinised by the authorised medical attendant of the entitled persons in cases where the treatment was received, in a local fund or private institution of indigenous medicine and by the District Medical Officer concerned in cases where the treatment was received from a private practitioner of indigenous medicine.

(2)     The bills relating to the indigenous medicine will be scrutinised by the medical officer or officers concerned of the three respective systems of medicine (Ayurveda, Sidha and Unani) employed in the Government Ayurvedic Hospital, Charminar, Hyderabad to be nominated by the Special Officer of the Medicine Department with the approval of the Government.

(3)     If the bills relate to both modern and indigenous medicine they will first be scrutinised by the authorised medical attendant, or the District Medical Officer, as the case may be, in regard to the modern medicine, and then by Medical Officers or Officers of the Government Ayurvedic Hospital, Hyderabad in respect of the indigenous medicine.

(4)     The claims in respect of treatment under Indian Medicine system be sanctioned by the Special Officer (Indian Medicine Department) after due scrutiny, wherever claims are admissible under rules.

Rule - 15. Medical Attendance for Honourable Speaker, Deputy Speaker, Honourable Chairman, Deputy Chairman, Ministers, etc.

(1)     A Minister or the Speaker of the Andhra Pradesh Legislative Assembly or the Chairman of the Andhra Pradesh Legislative Council and the Members of his family shall be entitled free of charge, to accommodation in hospitals maintained by the State Government and also to medical treatment and attendance on the same terms and conditions as are applicable to the officers of the Indian Administrative Service under All India Services (Medical Attendance) Rules, 1954.

(2)     A Minister or the Speaker or the Chairman and the members of his family shall be required to furnish the certificate prescribed in clause (a) of sub-rule (3) of Rule 8 of the All India Service (Medical Attendance) Rules, 1954 in respect of his claims for re-imbursement of the medical expenses allowable under the said rules for treatment at his residence under circumstances referred to in Rule 1 of the said rules.

Explanation. For the purposes of this rule 'family' means the wife, son, daughter (including a validly adopted son, step-son and step-daughter, father, mother, brother and sister of the Minister, or the Speaker or the Chairman, residing with and wholly dependent on him and not self-supporting relations) but does not include a married daughter or sister who is under her husband's protection.

(3)     A Minister and the members of his family will be entitled free of charges, to accommodation in hospitals maintained by the State Government and also to medical treatment and attendance on the same terms and conditions as are applicable to the highest category of servants employed under the Government of Andnra Pradesh, the highest category of Government Servants who get the maximum concessions and benefits in the matter of free medical attendance and treatment in Government Hospitals, provided that the Minister and members of this family shall be entitled to the supply of diet free of charge.

(4)     The Deputy Speaker of the Legislative Assembly, the Deputy Chairman of the Legislative Council, Chief Whip, Chairman and Vice-Chairman of the Regional Committee, the Parliamentary Secretaries, if any, the Members of the Legislative Assembly and Council who do not hold any of the offices referred to in Sections 3-A to 5-A of the Andhra Payment of Salaries and Removal of Disqualifications Act, 1953, (Andhra Act III of 1954) and the members of the families of all those mentioned above shall be entitled, free of charge, to accommodation in hospitals maintained by the State Government and also medical treatment and attendance on the same terms and conditions as are applicable to the Gazetted Officers of the State Government.

Rule - 16. Medical Attendance for very important personages.

Very important personages, if they fall sick during their visit to and stay in Andhra Pradesh should be provided with free medical assistance which should cover apart from treatment which is neither prolonged nor specialized and such as a hospital would ordinarily provide.

Rule - 17. Medical Attendance to Members of State Legislature.

Members of the State Legislature and members of their families are eligible for free medical facilities as are given to all Gazetted Officers of the State Government.

They will accommodated in the paying rooms on par with Grade III Officers (as defined in the Andhra Pradesh Travelling Allowances Rules, i.e., Gazetted Officers drawing pay between Rs. 750 and 1,000) of the State whenever they are admitted for treatment in the Government Hospital in the State.

Rule - 18. Medical Attendance for Officers of the All India Services, Andhra Pradesh State on Higher Judicial Officers.

Rule 15 will apply for purposes of "Medical Attendance" on officers of the Indian Administrative and Police Services and their families and officers of the Andhra Pradesh State Higher Judicial Services and their families.

Rule - 19. Treatment of T.B.

(1)     Rules regulating admission of T.B. patients in Government T.B. Institutions and other Government Medical Institutions where there are T.B. wards are given in Appendix V.

(2)     The following private Hospitals which are in receipt of grants from the State Government are recognised as treatment centres for the Non-Gazetted Officers and Employees of Local Bodies drawing pay not exceeding Rs. 300 P.M. and their families.

(i)       The U.M.T.B. Sanatorium, Madanapalle.

(ii)      Visrantipuram T.B. Sanatorium, Rajahmundry.

(3)     An officer who wishes to enter the institution for treatment and claim reimbursement of the charges from the Government should obtain in advance a certificate from the local District Medical Officer to the effect that his case is one that requires treatment in specialised T.B. Institution.

(4)     Ten beds in the U.M.T.B. Sanatorium, Madanapalle and five beds in the Visrantipuram T.B. Sanatorium, Rajahmundry are reserved in the general wards for the treatment of Government Servants and members of their families.

Rule - 20. Medical Advances to N.G.Os.

Government Servants (non-gazetted officers) are eligible for advances to meet the expenses on medical attendance and treatment. The grant of advance shall be regulated by the rules given in Appendix VI.

Rule - 21. Reciprocal Arrangements with other Governments.

The Government of Andhra Pradesh have entered into reciprocal arrangements with the Government of Madras, Mysore and Kerala for free medical attendance and treatment of Government Servants while they are on duty or in transist at the Hospitals of the respective Government, subject to the following conditions.

(1)     Government Servants of any of the States mentioned above will be given free accommodation in class admissible to corresponding category of the employees of this Government, surgical and Nursing services including X-ray examination, radium treatment and such other special examinations as may be necessary in respect of which facilities are available in the Hospital. Special treatment shall also be given free of charge on the advice of the Authorised Medical Attendant.

(2)     The Government Servant in question shall, however, be charged for diet (in the case of Gazetted Government Servants) and they shall also have to purchase such drugs as may not be available in the hospital stores and may claim reimbursement from their parent Government if it is admissible under their rules.

(3)     These arrangements have come into force with effect from 29-8-1963 in the case of Madras Government and 1-9-1963 in the case of Mysore Government.

Rule - [22.

All categories of Government Servants and other entitled persons who are eligible under current rules for reimbursement of expenses on medical treatment within India would be eligible for reimbursement of expenses incurred on medial treatment outside India for which facilities are available in this Country also, subject to the maximum of Rs. 40,000 (Rupees forty thousand only) which includes, air passage of patient and expenditure incurred towards Personal Attendant also.

They are also eligible for the reimbursement of the actual expenditure on such medial treatment where there are no facilities available in the Country. Expenditure on air-passage of the person treated as well as the air-passage of the accompanying personal attendant would also be reimbursed by Government in such cases.][5]

 

APPENDIX I

[Vide Rule 3 (4) of the Rules]

The following Medical Officers are appointed to act as Authorised Medical Attendant for the various State Government Servants and other entitled personnel.

When treatment is obtained under Allopathic or Modern System of Medicine

Note :

(1)     The term "Civil Surgeon and Assistant Surgeon" includes specialist and Honorary Medical Officers of corresponding rank.

(2)     At places where there is no Civil Surgeon or any Officer of equal rank, the Assistant Surgeon residing at the place shall be regarded as authorised Medical Attendant for both the categories mentioned above.

(3)     At places where there is neither a Civil Surgeon nor an Assistant Surgeon the nearest Assistant Surgeon or Civil Surgeon shall be regarded as Authorised Medical Attendant for both the categories mentioned above. (G.O.Ms.No. 1792, Health, Dt. 7-6-1963)

When treatment is obtained under Indian Systems of Medicine

 

APPENDIX II

LIST B

The Following preparations are classified as Foods :

(I)      Baby Foods, Milk Foods and Invalid Foods, Other than those Indicated below :

Allenbury's Cereal

Allenbury's Diet

Allenbury's Humanized Milk Food No. 1

Allenbury's Humanized Milk Food No. 2

Allenbury's Malted Food No. 3

Ambrosia Benger's Food

Bournvita

Cow and Goat Foods :

(1)     Buerlac

(2)     Brestol Supplementary Food

(3)     Calcilac

(4)     Cerex

(5)     Daltose C.G.

(6)     Frailac

(7)     Full Cream Milk Food

(8)     Half Cream Milk Food

(9)     Hemolac

(10)   Humanised Milk Food

(11)   Lacidac Full Cream

(12)   Medilac

(13)   Peptalac

(14)   Prentalac

(15)   Prelac

(16)   Separated Milk Food

(17)   Special Half Cream Milk Food

(18)   Weylac

Dorsella Glaxo Products :

(1)     Colact

(2)     Farex

(3)     Ferrolac

(4)     Ostermiik No. 1 and No. 2 Lacta Milk Food Lactegol/lactatone

Libbp Shomogenised Foods

Malted Milk, e.g., Barleva Beulah Horlicks

Mellin's Food

M.O.F.

Nestle's Preparations :

(1)     Condensed Milk

(2)     Lactogen

(3)     Milk Food

(4)     Milo Tonic Food

(5)     Homogenised Foods

Neave's Food

Neave's Milk Food

Numel

Oatrex Infant and Invalid Food Fine and Medium (Kings)

Ovaltine

Ovaltine Rusks

Robinson's Preparations :

(1)     Patent (Barley)

(2)     'Patent' Greats

(3)     Robrex Sanatogen

Savory and Moore Food

Sister Laura's Food

Slippery Eim Foods

Strained Foods, e.g., Neinz and Scott's Torbat Lactic Oats

Turfood Follow on Food

Turfood Hunmanised Food

Turfood Prosol

Turfood Seeway

Vitasac Vivemin

And Similar Preparations

(II)     Compound Foods of Specified Vitamin Content :

Bemax

C.V.B. Marmite Roboletin Virol

And Similar Preparations

(III)   Glucose Preparations :

Glucodin

Glucose B.D.

Glucose With Vitamin D

And Simliar Preparations

(IV)   Liquid Foods and Wines :

Apple Juices

Barluze

Diabetic Cordial Glucosol Lembar Lucozade Ribena

Robinson's Lemon Barley Rose-H.I.P., L.B.W,

Rose's Squashes and Dietic Squashes and All Alcoholic Beverages, Wines, and Spirit and Similar Preparations.

(V)     Malt Extract Preparations :

Bronomalt

Bynegen

Halimalt

Malt Extracts

Malted Wheaten Food

Ostomalt

Radio-Malt

Vimaltol

Vitamin Malt Extracts

And Similar Preparations

(VI)   Meat and Vegetable Extract and Juices :

Bovril

Brand's Essence Faif s Food Jelly Lemco

Oxo

Valentine Meat Juices

And Similar Preparations

(VII)  Mineral and Soda Waters :

Apentta Water Contercxevile

Maveern Mineral Water Soda Water Trefrriw Water Vichy Water and Tablets

And Similar Preparations

(VIII)    Miscellaneous Preparations :

Arrowroot

Aurum Ambrosium

Blackcurrent Pastilles

Charcoal Biscuits

Dextrin Maltose

Diabetic Preparations, e.g., Energen Preparations

Glucose Barley Sugar

Iodised Salt

Kellog's All Bran

Lactose

Malted Milk Tablets, e.g., Barlova, Harlicks, Ovaltine

M alto-Dextrin

Natex Slimming Food

Nestrovite Tablets

Saccharine Tablets

Salt Substitutes

Saxin

Verisal Herbs

Virolax

Vitaminised Chocolate

And Similar preparations

 

LIST C

 

AMENDMENT No. I

Copy of letter No. 41-1/67-MG, dated the 12th July, 1967 from the Director-General of Health Services, New Delhi, addressed to all State A.M.Os., all Ministries of Government of India, and all Administrative Sections

Delete the following medicines from the latest list of Inadmissible Medicines (Revised upto 1st January, 1967) which supersedes the previous list issued in 1958 and Amendments I-X thereto forwarded with the Directorate Letter No. 41-1/67, MG, dated 16th/l 7th February, 1967 :

Insert the following medicines in the list of Inadmissible Medicines to above.

Algipan Ointment

Geronyl Tablets

Lavagol

Sorbiline

Surgical Belts

Collare (Not Medicine)

Hydraminos

Magmag Plaster

Surpholine

 

AMENDMENT No. II

Copy of letter No. F 41-1/67 M.G., dated 23rd August, 1968 from Director-General of Health Services, New Delhi, Addressed to all State A.M.Os., all Ministers of the Government of India.

Delete the following medicines from the latest list of Inadmissible Medicines (Revised upto January, 1967) which supersedes the previous list issued in 1958 and its subsequent Amendment I-X

The under mentioned items may be inserted in the list of Inadmissible Medicines referred to above :

Chelgeatone

Corex

Isabgol

Irivine

Sat Isabgol

 

AMENDMENT No. III

(No.41-1/67 MG (Director-Genl. of Health Ser), New Delhi, Dt. 3-4-1968)

Delete the following medicines from the latest list of Inadmissible Medicines (Revised upto the 1st January, 1967) forwarded with this Directorate letter No. 41-1/67-MG, dated 16th/17th February, 1967 :

 

AMENDMENT No. IV

Copy of letter No. 41-1/77-MG, dated 10th September, 1958, New Delhi, Director-General of Health Services, addressed to (1) all State A.M.Os., (2) All Ministries of the Government of India, etc., (3) All Administrative Sections.

Delete the following medicines from the latest list of Inadmissible Medicines revised upto 1st January, 1967 (and subsequent three amendments) which supersedes the previous list issued in 1958 and its subsequent Amendments I-X.

The undermentioned items may be inserted in the list of Inadmissible Medicines referred to above :

(1)     Perilexmalt

(2)     Phosformin

 

AMENDMENT No. V

Copy of letter No. 41-6/69-MG, dated the 12th August, 1969, from the Director General of Health Services, addressed to all State A.M.F.Os., all Ministries of Government of India.

Deleted the following medicines for the latest list of Inadmissible Medicines revised upto 1st January, 1967 (and subsequent amendments) which supersedes the previous lists issued in 1958 and its subsequent Amendment I-X.

Regarding item ‘Powders’ on Page 33, Column (2) of the above mentioned list of Inadmissible Medicines is clarified that ‘Powders’ prepared from Inadmissible Medicines or talcum powders will be inadmissible.

Insert the following medicine in the list of Inadmissible Medicines referred to above :

 

AMENDMENT No. VI

Copy of letter No. 41-1/67 MG, dated 9-1-1970, from Director General of Health Services, New Delhi, Addressed to all State A.M.Os., all Ministeries of Government of India, all Admn., Sections and the Comptroller and Auditor General, New Delhi.

Deleted the following medicines from the latest list of Inadmissible Medicines revised upto 1-1-1967 (and subsequent four amendments) which supersedes the previous list in 1958 and its subsequent Amendments I-X.

 

AMENDMENT No. VII

(No.41-6/69-MO, Director General of Health Services, New Delhi, Dt. 4-5-1970)

Delete the following medicines from the list of Inadmissible Medicines revised upto 1-1-1967 and subsequent amendments.

 

AMENDMENT No. VIII

Copy of Letter No. 41-6-69-MG, New Delhi, 21-1-1971, from Director General of Health Services, Medical General Section addressed to all State A.M.Os., all Ministries of Government of India and Administrative Sections.

Delete the following medicines from the latest list of Inadmissible Medicines (revised upto 1st January, 1967) and its subsequent amendments.

List of Inadmissible Medicines in the Indian system of treatment

 

APPENDIX III

[Vide Rule 5 (3) (iii)]

(1)     The claims of all Hon'ble Ministers, the Hon'ble Speaker, the Hon'ble High Court Judges, and members of the All India Services, who are governed by the All India Services (Medical Attendance) Rules, 1954 shall be preferred to the Accountant-General direct for scrutiny and payment of the amounts claimed with reference to these rules, provided the claims are covered by the rules.

(2)     The reimbursement bills arising

(i)       in the District will be scrutinised and passed for payment by the concerned District Medical Officers ;

(ii)      in the Hyderabad city will be scrutinised and passed for payment by the Superintendents of the concerned Hospitals. 

 

EXECUTIVE INSTRUCTION

Medical attendance - Reimbursement of expenditure incurred by Government Servants under Integrated Medical Attendance Rules, 1972 - Reference to Medical & Health Department - Instructions – Issued

(G.O.Ms.No. 3142/K1/85-1, Medical and Health Dept, Dt. 17-4-1986)

Order :

(1)     According to Rule 5(3)(iii) of the Integrated Medical Attendance Rules, all claims for refund of expenses incurred on account of the purchase of the special medicines should be preferred in the manner indicated in Appendix III. According to para 2(ii) of the said Appendix, the reimbursement bills arising in the Hyderabad City will be scrutinised and passed for payment by the Superintendents of the concerned Hospitals. According to para 4 of the said Appendix claims for reimbursement should be accompanied by an Essentiality Certificate from the Authorised Medical Attendant or from the Medical Officer incharge of the case in the hospital.

(2)     With reference to the provisions referred to in para 1 above employees of various departments of Secretariat are claiming reimbursement of expenditure incurred by them on medicines for treatment of self and family members on the basis of essentiality certificate and certificate of non-availability of the drugs given by the Authorised Medial Attendant of the concerned Hospital and sometimes certificate of non-availability of these drugs in the Secretariat dispensary, issued by the Medical Officer of Secretariat Dispensary. The Departments of Secretariat are referring such claims for reimbursement of expenditure to the Medical and Health Department for concurrence. Reference of such cases to this department has been on the increase resulting in unavoidable work load in this department and delay in reimbursing the claims. The Secretariat departments are therefore informed that the proposals for sanction of reimbursement of expenditure for treatment in Government Hospitals within the State which are accompanied by an essentiality certificate and certificate of non-availability of medicines from the Authorised Medical Attendant and when they are satisfied that the claim is in accordance with the provisions in Appendix III to Andhra Pradesh Integrated Medical Attendance Rules, 1972, need not be referred to Medical and Health Department for remarks/acceptance. This applies to the cases referred by Heads of Departments to the Administrative Departments of Secretariat also.

(3)     However as provided in the note under para 2(h) of the Appendix III to the Integrated Medical Attendance Rules, 1972, all cases requiring special sanction or relaxation; clarification or interpretation of the State Medical Attendance Rules should be referred to this department invariably.

[6][(iii) For District Medical reimbursement bills, if any doubt arises the medical reimbursement bills other than those pertaining to the Municipal limits of the District Headquarters should be referred to the District Medical and Health Officer concerned, and for the bills arising within the Municipal limits of District headquarters to the Superintendent of the District Head quarters Hospital concerned.

(iv)   In twin cities of Hyderabad and Secunderabad, if any doubt arises the medical reimbursement bills arising within the municipal limits of Hyderabad and Secunderabad should be referred to the Superintendent, Osmania General Hospital Hyderabad/Gandhi Hospital, Secunderabad, respectively].

(3)     Any claim which has been preferred six months after the last date of the period of treatment shall ordinarily be rejected.

(4)     Claim for reimbursement should be preferred in the prescribed form and should be accompanied by Essentiality Certificate from the Authorised Medical Attendant or from the Medical Officer in charge of the case in hospital.

 

(The prescribed application form and essentiality certificate are given below)

Application for claiming refund" of medical expenses incurred in connection with Medical Attendance and/or treatment of Andhra Pradesh Government servants and their families.

(1)     Name and Designation & Section of (in block letters ).......................................

(2)     Office in which employed..........................................................................................

(3)     Pay of the Govt, servant as defined in FRs and other employments which should be shown separately.................................................

(4)     Place of duty...............................................................................................................

(5)     full residential address with door No. and name of the Mohalla....................................

(6)     Name of the patient him/her relationship to the Govt.servant in case of children state age also............................................................

(7)     Place at which the patient fell ill.............................................................................

(8)     Nature of illness and its duration............................................................................

(9)     Details of amount claimed cost of Medicines purchased from the market/ list of medicines cash memos, and the essentiality certificate should be attached each in duplicate signed by treatment doctors.....................................................................

(10)   Total amount claimed Rs..........................................................................................

 

Declaration to be signed by the Government Servant

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 a member of my family as defined under the Government Servant Medical attendance rules and wholly dependent upon me.

Signature of Govt. Servant

and Office to which attested

Certificate granted Mr/Mis/Miss................................................. Wife/son/daughter of Mr.....................................................employed as................................................

CERTIFICATE-A

(To be completed in the case of patients who are not admitted to hospital for treatment)

(1)     Dr................................................................................hereby certify 

(a)      That I charged Rs.................................for....................................consultation on.......................................................of my consultation room/at the resident of the patient

(b)      That I charged Rs...............................................for administering intramuscular/ intravenous/subcutaneous injections on.................................................................(Dose to be given) at my consulting room/at the residence of the patient.

(c)      That injections administrated repay in formatting or propyloctane purpose 

(d)      That the patient has been under treatment at…....................................................... hospital/consulting room and that the under mentioned medicines prescribed by my in this connection were essential for the recovery/prevention of serious deterioration in the condition of the patient. The medicines are not stocked in the hospital and do not include proprietary preparations for which cheaper substance of equal therapeutic value are available not preparations which are primarily foods tonics tests of distractions.

Name of Medicine

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

 

Declaration to be signed by the Government Servant

I hereby declare that the statements in this application are true to the best of my knowledge and belief and that the person for whom medical expenses were incurred is a member of my family as defined under the Andhra Pradesh Government Servants Medical Attendance Rules, 1972, and wholly dependent upon me.

Signature of the Government Servant and officer to which attached.

 

Essentiality Certificate

I certify that Mrs./Mr./Miss..............wife/son/daughter of Mr......................employed in the............has been under my treatment for.............diseases from to......................at................Hospital and that the under...................(my consulting room)....................mentioned medicines prescribed by me in this connection were essential for the recovery............(prevention of serious deterioration in the condition) of the patient.

The medicines are not stocked in the.............. (hospital for supply to patients) hospital and do not include proprietary preparations for which cheaper substances of equal therapeutic value are available, or preparations which are primarily foods, toilets or disinfectants.

Signature and Designation of Authorised Medical Attendant.

Signature of the Medical Officer-in-charge in the case of the Hospital.

INSTRUCTIONS

(A)     Essentiality Certificate :

(1)     The essentiality certificate should be filled in by the Authorised Medical Attendant himself in the prescribed form as shown on reverse.

(2)     Separate Certificate should be produced in respect of the treatment given to each member of the family by the claimant.

(3)     The essentiality certificate should be signed only be the Authorised Medical Attendant who actually give the treatment.

(4)     Any Certificate countersigned by A.M.O., who is not A.M.A., shall be rejected.

(5)     It shall be the responsibility of the A.M.A. to exclude preparations which are primarily in the nature of foods, toilets, or disinfectants. He should indicate in his certificate which of the items included in the vouchers come under these categories.

(6)     Name of the patient, relationship with the Government servant in case of the family member, disease, period of treatment and place of treatment should carefully and clearly written by the A.M.A. himself in the essentiality certificate.

(7)     The names of medicines with their cost should clearly be shown in the essentiality certificate by the A.M.A. the names of medicines which are not eligible shall be disallowed.

(B)     Bills in Original given to the Claimant by the Druggists and Dispensing Chemists.

(i)       bills produced on transparent papers whether it is with or without seal of the Druggists shall be rejected ;

(ii)      the bill should be a cash voucher only ;

(iii)     each original bill should contain the name of the claimant or patient and the date of issue.

(iv)    the name of the drug and its cost should be legibly written.

(2)     The claimant should prepare a typed duplicate copy of each bill and send it along with his application. The duplicate copy or copies of the bill will be retained in his office with the connected file.

(3)     The Authorised Medical Attendant should countersign both the original and true copies of the bills. He should affix his seal not only to these bills but also to the essentiality certificates.

(4)     The sanctioning authority should personally satisfy himself

(a)      that the essentiality certificates and the bills produced by the claimant are genuine ;

(b)      that the dates of the bills and the vouchers are within treatment periods mentioned in the essentially certificates ;

(c)      that preparations which are in the nature of primarily foods, toilets and disinfectants are excluded, and

(d)      that the claim is in accordance with the rules in force during the period of treatment.

(5)     Original bills produced by the claimant should be initialled by the sanctioning authority or by any gazetted officer under him who deals with the application and then returned to the claimant.

(6)     The claimant should surrender the original bills and the essentiality certificate to the Treasury who disburses the bills amount.

 

APPENDIX IV

[Vide Rule 7(4)(v)(b)]

List of Medicines recommended for use by Local Registered Medical Practitioners

 

 

APPENDIX V

[Vide Rule 19(1) in Port 1}

Rules Regulating Admission of Tuberculosis Patients in Government Tuberculosis Institutions and other Government Medical Institutions where there are

Tuberculosis Wards

1. General :

(1)     No patient should come for admission to a hospital or sanatorium unless intimation regarding the availability of a bed is received by him from the authorities of the hospital or sanatorium.

(2)     Those who come without notice are liable to be refused admission either for want of beds or if the cases are considered unsuitable for admission.

(3)     No case from other hospitals should be sent to the tuberculosis hospital or sanatorium direct, but should be asked to attend the nearest tuberculosis clinic, if such a clinic is functioning within a reasonable distance.

(4)     The opinion of the T.B. Control Officer or the Superintendent of Government T.B. Sanatorium or Hospital concerned shall be final with regard to the suitability of a case for admission.

(5)     Each patient, whether he seeks admission in the special ward or general ward should be required to pay at the time of registration the cost of telegram that should be sent to him intimating vacancy of bed.

2. Rules for admission to General Wards :

(1)     A separate waiting list of all suitable cases should be maintained by each tuberculosis institution.

(2)     Patients seeking admission in the general wards of the T.B. sanatorium will be examined by the concerned Superintendent of T.B. Sanatorium who will prepare a waiting list of such patients who require sanatorium treatment and assign a serial number for each patient and communicate the list to the State T.B. Control Officer, Hyderabad. Intimation regarding vacancies will be sent to the patients direct by the Superintendent of the Sanatorium. Each patient will be given a time limit of five days for joining. If no reply is received within five days requesting extension of the time limit for joining the patient will be struck off from the waiting list. On such applications from the patients the time limit may be extended to a maximum of three weeks for admission.

The Superintendent of the Sanatorium should send to the State Tuberculosis Control Officer, Hyderabad at the end of every month, the serial number of the patients who have been admitted and the serial number of the patients whose names have been struck off from the waiting list for non-receipt of reply.

(3)     Admission should be made strictly in the order of priority of entry in waiting list unless some emergency has occured which requires immediate attention.

(4)     Advance cases which have no chance of recovery should not be put on the waiting list.

(5)     Letters of recommendations received with regard to admission of patients direct to hospital or Sanatorium should not be taken into consideration, but if on an examination the cases are found to be suitable, they should be included in the waiting list and should take turn along with other cases.

(6)     All Government Servants including members of the families, if found suitable for admission will be admitted immediately. Police Constables will be given special priority over other Government Servants. Ex-Servicemen, Suffering with T.B. will be given preference in admission after State Government Servants.

Note :Central Government Servants and Railway Servants should not be treated as Government Servants for purposes of this rule.

(7)     Advanced cases among Government Servants should not be admitted unless it be for purposes of issue of medical certificates, invalidation certificates, etc.

(8)     Emergencies which require immediate attention such as Homoeopthysis, Spontaneous, Pneomothorax, etc., whether they are on the waiting list, or not, and whether they are early or advanced cases should be admitted immediately and kept in the hospital or sanatorium till the emergency disappears. After that, if they are found suitable for treatment their names will be included in the waiting list on discharge from the hospital or sanatorium and admitted when their turn comes.

(9)     Patients sent by Tuberculosis Clinics and hospitals in the mufassal for operative procedure such as Thoracoscopy, Thoracoplasty, etc., should be taken in directly and sent back to the respective places after operation.

(10)   Patients sent from other hospitals for admission should also be put on the waiting list and admitted according to seniority in the waiting list.

(11)   Only early cases of tuberculosis amongst convicts should be admitted in the Government Tuberculosis Sanatoria.

3. Rules for Admission to Special Wards :

(1)     Heads of Government Tuberculosis Institutions will maintain a separate waiting list for admission in the special wards, send necessary intimation to the patients and control their admission.

(2)     A registration fee of Rs. 25/- should be charged for including the same in the waiting list for special wards and this amount should be remitted along with application for admission. This amount will be adjusted towards hospital stoppages payable by patients when admitted. If the patient does not turn up within seven days from the date of receipt of intimation of the vacancy of a bed, and if no extension of time is obtained from the Superintendent of Sanatorium, the registration fee collected will be forfeited to Government and the bed will be given to the patient next in the waiting list.

The registration fee will be refunded in cases (a) where the intimation of a vacancy of bed is sent after three months from the date of registration and where the individual does not then propose to seek admission, and (b) where patients expire before the receipt of intimation regarding the availability of beds or within seven days from the date of receipt of such intimation.

4. Admission of Patients, fit for Surgical Treatment :

Cases provisionally suitable for surgical treatment should also be placed on the common waiting list by the  Superintendents of the concerned Tuberculosis Sanatoria, marked the letter “S” in red ink, or in some other coloured ink. Such patients should be told that they are being admitted into the Sanatorium only on a provisional basis that if, after observation they are found suitable, they will be given the necessary surgical treatment and that otherwise they will be discharged from the Sanatorium and put in the waiting list again at the appropriate place. An undertaking in the following form should be obtained form each of such patient.

 

FORM

"I understand that I am being admitted into the Tuberculosis Sanatorium on a provisional basis for observation whether any case is suitable for a surgical procedure. I agree that, if the case is suitable for such a procedure, I will undergo the necessary surgical treatment. If it is decided by the Superintendent my case is not suitable for surgical treatment I agree to be discharged from the observation ward and to have my name placed in the waiting list at the appropriate place".

The Mass Radiography beds will be used for observation purpose.

Note :Pregnant women should be given the same priority as in the case of early surgical cases in regard to their admission in the Sanatorium.

5. Discharge of Chronic Patients :

(1)     The Superintendents of the Sanatoria will discharge the patients who become chronic even though sputum in positive, thus making the vacant beds available for more suitable or early cases. In order to avoid complaints about the disease of these classes of patients, a committee may be constituted consisting of the Superintendent, Assistant Superintendent, and the Pathisiologist or the Resident Medical Officer where there is no post of Pathisiologist, and it should meet twice a month to decide on the discharge of such patients.

(2)     These cases found unsuitable at the time of admission for Sanatorium type of treatment should be kept on for a reasonable period of observation and the medical officer should be empowered to discharge them on making certain that such patients are not likely to be benefited by their stay in Sanatorium any further.

6. Wards for cases detected through Mass Radiography Survey :

In the hospital for tuberculosis diseases, Irrumnuma, ward of 24 beds shall be set apart exclusively for the accommodation and treatment of Tuberculosis cases detected through mass radiography surveys and a separate waiting list, for this ward will be maintained. The persons in the separate waiting list, if not already admitted into the reserve ward shall be admitted to the other wards in this hospital according to their turn in the order of priority, their names being entered in the waiting list for the general wards also in their turn of priority for the purpose.

7. Medical Attendance on the Tuberculosis X-ray and Radiography Patients:

(i)       The following are the Scheduled rates for taking further X-ray picture of a person, who has been initially subjected to mass radiography, if his income is Rs. 100/- per mensem and above provided however, that for the first follow up, half the fees shall be levied.

(ii)      With reference to Rule 13(b) hospital stoppages will be levied in respect of persons who are employees of firms, and who after mass-radiography are admitted as in-patients of the hospital for the Tuberculosis Diseases, Irrumnuma even if their income is below Rs. 100/- per mensem and the charges will be collected from the employees concerned. These patients will be admitted only with the consent and permission of the employees. The necessity and urgency for the treatment of such cases should be explained to the employers concerned.

(iii)     Fees at the following rates will be levied from employers for issue of certificates in respect of their employees, who are subjected to mass-radiographic examination or treatment for tuberculosis.

(iv)    Hospital stoppages shall be levied at prescribed rates from members of the general public who are subjected to mass-radiography and who undergone the treatment in the Hospital for Tuberculosis diseases if their income is Rs. 100/- and above per mensem.

 

APPENDIX VI

PART I

[Vide Rule 20]

The Andhra Pradesh Rules of Advance for Medical Attendance and Treatment

(I)      The Advances shall be regulated by the following rules :-

(1)     These rules shall be called "The Andhra Pradesh Rules of Advances for Medical Attendance and Treatment".

(2)     These rules shall apply to all the Non-Gazetted Employees of the State.

(3)     The advances may be granted to Non-Gazetted Employees of the State to meet the expenses of medical attendance and treatment of himself or any member of his family which he is entitled to be reimbursed from the State funds under the Medical Attendance Rules.

(4)     The advances shall be treated like advances of travelling allowance and pay on transfer and recovery must be effected by adjustment of claim for reimbursement of medical expenses. 

(5)     The Head of the Office competent to draw pay bills of his office, may sanction, draw and disburse the advances to all the Non-Gazetted employees working under him; where the Head of an Office drawing pay bills happens to be Non-Gazetted Employee, the advance has to be sanctioned to him by the Officer immediately superior to him but he may himself draw the advance.

(6)     The amount of the advance shall be limited to the amount required to meet actual reimbursable medical expenses certified by the Authorised Medical attendant of the employee or the nearest Civil Assistant Surgeon subject to a maximum of Rs. 50/- at a time. If the sanctioning authority is satisfied that the case is emergent, he may sanction an advance upto a maximum limit of Rs. 50/- without insisting upon completion of necessary formalities.

(7)     When an advance is sanctioned to a non-permanent Government Employee it has to be drawn and disbursed to him only after a bond in Form II of the Andhra Pradesh Financial Code, Volume I is executed by him together with the surety of a permanent Government Servant drawing a pay not less than the borrower.

(8)     (a) The advance should be adjusted in full within a period of three months from the date of drawal of the advance by presenting the claim in the form prescribed under the Medical Attendance Rules irrespective of the fact that the treatment last for more than three months. The claim should be furnished to the Director of Medical and Health Services or the Special Officer, Indian Medicine, as the case may be, through the Authorised Medical Attendant and the Medical Officer who gave the treatment. After the claim is received back from the Director of Medical and Health Services/Special Officer Indian Medicine, it should be presented to the Treasury or the Accountant-General, Andhra Pradesh, as the case may be by the Heads of Offices for adjustment against advance drawn.

(b) A second advance of this kind should not be granted until the first one has been fully adjusted. The Bill for the 2nd advance should be accompanied by the certificate from the sanctioning authority that the previous advance has been adjusted in full. 

If the advance is not adjusted or returned within a period of three months it should summarily be recovered from his salary.

(9)     When any portion of the claim for reimbursement of medical expense is for any reason disallowed, such amount should be recovered from the salary of the individual in four instalments starting with the pay drawn immediately after the claim has been disallowed.

(10)   In every office the drawal of these advances should be recovered in the register of temporary advances and their recovery by adjustment or refund should be watched. When a borrower is transferred to a new office the details of the advance should be closed. In the new office which the borrower joins, the particulars of the advance should be entered in the Register and the recovery watched.

(11)   Ordinarily not more than one advance shall be granted in respect of the same illness or injury, but when the amount of the first advance has already been spent, a second advance can be sanctioned when the sanctioning authority is satisfied that the previous advance has already been spent and the Medical Officer concerned has certified the necessity of further expenditure. The total amount of both the advances shall not exceed Rs. 30 or four month's pay which ever is less. There is no objection to the borrower if a claim for the adjustment of the first advance even before the treatment is over and later on presenting a second claim regarding the further expenses to be adjusted the second advance.

(12)   The term "Pay" for this purpose shall mean the pay actually drawn, including personnel pay, as on the date of application but shall exclude special pay.

(II)     The advance granted under these rules should be accounted for under new subhead, "Advance for Medical Attendance and Treatment" to be opened under the head "T.III. Deposits Advances I. Civil Advances".

 

Certificate to be furnished by the Medical Officer under Rule 6

Certified that Sri/Smt…............... a member of the family of Sri/Smt…......... working as…................in the office of…...........at….........is suffering from…..........and that a sum of Rs…..........(Rupees….............) only is necessary as advance to cover the medical expenses reimbursement by Government in this case. 

 

Certificate by Medical Officer under Rule 11

Certified that Sri/Smt…..........a member of the family of Sri/Smt…..............working as…..................in the Office of the…............... at…............(Place) is still suffering from…........................and that a further sum of Rs…........(Rupees…......) only is necessary as advance to cover the reimbursable medical expenses in this case as from this date.

Note :-Strike off the unnecessary portion when the certificate relates to the Government Employee himself.

 

PART II

Rules relating to Medical Attendance of Central Government Employees and their Families, Military Personnel, Merchant Navy and Special Police Establishments.

Note :-Not Printed.

 

EXECUTIVE INSTRUCTIONS

(1)     Facilities of admission and treatment to pensioners at Government hospitals -Consolidated orders – Modifications

(2)     Medical Advance -Treating like T.A. Advance

[U.O. Note No. 5463A/167/A & L/82-1, Fin. & Plg. (Fin. Wing. Accts. & Loans), Dt. 30-3-1982]

Ref. :-

(1)     From the Acctt.-Genel., A.P., I, Hyd., Lr.No. TM/I/II/12-53/76-79/4, Dt. 27-4-1979.

(2)     G.O.Ms.No. 426, M. & H. (K 1), Dt. 28-7-1981.

Order :-

(1)     In the reference first cited, the Accountant-General, Andhra Pradesh, I Hyderabad has suggested amendments to the Andhra Pradesh Integrated Medical Attendance Rules, 1972 and has requested the Government to issue specific instructions to all the drawing and disbursing officers/all the Treasury Officers and the Pay and Accounts Officers to treat Medical Advance like advance of T.A. and Pay on transfer.

(2)     The matter has been considered carefully, keeping in the changed conditions the Drawing and Disbursing Officers, and the Treasury Officers and the Pay and Accounts Officers are hereby directed to treat the advance for Medical treatment as an advance of T.A. and Pay on transfer and efforts shall be made that such an advance for Medical treatment is adjusted within the time stipulated, avoid probable objections at a later date.

(3)     Advances for Medical Treatment

[Memo. No. 39027/724/BG/82, F.& P. (Fin. Wing-B.G.), Dt. 21-9-1982]

Ref. :-G.O.Ms.No. 1274, M. & H., Dt, 29-12-1978.

Order :-

(1)     Under the revised accounting classification which has come into force with effect from 1-4-1974, the expenditure on Medical advances was being classified under "766. Loans to Government Servants-MH. 25 Other Advances, SH (03) Advances for Medical attendance and treatment. But in consultation with the Accountant-General, Andhra Pradesh, Hyderabad certain amendments were issued to the A.P. Integrated Medical Attendance Rules, 1972, through the reference cited. Among other things it was also ordered therein that the Medical advances shall be treated like advances of Travelling Allowance and pay on transfer and the recovery must be affected by adjustment from the claim for reimbursement of medical expenses. Even though orders have been issued to the above effect, it has been brought to the notice of the Government that the Medical advances are still being accounted for under "Loans and Advances".

(2)     The Director of Treasuries and Accounts is therefore requested to issue suitable instructions to all District Treasury Officers to adopt the revised classification debiting the expenditure on Medical advances to the Service head of account instead of Loans and Advances head of account.

(4)     Reimbursement of Medical expenditure - Instructions

[U.O. Note No. 3142/K1/85-1, M. & H, Dt. 17-4-1986]

Order :-

(1)     According to Rule 5(3) (ii) of the Integrated Medical Attendance Rules, all claims for refund of expenses incurred on account of the purchase of the special medicines should be preferred in the manner indicated in Appendix-Ill. According to Para 2 (ii) of the said Appendix, the reimbursement bills arising in the Hyderabad City will be scrutinised and passed for payment by the Superintendents of the concerned Hospitals. According to Para 4 of the said Appendix, claims for reimbursement should be accompanied by an Essentiality Certificate from the Authorised Medical Attendant or from the Medical Officer in-charge of the case in the hospital.

(2)     With reference to the provisions referred to in Para 1 above, employees, of various departments of Secretariat are claiming reimbursement of expenditure incurred by them on medicines for treatment of self and family members on the basis of essentiality certificate and certificate of non-availability of the drugs given by the Authorised Medical Attendant of the concerned Hospital and sometimes certificate of non-availability of these drugs in the Secretariat dispensary, issued by the Medical Officer of Secretariat Dispensary. The Departments of Secretariat are referring such claims for reimbursement of expenditure to the Medical and Health Department for concurrence.

Reference of such cases to this department has been on the increase resulting in avoidable work load in this department and delay in reimbursing the claims. The Secretariat departments are therefore informed that the proposals for sanction of reimbursement of expenditure incurred by Government Servants which are in accordance with the provisions of rules referred to in Para 1 above, Viz., the calims for reimbursement of expenditure for treatment in Government Hospitals within the State which are accompanied by an Essentiality Certificate and certificate of non-availability of medicines from the Authorised Medical Attendant and when they are satisfied that the claim is in accordance with the provisions in Appendix-Ill to Andhra Pradesh Integrated Medical Attendance Rules, 1972, need not be referred to Medical and Health Department for remarks/acceptance. This applies to the cases referred by Heads of Departments to the Administrative Departments of Secretariat also.

(3)     However as provided in the note under Para 2 (ii) of the Appendix - III to the Integrated Medical Attendance Rules, 1972, all cases requiring Special sanction or relaxation ; clarification or interpretation of the State Medical Attendance Rules should be referred to this department invariably.

(5)     Treatment underwent in the Appollo Hospital, Madras, etc., for by-pass surgery, etc., - Certain instructions issued

(G.O.Ms.No. 69/K1/89-1,, KM. & F.W. Dept, Dt. 14-3-1989)

Ref. :-

(1)     G.O.Ms.No. 317, M&H (K l), Dt. 7-5-1986.

(2)     G.O.Ms.No. 72, I&CAD (Irrigation Ser. II) Dept., Dt. 4-2-1988.

Order :-

(1)     Certain instructions were issued in the Government Order 1st cited in respect of availment of medical treatment for Kidney transplantation and Coronory Bypass Surgery in private hospitals in the State by the Government employees. Government servants and others entitled for treatment under the Medical Attendance Rules,.1972 were permitted to undergo Kidney transplantation operation in the Mahavir Hospital, Hyderabad and Coronory Bypass Surgery in the Durga Bai Desmukh Hospital, Andhra Mahila Sabha, Hyderabad, on the letter of advice given by the Authorised Medical Attendant in the Osmania General Hospital/Nizams's Institute of Medical Sciences, Hyderabad respectively where the above operations are done. A condition was also stipulated in the G.O. first cited to the effect that those who obtain prior permission of the Director of Medical Education, Kidney Transplantation and Coronory Bypass Surgery will be eligible for reimbursement of all admissible expenditure including charges for accommodation and also for an advance as per the estimate given by the concerned hospital undertaking the operation.

(2)     Though the above facilities were extended to the Government employees for treatment, some of the Heads of Departments are sending proposals to Government recommending for sanction of the claims of the Government employees for reimbursement of the expenditure incurred by them for their treatment for Coronory Bypass Surgery and Kidney transplantation, etc., in private hospitals, like Appollo, etc., outside the State in deviation of the instructions issued in the Government Order 1st cited and though relevant instructions were issued from time to time.

(3)     The Government after careful consideration have decided not to reimburse the claims of the Government employees who undergo treatment in Appollo Hospital, Madras or any other institutions outside the State or in Hyderabad hereafter, which are not in accordance with the instructions issued in the Government Order 1st cited unless specific prior permission is obtained from the Government.

(6)     Medical treatment to Government Employees -

Reimbursement of Medical expenditure incurred - Fixing the maximum ceiling to *Rs. 40,000/-

[G.O.Ms.No. 281, H.M. & F.W. (K), Dt. 1-5-1989]

Note :-These orders as amended subsequently are applicable to the non-teaching staff of all Universities in the State-Vide of G.O.Ms.No. 542, Edn., Dt. 20-11-1998.

Ref. :-

(1)     G.O.Ms.No. 170, M&H(K1), Dt. 14-3-1985.

Order :-

In the G.O. first read above, orders were issued fixing the maximum limit of */**Rs. 40,000/- to Government Employees towards reimbursement of expenses incurred by them on medical treatment, subject to the condition specified therein.

However, several instances have come to the notice of the Government to the effect that Government Employees are claiming huge amounts towards medical treatment beyond the permissible ceiling limit of Rs. 40,000/- fixed by the Government.

Since the Government is providing free treatment to persons belonging to Weaker Sections of the society who are green-card-holders, the Government after careful examination have decided and direct that the maximum ceiling limit of */**Rs. 40,000/-(Rupees forty thousand only) be fixed for the State Government employees towards their medical reimbursement, whether they obtain treatment in the State Government Hospitals, or in other States in India, or outside India, includes Air Passage of patient and expenditure incurred towards Personal Attendant. If the treatment is required abroad, or outside the State, the Authorised Medical Attendant should certify to the effect that there is need for obtaining the treatment of the patient, i.e., outside the State, or outside India and prior

*Note :-The ceiling has been raised to Rs. 75,000/- see page 189 of this book.

**Note :-The ceiling has been raised to Rs. 1,00,000/- for major ailments i.e. Byepass Surgery, Kidney Transplantation, Cancer and Neuro Surgery. This benefit is limited for serving employees and their dependents. (G.O.Ms.No. 58, H.M. & F.W. (K), Dt. 1-5-1989)

approval of the Director of Medical Education/Government in Health Medical and Family Welfare Department should also be obtained by the person who wants to obtain treatment outside the State, and outside the Country. A certificate from the Director, Medical Education is also to be obtained by the Department concerned who process the claim putforth by the individual for sanction of the expenditure by producing the bills/ vouchers to be reimbursed. These orders shall come into force with effect from 1-5-1989.

All the Departments of Secretariat and all the Heads of Departments are informed that any claim of the Government Employees for reimbursement of their medical expenditure beyond the maximum limit of *Rs. 40,000/- as specified in Para 3 above shall not be entertained and they should issue instructions to all their subordinates to follow these orders strictly.

(7)     Medical Treatment - Cardiac Surgery - Free of charge to members of public belonging to weaker sections in Government hospitals - Orders - Issued

(G.O.Ms.No. 580, KM. & F.W. (SCK) Dept, Dt. 30-9-1989)

Order :-

Of late several requests are being made by the members of public directly or though their representatives for financial help towards payment of expenses on medical treatment and on cardiac surgery undertaken by certain hospitals under the control of the Government where such facilities are available. Govt, depending on the eligibility of the person and need for such medical treatment have been authorising the concerned hospitals for giving free treatment or for free cardiac surgery as the case may be with a request to send necessary bills to the Revenue Department for effecting payment towards the cost of consumable, disposables from out of Chief Ministers Relief Fund.

As requests for financial aid towards cardiac surgery are ever increasing and in order to rationalise the entire procedure the following guidelines are issued :

(1)     All requests made by the members of public belonging to weaker sections of society, recommended by any Department, M.L.As., MPs, Ministers, etc., shall be forwarded for examination by the Government in Health, - Medical and Family Welfare Department. No representations made by any individual or representatives of the patients shall be received by any hospital either for examination or for treatment free of cost unless specific orders are issued by the Government.

(2)     The applicant requesting free medical treatment/cardiac surgery shall be a member of weaker sections of society and shall possess a green ration card.

(3)     The bonafides of the applicant requesting free treatment for his dependent shall be verified to ascertain that the dependent's name figures in the green ration card possessed by him and is the same person for whom medical treatment is sought.

(4)     The beneficiary shall execute a bond on a five rupee stamped paper (non-Judicial) to the effect that he/she is member of the family of the green ration card holder.

(5)     The applicant shall affix a passport size of latest photograph of the beneficiary/ dependent on the righthand top corner of the applicant for and also enclose a xerox copy of the green ration card before sending to the Government.

(6)     Government in Health, Medical and Family Welfare Department after verifying the application form and if it found that the applicant or his dependent fulfills all conditions for free medical treatment/free Cardiac Surgery necessary orders will be issued to the hospitals under the control of Government where such facilities are available for free medical treatment/free cardiac surgery and only after issue of such orders the cases shall be admitted and given free treatment/surgery. Expenditure on consumables/disposables, if any shall be met by Government from out of Chief Minister's Relief Fund.

(7)     The concerned hospitals where cardiac surgery is done free of cost to any person on the orders of Government in Health, Medical & Family Welfare Department, shall at the end of every month send a statement, quoting relevant references from the Government in Health, Medical and Family Welfare Department of Health of patients, treatment given, surgery conducted and the costs involved with regard to consumables or disposables to the Revenue Department for purposes of effecting necessary payment from out of Chief Minister's Relief Fund under intimation to Health, Medical & Family Welfare Department.

(8)     Medical Attendance - Issuing of letter of advice to undergo treatment / Open Heart Surgery outside the State - Certain Instructions Issued

(Memo.No. 2113/K1/89-1, H.M. & F.W. Dept, Dt. 4-10-1989)

Order :-

(1)     It is observed that despite the instructions issued by Govt, in Memo. No. 69/K1/89-1, HM&FW, dt. 14-3-89, the authorised Medical Attendant to hospitals on outside Govt. Hospitals have indiscriminately referred cases to hospitals outside the State for treatment/Surgery without referring such case in the first instance to the Govt. Hospitals, viz., Gandhi Hospital, Secunderabad, Osmania General Hospital, Hyderabad where such facilities are already available for such treatment or to Nizam's Institute of Medical Sciences, Hyderabad which is a "REFERRAL" Hospital. On account of this the department concerned have been placed in embrassing situation, which lead to with unnecessary correspondence with Government.

(2)     Government have examined the matter carefully and direct that all the authorised Medical Attendants should refer the cases that come to them for treatment/ surgery to Osmania Genl. Hospital, Hyderabad, Gandhi Hospital, Secunderabad or Nizam's Institute of Medical Sciences, Hyderabad, of serious nature in any case they should not refer such cases to hospitals outside when facilities are available for such treatment/surgery in these government Hospitals of this State while issuing the letter of advice to Nizam's Institute of Medical Sciences, Hyderabad, they should certify that necessary facilities are not available in their Institutions. They should refer a case for Treatment/surgery outside the State only in consultation with Nizam's Institute of Medical Sciences, Hyderabad, and on obtaining a certificate that there are no facilities available in Nizam's Institute of Medical Sciences.

(3)     All the Medical Officers of the Hospitals, and Dispensaries in the State should adhere to the above orders scrupulously, any deviation of these instructions will be viewed seriously.

(9)     Facilities of admission and treatment to the pensioners and their family members in Super Specialities Hospitals - Reimbursement of medical expenditure incurred thereon

[G.O.Ms.No. 401, HM & FW (K 1), Dt. 25-6-1991]

Ref. :-

(1)     G.O.Ms.No. 35, M&H, Dt. 26-1-1981.

(2)     G.O.Ms.No. 718, M&H, Dt. 26-11-1981.

(3)     From the Secretary, The Hyderabad Pensioner's Association, Hyderabad, Ref. No. 28/B/89/HPA, Dt. 28-8-1989.

(4)     From the Director of Medical Education, Lr.Rc.No.l6793/MA.C/89, Dt. 4-12-1989.

Order :-

(1)     In the G.Os. first and second read above, it was ordered among other that the retired Government Employees are entitled to free medical treatment in all the Government Hospitals in the State and that they are not eligible to claim reimbursement of medical expenses and for medicines purchased in the open market, if any, on the prescription of the Government Medical Officers.

(2)     In the reference third read above, Secretary, the Hyderabad Pensioners Association, Hyderabad has represented that pensioners are likely to fall sick frequently due to their old age and require medical attention and that due to meagre pension they cannot afford to spend huge amounts towards medical treatment. He has therefore requested that free medical aid, in all General Hospitals under the control of Government and Super Specialities Hospitals including Nizam's Institute of Medical Sciences, Hyderabad, may be provided and necessary orders will be issued in this regard.

(3)     After careful examination, the Government have decided to provide medical treatment to all retired Government Employees and their dependents on par with serving Government Employees. In partial modification of the orders issued in the G.Os. first and second read above, Government hereby direct that medical treatment provided at Nizam's Institute of Medical Sciences, Hyderabad to the retired Government Employees and their dependents on par with serving Government Employees who suffer with serious ailments of the Heart, Kidney, Brain Cancer or any other disease or Surgery for which facilities are not available in any of the teaching hospitals in the State and for reimbursement of the cost of the treatment including consumable and disposable and medicines direct to Nizam's Institute of Medical Sciences, Hyderabad subject however to a maximum limit of Rs. 40,000/- (Rupees Forty thousand only) or as fixed by Government from time to time as in the case of serving Government Employees. The reimbursement shall not however, be allowed if they have obtained treatment in any other private hospitals. The Nizam's Institute of Medical Sciences, Hyderabad shall take up cases only on authorisation by Authorised Medical Attendant of any teaching hospitals as in the ease of serving Govt. Employees. The Nizam's Institute of Medical Sciences, Hyderabad shall take up treatment direct to the pensioners upto the limit fixed by Government subject to scrutiny of the bills by Director of Medical Education and claim reimbursement from Government.

(4)     The expenditure on this account shall be met from the concerned Office/ Department from where the Pensioner worked last and retired on attaining the age of superannuation and shall be debited to the "Salaries Head" as in the case of regular Govt. Employees.

(5)     These orders shall come into force with effect from the date of issue of orders.

(10)   Nizam's Institute of Medical Sciences - Medical treatment of Govt. Employees and their dependents - Reimbursement of expenditure - Simplification of procedure - Orders - Issued

[G.O.Ms.No. 445, HM&FW(E2), Dt. 19-7-1991]

Ref. :-

G.O.Ms.No. 609, HM&FW, Dt. 21-11-1988.

Order :-

(1)     The Government have, for sometime, been considering simplification of the procedure for treatment of Government Servants at the Nizam's Institute of Medical Sciences. 

The procedure has been outlined in the G.O. cited. Presently the Nizam's Institute of Medical Sciences is regarded as referral hospital subject to the following conditions :-

(a)      The Nizam's Institute of Medical Sciences will be a referral hospital other than for emergencies.

(b)      Referral of patients to Nizam's Institute of Medical Sciences should be from the teaching hospital with the approval of the Head of the Departments/Speciality concerned.

(c)      The referring hospital should ensure that facilities available in that hospital are fully utilised in the first instance ; and

(d)      The referring hospitals should refer the cases with all details including a referral summary.

(2)     Under the present procedure, the teaching hospitals in the State are referring cases of Government Servants requiring specialised treatment to the Nizam's Institute of Medical Sciences whenever facilities are not available with them for treatment of various ailments. The sanction of expenditure for treatment incurred at Nizam's Institute of Medical Sciences is being regulated in terms of the provisions of the Andhra Pradesh Integrated Medical Attendance Rules, 1972. These rules require that the bills of Nizam's Institute of Medical Sciences should be scrutinised by the Director of Medical Education before sanction is accorded for payment by the concerned Heads of Departments.

(3)     The above procedure has been found to be cumbersome and there are some cases of delay in the referral of even emergency cases to Nizam's Institute of Medical Sciences by the teaching hospitals. The procedure of pre-scrutiny of bills by the Director of Medical Education is also causing delays.

(4)     After due consideration, it has been decided that Government Employees or their dependants can obtain treatment at Nizam's Institute of Medical Sciences directly for the following ailments ("earmarked categories"). In respect of these cases, referral by a teaching hospital will not be required.

(a)      Acute Mycardial Infraction (Cardiology Department)

(b)      Acute renal failure (Nephrology Department)

(c)      Severe cases of head and spinal injury (Neuro-Surgery Department)

(d)      Cases of Coma (Neurology Department)

(5)     With regard to the above earmarked categories, the following procedure shall be followed :-

(a)      The Nizam's Institute of Medical Sciences need not insist on advance payment by the Government Servants and may commence treatment immediately taking into account the seriousness of the case.

(b)      The Nizam's Institute of Medical Sciences should prepare an estimate of the approximate expenditure for the treatment and hand it over to the concerned Government Employee who, in turn may apply for advance to the concerned Head of Department. The estimate of expenditure shall be calculated only with respect to items reimbursable under the Andhra Pradesh Integrated Medical Attendance Rules. This has to be ensured by Nizam's Institute of Medical Sciences. After the advance is sanctioned the amount of advance shall be made over by the Head of Department directly to Nizam's Institute of Medical Sciences. Normally, the Head of Department should ensure that the amount sanctioned as advance reaches Nizam's Institute of Medical Sciences within a period of 15 days. The amount of advances drawn shall be adjusted by preferring claims by the respective departments with the necessary certificates and vouchers.

(c)      Orders delegating powers to Heads of Departments for drawing of advances are being issued separately.

(d)      It will no longer be necessary to get the bills scrutinsed by the Director of Medical Education. The Nizam's Institute of Medical Sciences shall take necessary steps to scrutinise the bills in accordance with the Andhra Pradesh Integrated Medical Attendance Rules and forward them for payment to the Head of the Department concerned. The bills so sent must relate only to items of expenditure admissible under the Andhra Pradesh Integrated Medical Attendance Rules.

(e)      The Nizam's Institute of Medical Sciences must make its own arrangements with the Government Employee concerned for payment with regard to items of expenditure in the bill which are inadmissible under the Andhra Pradesh Integrated Medical Attendance Rules. Likewise, the Nizam's Institute of Medical Sciences must make its own arrangements with the Government Employee concerned for payment of bills it excess of Rs. 40,000/- which is the limit for reimbursement of medical expenses incurred by a Government Servant.

(6)     With regard to any matter not covered by the above procedure, the provisions of the G.O. cited shall continue to apply. In respect of the other cases, viz., cases not falling under any of the above earmarked categories, the existing instructions issued in the G.O. cited will continue to be in force.

(11)   NIMS - Medical treatment of Govt, employees and their dependents -Reimbursement of expenditure - Simplification of procedure - Regarding

(Letter No. 2706/K1/92-1, HM & FW Dept, Dt. 30-1-1992)

Ref. :-

G.O.Ms.No. 445, HM & FW, Dt. 19-7-91.

Order :-

(1)     In the G.O. cited, orders have been issued identifying the earmarked ailments one each in the Departments of Cardiology, Nephrology, Neuro-surgery and Neurology of Nizam's Institute of Medical Sciences in which the Government employees and their dependents have been permitted to approach the Nizam's Institute of Medical Sciences directly for the treatment without reference from teaching hospitals in the State. It is however noticed that the cases received from other Departments for various other ailments, the Government employees and their dependents are directly approaching the Nizam's Institute of Medical Sciences for treatment i.e., other than those identified as mentioned above and others obtaining the estimates for the treatment and approaching the government for sanction of advance to obtain treatment or for reimbursement for the treatment already obtained. In the Estimation Certificates/Bills issued by the Nizam's Institute of Medical Sciences authorities, there is no indication as to whether or not, the ailments for which treatment is sought for or obtained are those identified for the treatment in Nizam's Institute of Medical Sciences as provided in para 4 of G.O.Ms.No. 445, H.M. & F.W., Dt, 19-7-1991. In the absence of such information, it has become necessary to enter into correspondence with the Departments and Nizam's Institute of Medical Sciences to obtain the exact position in terms of the aforesaid orders thereby resulting in delay in settlement of medical claims of the employees consequently a subject of criticism.

(2)     With a view to avoid correspondence and consequential delay in settlement of medical claims of the Government employees/pensioners, I am directed to request you kindly to incorporate in the estimation certificate to be sent or on the medical bills to be given by Nizam's Institute of Medical Sciences to the Government employees or retired Government employees, as the case may be, a certificate whether or not the case is covered by the orders issued in G.O.Ms.No. 445. H.M, & F.W., dated 19-7-91 or whether it meets the requirement prescribed in G.O.Ms.No. 609, H.M. & F.W. dated 21-11.1988 (i.e., reference to Nizam's Institute of Medical Sciences from a Teaching Hospital).

(12)   Sanction of Medical Advance for Medical treatment of Govt. Employees and their dependants in NIMS, Hyd. for certain serious diseases - Delegation of powers to Heads of Departments for sanction of Advance - Orders Issued.

[G.O.Ms.No. 86, F&P, Dt. 1-6-1992]

Ref. :-

(1)     G.O.Ms.No. 609, HM&FW (E2), Dt. 21-11-1988.

(2)     G.O.Ms.No. 445, HM&FW (E2), Dt. 19-7-1991.

(3)     G.O.Ms.No. 184, HM&FW (Kl), Dt. 2-4-1992.

Order :-

(1)     In the G.O. 1st read above, Government have issued orders declaring Nizam's Institute of Medical Sciences as referral Hospital subject to the following conditions :-

(1)     The Nizam's Institute of Medical Sciences will be a referral Hospital other than for emergencies.

(2)     Reference of patients to Nizam's Institute of Medical Sciences should be from the Teaching Hospitals with the approval of the Head of the Department/Speciality concerned.

(3)     The referring hospitals should ensure that facilities available in that hospitals are fully utilised in the first instance.

(4)     The referring hospitals should refer the cases with all details including a referral summary.

(5)     The patients should be clearly informed that taking up of the case by the Nizam's Institute of Medical Sciences is dependent on the availability of accommodation and other facilities in the Nizam's Institute of Medical Sciences.

(2)     In consideration of the difficulties being experienced by the beneficiaries and also the delay involved in setting the medical claims, it has been decided to delegated the powers to the concerned Heads of Departments for sanction of Medical advances to the employees working under their administrative control in respect of the following diseases without referral by Authorised Medical Attendant vide orders' issued in G.O. 2nd read above.

(a)      Acute Myocardial In Infraction (Cardiology Department)

(b)      Acute renal failure (Nephrology Department)

(c)      Severe cases of head and spinal injury (Neuro-Surgery Department)

(d)      Cases of Coma (Neurology Department)

(3)     The medical claims of State Government Employees covered by A.P.I.M.A. Rules, 1972 can be broadly categorised into :

(i)       Claims preferred against treatment in Govt. Hospitals/Referral Hospitals/ Recognised Hospitals.

(ii)      Claims preferred against treatment in unrecognised Private Hospitals.

(iii)     Calims preferred against treatments in NIMS who were admitted direct without reference by the A.M.A. under emergency circumstances to undergo treatment for the diseases noted under Para 2 above.

(4)     At present in respect of the claims noted against Items (i) and (iii) under Para 3 above, Government is vested with the powers of sanction of medical advances to Government Employees and their dependents towards medical expenditure incurred while undergoing treatment for certain diseases.

(5)     In respect of claims preferred by the individuals either for sanction of advance or for reimbursement of medical expenditure incurred for treatment undergone in unrecognised Private Hospitals the Government would not entertain such claims normally.

(6)     After due consideration, it has been decided to delegate the powers to Heads of Departments concerned for sanction of medical advance to Government Employees and their dependents and settlement of final bills for undergoing treatment in NIMS in respect of cases referred to under G.O.Ms.No. 445, HM&FW (E2) Dept., Dt. 19-7-91 subject to the following conditions :-

(a)      the maximum amount should not exceed Rs. 50,000/- and the expenditure incurred over and above Rs. 50,000/- should be borne by the individual.

(b)      The Head of the Department should ensure that the amount sanctioned as advance shall be paid to NIMS by means of Cheque/Draft within 15 days from the date of receipt of estimation of the expenditure from the NIMS.

(c)      The advance drawn and paid to the NIMS shall be adjusted by preferring claims by the concerned Head of the Department within 3 months from the date of drawal of advance with necessary certificates and vouchers prescribed in A.P.I.M.A. Rules, 1972.

(d)      The claim sent by the NIMS must relate only to the items of expenditure admissible under the A.P.I.M.A. Rules, 1972.

(e)      The bills need not be sent to the D.M.E. for scrutiny and the claim be admitted based on the admissibility certificate issued by NIMS.

(7)     If a Government Servant seeks admission in NIMS vide orders issued in G.O.Ms.No. 609, H&M, Dt. 21-11-1988 the Head of the Department is competent to sanction advances and also the final bill following the conditions mentioned in Para 6 above. In addition he shall ensure that the patient is preferred to NIMS, Hyderabad by the Authorised Medical Attendant. The A.M.A. of the Teaching Hospitals with the approval of the Heads of the Departments/Specialists of the Hospital alone have to refer the cases to NIMS. Other Heads of Departments of any mofusall/Headquarters or City Hospitals who are not the Heads of Departments/Specialists of the Teaching Hospitals would not be reckoned as Authorised Medical Attendants, competent to refer the cases to NIMS covered vide order issued in G.O.Ms.No. 609, M&H, dated 21-11-1988.

(8)     Where the authority referring the cases to NIMS is not deemed as Authorised Medical Attendant, such cases are to be referred to Government for relaxation of A.P.I.M.A. Rules, in HM & F.W. Dept., and Finance and Planning (FW) Department for concurrence and for relaxation of A.P.I.M.A. Rules. The Head of the Department is not empowered to sanction advance if relaxation of A.P.I.M.A. Rules is involved.

(9)     The Government extend the facility available for Central Government Servant wherein a member of the family can also apply and draw the advance when the Government Servant is critically ill and hospitalised so as the avoid inconvenience. In such cases the wife or a legal heir of the Government Employee shall submit an application for sanction of advance to the Head of the Department under whom the employee is working in case the employee is critically ill and cannot sign the application. This facility is available to all Government Servants who avail of the facilities in the NIMS, Hyderabad under G.O.Ms.No. 445, H.M. & F.W. (E2) Dept, dated 19-7-1991 and G.O.Ms.No.609, H.M. & F.W. (E2) Department, dated 21-11-1988.

(10)   The advance sanctioned shall be debited to the Service Head of Account to which the pay and other allowances of the employee are being debited.

(13)   Provision of Corrective Glasses and Hearing Aids - Fixation of limit of expenditure for reimbursement - Orders - Issued

[G.O.Ms.No. 276, HM & FW (K1), Dt. 11-5-1993]

Ref. :-

(1)     G.O.Ms.No. 175, HM & FW, Dt. 7-3-1990.

(2)     Govt. Memo. No. 2118/K1/90-1, Dt. 28-4-1990.

(3)     From the Director of Medical Education, Lr.No. 14845/MA B/90, Dt. 23-8-1990.

Order :-

(1)     In the Government Order 1st cited above orders have been issued to amend the Andhra Pradesh Integrated Medical Attendance Rules, 1972. As per this amendment the cost of Artificial Limbs, Hearing Aids, Corrective Glasses, Artificial Teeth and Invalid Chatirs are reimbursable to the eligible patients who are entitled to the facilities for sanction of medical reimbursement.

(2)     Government after careful reconsideration of the above order issued in G.O.Ms.No. 175, HM & PW, dated 7-3-1990 hereby order the cancellation of G.O.Ms.No. 175, HM&FW, dated 7-3-1990.

(3)     All existing claims which have been received pursuant to the issue of G.O.Ms.No. 175, HM&FW, dated 7-3-1990 will be settled by 30-6-1993. These existing claims should pertain to claims received in pursuance of G.O.Ms. No. 175, HM &FW, dated 7-3-1990, till the date of the cancellation of the Government Order.

(4)     For settlement of the existing claims received pursuant to issue of G.O.Ms.No. 175, HM & FW, dated 7-3-1990 the scale at which the settlements have to be made has been considered by the Government and after taking into consideration the proposals received from the Director of Medical Education the Govt, hereby decide that the maximum expenditure eligible for reimbursement to the Government Employees and their family members for settlement of the existing claims preferred by them before issue of this Government Order will be as follows :-

(5)     Necessary order amending the Andhra Pradesh Integrated Medical Attendance Rules, 1972 in this regard will be issued separately.

(14)   Medical Attendance to State Government employees at Sri Venkateswara Institute of Medical Sciences, Tirupathi with eligibility for reimbursement / medical -advance - Orders - Issued

(G.O.Ms.No. 544, H.M. & F.W. Dept, Dt 9-11-1993)

Ref. :-

(1)     G.O.Ms.No. 445, H.M. & F.W. Dept., Dt. 19-7-1991.

(2)     G.O.Ms.No. 184, H.M. & F.W. Dept., Dt. 2-4-1992.

(3)     G.O.Ms.No. 86, Fin. & Plg. (FW) Dept, Dt. 1-6-1992.

Order :-

(1)     The medical attendance to State Government employees and their dependent family members is governed by the provisions of Andhra Pradesh Medical Attendance Rules, 1972. As an additional facility orders were issued in the Government Orders first read above allowing them to obtain treatment at Nizam's Institute of Medical Sciences directly without reference in the following medical situations with eligibility for reimbursement of the admissible expenditure therefore or for advance with reference to the estimate furnished by the Nizam's Institute of Medical Sciences subject to the monetary ceiling fixed by the Government from time to time.

(a)      Acute Mycardinal Infraction (Cardiology Department)

(b)      Acute Renal Failure (Nephrology Department)

(c)      Severe cases of Head and Spinal injury (Neuro-surgery Department)

(d)      Cases of Coma (Neurology Department)

In all other cases also the facility of treatment for them at Nizam's Institute of Medical Sciences with eligibility for reimbursement or advance is made available subject to reference to that Institute by a Specialist Head of the Department of a teaching hospital and subject to the monetary ceiling as mentioned above. Orders have also been issued in the Government Order third read above delegating powers to the Heads of Departments for the sanction of advances within the monetary ceiling for the treatment at Nizam's Institute of Medical Sciences as indicated above.

(2)     In quite a number of cases the employees working in the border districts of Nellore, Chittoor and Cuddapah are obtaining treatment in neighbouring States and coming up with requests for reimbursement. Each of these cases are being examined on merits and such of those cases, where the required treatment is not available in State Government Hospitals within the area of the State, a liberal view is being taken and such claims are being allowed in relaxation of rules on compassionate grounds in view of the distance involved in coming to State capital.

(3)     Now the Super Speciality Hospital, viz., Sri Venkateswara Institute of Medical Sciences, Tirupathi, financed by Tirumala Tirupathi Devasthanam, has commenced functioning at Tirupathi as a Society with the following specialities :

(1)     Cardiology

(2)     Cardio Thoracic Surgery

(3)     Neurology

(4)     Urology

(5)     Nephrology

(6)     Endocronology

The President, Andhra Pradesh Non-Gazetted Officers Association in his representation fourth read above has requested for according permission for treatment at this institution as at Nizam's Institute of Medical Sciences, Hyderabad.

(4)     Government have reviewed the matter including the policy as mentioned in para 2 above and hereby extend the facility of treatment at Sri Venkateswara Institute of Medical Sciences, Tirupathi to all those who are eligible for Medical Attendance under Andhra Pradesh Integrated Madical Attendance Rules, 1972 on the same lines as applicable for the treatment at Nizam's Institute of Medical Sciences, Hyderabad including the eligibility for advance. Simultaneously, Government have also decided not to allow relaxation of Andhra Pradesh Integrated Medical Attendance Rules, 1972/Orders in the cases of the type mentioned in para 2 above with immediate effect.

(5)     These orders will have prospective effect from the date of issue of this orders.

(15)   Medical Attendance facilities of admission and treatment to the Pensioners and their dependants in Super Specialities Hospitals at Nizam's Institute of Medical Sciences, Hyderabad and Sri Venkateswara Institute of Medical Sciences, Tirupathi with eligibility for reimbursement/medical advance - Orders - Issued

(G.O.Ms.No. 579, H.M. & F.W. Dept, Dt. 1-12-1993)

Ref. :-

(1)     G.O.Ms.No. 401, H.M. & F.W. Dept, Dt. 25-6-1991.

(2)     G.O.Ms.No. 445, H.M. & F.W. Dept., Dt. 19-7-1991.

(3)     G.O.Ms.No. 184, H.M. & F.W. Dept., Dt. 2-4-1992.

(4)     G.O.Ms.No. 86, Fin. & Plg. (FW) Dept., Dt. 1-6-1992.

(5)     G.O.Ms.No. 544, H.M. & F.W. Dept., Dt. 9-11-1993.

(6)     From the President, State Govt. Pensioners Association, Dt. 16-7-93.

Order :-

(1)     Orders were issued in the Government order second read above allowing the government employees and their dependant family members to obtain treatment at Nizam's Institute of Medical Sciences, Hyderabad directly without reference in the following medical situations with eligibility for reimbursement of the admissible expenditure therefor or for advance with reference to the estimate furnished by the Nizam's Institute of Medical Sciences, subject to the monetary ceiling fixed by Government from time to time :

(a)      Acute Mycardial Infraction (Cardiology Department)

(b)      Acute Renal Failure (Nephrology Department)

(c)      Severe cases of head and spinal injury (Neuro-Surgery Department)

(d)      Cases of Coma (Neurology Department).

In all other cases also the facility of treatment for them at Nizam's Institute of Medical Sciences, with eligibility for reimbursement or advances is made available subject to reference of the patient to that Institute by a Specialist/Head of the Department of a teaching Hospital and subject to the monetary ceiling as mentioned above. Orders have also been issued in the Government Order fourth read above delegating powers to the Heads of Departments for the sanction of advances within the monetary ceiling for the treatment at Nizam's Institute of Medical Sciences, Hyderabad as indicated above.

(2)     In the G.O. fifth read above orders have been issued extending the facility of treatment at Sri Venkateswara Institute of Medical Sciences, Tirupathi to all those who are eligible for medical attendance under Andhra Pradesh Integrated Medical Attendance Rules, 1972 on the same lines as applicable for the treatment at Nizam's Institute of Medical Sciences, Hyderabad including the eligibility for advance.

(3)     In respect of State Government Pensioners, orders were issued in the Government order first read above to the effect that medical treatment be provided at Nizam's Institute of Medical Sciences, Hyderabad to the retired Government employees and their dependants on par with serving Government employees who suffer with serious ailments of the Heart, Kidney, Brain, Cancer or any other disease or surgery for which facilities are not available in any of the teaching hospitals in the State and for reimbursement of the cost of the treatment including consumables and disposables and medicines direct to Nizam's Institute of Medical Sciences, Hyderabad subject to however to a maximum limit of Rs. 40,000/- (Rs. Forty thousand only) or as fixed by Government from time to time as in the case of serving Government employees. It was also ordered therein that the Nizam's Institute of Medical Sciences, Hyderabad shall take up cases only on authorisation by Authorised Medical Attendant of any teaching hospitals as in the cases of serving Government employees.

(4)     The President State Government Pensioner's Association, Hyderabad in his representation sixth read above, has stated that the pensioners are facing difficulties on account of the cumbersomeness of the existing procedure and they are also experiencing delays in the referral of emergency cases to Nizam's Institute of Medical Sciences, Hyderabad by the teaching Hospitals. He has therefore requested to issue orders extending the concessions and facilities provided to serving Government employees in G.O.Ms.No. 445, Health, Medical and Family Welfare, Department dated 19-7-1991 and G.O.Ms.No. 86, Finance and Planning (FW) Department dated 1-6-1992 to State Government Pensioners. Further, he has also requested that the Pensioners and their dependants in Rayalaseema Region and Nellore Districts may be permitted to obtain treatment at the Super Speciality Hospital, Tirupathi on the ana'ogy of the procedure laid down in respect of Nizam's Institute of Medical Sciences, Hyderabad.

(5)     After careful examination, the Government here by extend the facility of treatment at Nizam's Institute of Medical Sciences, Hyderabad and Sri Venkateswara Institute of Medial Sciences, Tirupathi to the State Government Pensioners and their dependent Family member on the lines similar to those provided for serving Government employees and their dependant family members as detailed in paras first and second read above including the facility of advance to the extent of ceiling amount of Rs. 50,000/ - as per G.O. fourth read above.

(16)   Sanction of Medical Advance to Government employees - Reimbursement for treatment, etc., for second time - Orders - Issued

(G.O.Ms.No. 223, H.M. & F.W. Dept., Dt. 23-4-1994)

Ref. :-

(1)     G.O.Ms.No. 170, M&H, Dt. 14-3-1985.

(2)     G.O.Ms.No. 281, H.M. & F.W. Dept., Dt. 1-5-1989.

(3)     G.O.Ms.No. 184, H.M. & F.W. Dept, Dt. 2-4-1992.

Order :-

(1)     Orders were issued in the Government orders 2nd read above fixing ceiling of reimbursement amount for the treatment obtained inside or outside India as Rs. 40,000/-. Subsequently orders were issued in the Government order 3rd read above increasing the ceiling of reimbursable amount from Rs. 40,000/- to 50,000/-.

(2)     The issue as to how the ceiling is applicable to Government officials was examined earlier and it was decided that it will apply to the entire treatment of an ailment including the expenditure towards tests and examination, operations if any and for post operative treatment whatever may be the duration of the treatment. Subsequently this decision was again revised in consultation with Finance and Planning (FW) Department regarding the applicability of ceiling for each spent in treatment and whether the employees can be allowed reimbursement or advance, as the case may be, according, to rules for the second and subsequent operations even including the operations for the same ailments.

(3)     The Government, therefore hereby order that the Government officials shall be allowed reimbursement or advance as the case may be according to rules for the second and subsequent operations even including the operations for the same ailments.

(17)   Medical treatment of Govt, employees/retired employees and their dependents - Reimbursement of expenditure - Treatment in private hospitals within the State and outside the State - Orders - Issued

(G.O.Ms.No. 38, H.M. & F.W. (K1) Dept, Dt. 23-1-1996)

Order :-

(1)     The Pay Revision Commission has made certain observations in regard to the medical facilities to the Government employees and retired employees and their dependents in teaching hospitals and also private hospitals within the State as well as outside the State.

(2)     The Government have constituted a Committee to go into the recommendations of the Pay Revision Commission and submit suggestions/recommendations. The said committee suggested the following recommendations :

(i)       that the existing system of reference of teaching hospitals shall be continued.

(ii)      that they have reiterated the recommendations made in 1986 to extend the facility of wellknown hospitals outside the State also.

(iii)     the maximum ceiling of Rs. 50,000/- may be continued and the same could be reviewed periodically. In respect of treatment in hospitals outside, the State with the permission of the Government the bills may be settled subject to scrutiny by director of Medical Education regarding entitlements of the officials who undergo treatment in such hospitals.

(iv)    Even in respect of twin cities also, where specialised treatment is available only in private hospitals which is not available in Government hospitals, the employees may be given the benefit of treatment in such hospitals subject to payment according to the entitlements and within the ceiling subject to scrutiny of bills by the Director of Medical Education.

(v)      In respect of suggestions at items (ii) to (iv) above, reference from Superintendent of a teaching hospital/Superintendent of District Headquarters hospitals, except in respect of cases like "Acute Mycordial Infraction" as may be specified, shall be necessary.

(3)     The above recommendations have been sent to the Director of Medical Education for his remarks and to suggest the hospitals which could be recognised for purposes of reimbursement. The Director of Medical Education considering the recommendations of the High Power Committee has submitted proposals to Government. After careful consideration of the recommendations of the Director of Medical Education, Government hereby permit the employees both serving and retired to secure treatment in the private hospitals both within and outside the State.

(4)     Under Rule 7 of the AP.I.M.A. Rules 1972 Government hereby recognised the following Private Hospitals within and outside the State for treatment to the Government employees, retired employees and their dependents.

 

LIST OF REFERRAL HOSPITALS (Private)

(5)     The above Private Hospitals both within the State and outside the State shall be regarded as referral hospitals subject to the following conditions :

(a)      The above private hospitals will be referral hospitals for all types of cases including Acute Mycordial Infracture ; Acute Coronary Disease, Acute Renal Failure; Severe cases of Head and Spinal Injury and cases of Coma.

(b)      Referral of patients to the above private hospitals should be from the Director, Nizam Institute of Medical Sciences, Hyderabad/Sri Venkateswara Institute of Medical Sciences, Tirupathi in respect of above cases, only on a Certificate given by the Director, Nizam's Institute of Medical Sciences, Hyderabad/Director, Sri Venkateswara Institute of Medical Sciences, Tirupathi stating that Nizam's Institute of Medical Sciences/ Sri Venkateswara Institute of Medical Science will not be able to cope with the work load in the interest of the health of the patient such a reference to Private Hospitals is essential.

(c)      The referring hospitals should ensure that facilities available in those hospitals are fully utilised in the first instance.

(6)     The ceiling of Rs. 50,000/- (Rupees Fifty thousand only) fixed by the Govt, vide G.O.Ms.No. 184, Health, Medical and Family Welfare, dated 2-4-1992 for reimbursement to Government employees including pensioners will be continued.

(7)     In respect of treatment in the above Private Hospitals with prior permission, the bills may be settled subject to scrutiny by Director of Medical Educational about the entitlement.

(18)   Re-imbursement of Expenditure - Treatment in Private recognised Hospitals within and outside the State - Admissibility of Medical Expenditure, with 20% cut on eligible amount without referral from Nizam's Institute of Medical Sciences, Hyderabad/Sri Venkateshwara Institute of Medical Sciences, Tirupathi in cases of emergencies - Orders - Issued

(G.O.Ms.No. 175, HM. & F.W. (K1) Dept. Dt. 28-5-1997)

Ref. :-

(1)     G.O.Ms.No. 38, HM & FW, Dt. 23-1-1996.

(2)     G.O.Ms.No. 258, HM & FW, Dt. 15-6-1996.

(3)     From the President, APNGO's Association, Representation dated 22-3-1996 and representation from certain service Associations.

(4)     From Dir. of Medical Edn., Lr. No. (RC) 3773/MA.A/96, Dt. 9-10-1996.

Order :-

(1)     In the Government orders 1st and 2nd read above orders were issued permitting the State Government Employees, both serving and retired to secure treatment in Private Hospitals within and outside the State indicating therein that under Rule 7 of the Andhra Pradesh Integrated Medical Attendance Rules, 1972, on a reference made by Nizam's Institute of Medical Sciences/Sri Venkateshwara Institute of Medical Sciences.

(2)     In the reference 3rd read above the Andhra Pradesh Non-Gazetted Officer Association and some other Service Associations represented that the orders issued in the Government Orders 1st and 2nd read above are not beneficial to the employees because of the condition that the employee has to obtain a referral certificate from Nizam's Institute of Medical Sciences, Tirupathi to get treatment in Super Speciality Hospitals within or outside the State and requested that this stipulation be omitted.

(3)     It has been observed that a number of cases are being referred to Government for relaxation of the Andhra Pradesh Integrated Medical Attendance Rules, 1972 when the treatment has been obtained directly at the Private Hospitals without referral from Nizam's Institute of Medical Sciences, Hyderabad/Sri Venkateshwara Institute of Medical Sciences, Tirupathi in view of the serious nature of the patient and lack of sufficient time to obtain such referral letter from the hospitals stated above.

(4)     After careful consideration of this issue in consultation with the Director of Medical Education, the Government have decided to permit employees both serving and retired and also to their dependants, to secure treatment in the Private Hospitals recognised in the Government Orders 1st and 2nd read above, when the case is serious which required immediate treatment and there is no sufficient time to get referral letter from Nizam's Institute of Medical Sciences, Hyderabad/Sri Venkateswara Institute of Medical Sciences, Tirupathi. All the competent authorities are therefore permitted to sanction reimbursement of Medical expenses for the treatment in Private Hospitals recognised in the Government Orders 1st and 2nd read above after satisfying themselves that the patient was admitted in the hospital in a very serious condition and it was an emergency case and there was no sufficient time to obtain referral letter from Nizam's Institute of Medical Sciences, Hyderabad/Sri Venkateswara Institute of Medical Sciences, Tirupathi, if necessary after obtaining a certificate from the hospital to that effect and after obtaining copy of the case sheet. In all such cases of the treatment without referral letter, a 20% cut has to be imposed on the eligible amount after getting the bills scrutinised by the Director of Medical Education, Hyderabad.

(5)     All the Departments of Secretariat and all Heads of Departments are also informed that such cases covered under para 4 above need not be referred for relaxation and the authority competent to sanction the medical reimbursement can sanction such reimbursement in the above cases also. In all other cases where the competent authority though not satisfied with the alleged seriousness of the condition of the patient, but when the patient has obtained treatment at a private hospital directly on his own choice shall be referred to Government for relaxation when the Heads of Departments consider that there is genuine cause for anxiety and recommend for relaxation.

(6)     All Departments of the Secretariat and all Heads of Departments are informed that the rejected cases shall not be reopened and the cases pending as on the date of this order with the concerned competent authorities may be disposed of as per above order.

(19)   Medical Attendance to Government Employees/Retired Employees -Reimbursement of treatment etc. incurred - Raising of maximum ceiling from Rs. 50,000 to Rs. 75,000/- - Orders - Issued.

(G.O. Ms. No. 161, H. M & F.W (Kl) Dept., dated 05-05-2000)

Ref. :-

(1)     G.O. Ms. No. 170, M & H, Dept., dated 14-03-1985.

(2)     G.O. Ms. No. 281, H. M & F.W, Dept., dated 01-05-1989.

(3)     G.O. Ms. No. 184, H. M & F.W (K1), Dept, dated 02-04-1992.

Order :-

(1)     Orders were issued in the Government Order third read above, fixing the maximum limit at Rs. 50,000/- (Rupees fifty thousands only) to Government employees towards reimbursement of expenses incurred by them on medical treatment, subject to the conditions specified therein.

(2)     The President, A.P. Retired Government Employees Association and Andhra Pradesh Non-Gazetted Officers Association in their representations fourth and fifth read above, have requested the Government to enhance the ceiling from Rs. 50,000/- to Rs. 1,50,000/- since the cost of treatment is invariably exceeding Rs. 50,000/-.

(3)     The Pay Revision Commission, 1999 has recommended to enhance the ceiling limit from Rs. 50,000/- to Rs. 75,000/- for reimbursement of the medical expenses to State Government employees.

(4)     Government after careful examination of the matter, have decided that the maximum ceiling of Rs. 50,000/- reimbursable to Government employees/ Retired employes and their dependents, towards reimbursement of medical expenditure shall be raised from Rs. 50,000/- to Rs. 75,000/- (Rupees seventy five thousand only) subject to the conditions existing now. Any expenditure in excess of the enhanced ceiling limit of Rs. 75,000/- shall however be borne by the Government employees/Retired Employees and their dependents themselves. However, the procedure of requirement of referral letter by NIMS or SVIMS to obtain treatment in recognised private hospitals shall be continued.

(20)   Certain guidelines for referral of Insured Persons and their beneficiaries and reimbursement of medical bills - Orders - Issuedi

(G.O. Ms. No. 117, HM & FW(Q2) Department, dated 27-03-2000)

Ref. :-

(1)     G.O. Ms. No. 364, H M & F W (Q2) Dept., dated 18-07-94.

(2)     G.O. Ms. No. 134, H M & F W (Q2) Dept, dated 28-03-95.

(3)     G.O. Ms. No. 346, H M & F W (Q2) Dept., dated 28-08-95.

(4)     From the DIMS, Hyderabad Lr. Rc. No. 16943/AIB/98, dated 21-07-99.

Order :-

(1)     The Director of Insurance Medical Services, Hyderabad in his letter 4th read above submitted certain proposals. Among other things he has proposed for constitution of Special Scrutiny Committee for scrutiny of the reimbursement bills.

(2)     The Government after examination of the proposals submitted by the Director of Insurance Medical Services, Hyderabad hereby decided and ordered to constitute "Special Scrutiny Committee" at the Directorate level for settlement of the medical reimbursement bills and credit bills of various corporate hospitals for a proper check and to avoid any split of bills by the patients for the same treatment for the same period with the following members:

(1)     Civil Surgeon Specialist (Cardiology): ESI Hospital, Sanathnagar/Nacharam/Ramachandrapuram. (Senior-most CSS in the same discipline).............. Member

(2)     Civil Surgeon Specialist (Anaestheisa): ESI Hospital, Sanathnagar/Nacharam/Ramachandrapuram. (Senior-most CSS in the same discipline).............. Member

(3)     Civil Surgeon Specialist (Orthopaedics): ESI Hospital, Sanathnagar/Nacharam/Ramachandrapuram. (Senior-most CSS in the same discipline).............. Member

(3)     The Government also ordered that where the facilities are not available in the Government hospital, the patients may be referred to Nizam's Institute of Medical Sciences/ Sri Venkateshwara Institute of Medical Sciences and if facilities are not available in the said Institutions the patients can be referred to the recognised corporate hospitals for the investigations/diseases given in Annexure through Hospitals Level Referral Committee as referred to in the references 1st to 3rd read above. Where the treatment facilities are not available within the State in the said recognised hospitals and essential to be referred to outside the State for treatment, all such cases shall be referred to Government, for approval for administrative as well as financial sanction. In such cases the maximum ceiling shall be restricted to Rs. 75.000/- (Rupees Seventy five thousand only) irrespective of the claim

(4)     The Government further ordered that:

(i)       Patients who are admitted directly in an emergency in NIMS/SVIMS and other recognised corporate hospitals without a referral from any ESI Hospital have to incur the expenditure and submit the bills for reimbursement. The following diseases are recommended only for reimbursement in "emergency admissions"

(a)      Acute Myocardial Infraction (Heart Attack)

(b)      Accidents involving head/Spine and crush injuries

(c)      Patients in Coma

(d)      Acute Paralytic Stroke

(e)      Acute Poisoning

(ii)      All claims of medical reimbursement are subject to a ceiling of Rs. 75,000/- (Rupees Seventy five thousand only).

(iii)     20% cut on admissible bills which are on par with NIMS tariff will be imposed, where the patient was admitted in emergency directly without referrals

(5)     The Director of Insurance Medical Services shall take farther necessary action in the matter.

Annexure to G.O. Ms. No. 117, H. M. & F. W. (Q2) Department, Dt. 27-03-2000

(21)   Reimbursement of expenditure for the treatment at private recognised hospitals within and outside the State and at Government Hospitals - Imposing of 20% cut on the admissible amount - Scrutiny of bills by Director of Medical Education and by the Superintendents of Government Hospitals - Orders - Issued.

(G.O. Ms. No. 373, H. M. & F. W. (Kl) Dept., dated 20-10-2000)

Ref. :- 

(1)     G.O. Ms. No. 38, H. M. & F. W. (Kl) Dept., dated 23-01-1996

(2)     G.C. Ms. No. 175, H. M. & F. W. (Kl) Dept, dated 29-05-1997.

(3)     From Finance and Planning (FW-PC. 1) Dept. D.O. Lr. No. 33081-A/ 542/PC. 1/99 Dated: 31.08.1999.

Order :-

(1)     In the Government Order first read above, orders were issued permitting the State Government Employees both serving and retired and their dependents to secure treatment in Private Hospitals within and outside the State indicated therein under Rule 7 of Andhra Pradesh Integrated Medical Attendance Rules, 1972 on a reference made by Nizam's Institute of Medical Sciences, Hyderabad/Sri Venkateswara Institute of Medical Sciences. Tirupathi.

(2)     In the reference second read above, the Government have permitted all the Competent Authorities to sanction reimbursement of medical expenses for the treatment at private recognised hospitals after satisfying themselves that the patient was admitted in the hospital in a very serious condition and it was an emergency case and there was no sufficient time to obtain referral letter from Nizams Institute of Medical Sciences, Hyderabad/Sri Venkateswara Institute of Medical Sciences, Tirupathi if necessary after obtaining a Certificate from the hospital to that effect and after obtaining copy of the case sheet. In all such cases of the treatment without referral letter a 20% cut has to be imposed on the eligible amount after getting the bills scrutinised by the Director of Medical Education, Hyderabad.

(3)     The Pay Revision Commission, 1999 has recommended that in case of treatment in recognised Corporate Hospitals without prescribed referral letter where reimbursement is recommended by the Director of Medical Education after thorough scrutiny, the cut imposed may be reduced from the present 20% to 10%. However, the referral itself must be insisted upon and it is only in the extreme cases of emergency that claims not supported by referral might be considered/honoured.

(4)     After careful examination of this issue in consultation with Finance and Planning (Finance Wing) Department, Government have decided to continue the existing procedure of 20% cut. The emergency certificate issued by the private hospital where treatment was obtained in emergency condition in a private hospital should be scrutinised and countersigned by the Director of Medical Education.

(5)     In case of treatment in Government Hospitals, Government also decided to do away with scrutiny of bills by Director of Medical Education, Hyderabad subject to scrutiny, and countersigning of the bills by the Superintendent of hospital (who is of Additional Director rank).

(22)   Nizam's Institute of Medical Sciences - Medical treatment of State Government Employees, Retired Employees and their Dependents - Reimbursement of Expenditure for all diseases without referral letter, etc. - Orders - Issued.

(G.O. Ms. No. 134, H.M. & F.W. (Kl) Department, dated 09-04-2001)

Ref. :- 

(1)     G.O.Ms. No. 445, H.M. & F.W, (E2) Department, dated 19-07-1991.

(2)     G.O. Ms. No. 175, H.M. & F.W. (Kl) Department, dated 29-05-1997.

Order :-

(1)     In the G.O. 1st read above Government have permitted the Government employees and their dependents to obtain treatment at Nizam's Institute of Medical Sciences for four earmarked diseases referred to therein without referral letter from Teaching Hospitals and reimburse in full admissible amount without scrutiny of the bills by the Director, Medical Education. Hyderabad.

(2)     In the G.O. 2nd read above Government have permitted the employees both serving and retired employees and also to their dependents to get the treatment at Recognised Private Corporate Hospitals under emergency circumstances without referral letter from Teaching Hospitals duly imposing 20% cut on the admissible amount,

(3)     Government have now decided that the State Government employees/Retired employees and their dependents may be permitted for full admissible reimbursement without imposing 20% cut for the treatment for all the diseases other than the earmarked four ailments in Nizam's Institute of Medical Sciences, Hyderabad directly, under emergency circumstances without referral letter from Teaching Hospitals subject to certain conditions.

(4)     Government after careful consideration of the matter have decided to permit Government employees both serving and retired and also their dependents to secure treatment for all diseases at Nizam's Institute of Medical Sciences, Hyderabad directly without referral letter from Teaching Hospitals "under emergency circumstances" subject to conditions mentioned in para 4 of G.O. Ms. No. 175, Health, Medical and Family Welfare (Kl) Department, dated 29.05.1997. In all such emergency cases of treatment without referral letter, imposing of 20% cut and scrutiny of bills by Director of Medical Education need not be insisted.

(5)     This order shall come into force with effect from 9-04-2001.

(23)   OP treatment at NIMS Hospital - Medical Reimbursement Claims of employees/ retired employees - Clarification - Issued.

(Memo. No. 40484/204/A2/2001, Fin. (Admn.lll) Dept., dated 06-02-2002)

Ref. :-

PAO Lr. No. PAO/Admn./Bills/2001-02/Medical/43, Dt. 13-12-2001

Order :-

The attention of the Pay and Accounts Officer, Hyderabad is invited to the para 3 of reference cited and he is informed that OP treatment at NIMS Hospital is not admissible as per APIMA Rules, 1972. With reference to point (iv) maximum ceiling amount of Rs. 75,000/- only is reimbursable if it is considered by the concerned departments as per existing rules in force. However the OP treatment at NIMS Hospital is not admissible as per the APIMA Rules, 1972.

(24)   The Andhra Pradesh Integrated Medical Attendance Rules, 1972 -Recommendations of the Committee for revision of the Rules - Orders - Issued.

(G.O. Ms. No. 74, HM & FW(K1) Dept., Dt. 15-03-2005)

Ref. :-

(1)     G.O.Ms.No.465, HM&FW(K1) Deptt., Dt. 18-8-2003.

(2)     Govt.Memo.No.l8300/Kl/2003-l, Dt. 8-9-2003.

(3)     From the DME, A.P., Hyd, Lr.Rc.No.20866/MA-A/03, Dt. 18-12-03.

(4)     Govt.Lr.No.l8300/Kl/2003-2, Dt. 31-1-2004.

(5)     From the President, A.P. Sect? Association, Hyd. repn. Dt. 19-7-2004.

(6)     Govt. Lr. No. 18300/K1/2003-4, Dt. 4-8-2004.

(7)     G.O. Ms. No. 250, HM & FW(K1) Deptt., Dt. 11-8-2004.

(8)     From G.A. (SW-II) Deptt., U.O.Note No. 101207/SWII-A1/2004-3, Dt. 9-9-2004.

(9)     Govt. Lr. No. 18300/K1/2003-2, Dt. 15-9-2004.

(10)   G.O. Ms. No. 413, GA (Poll-D) Deptt, Dt. 9-12-2004.

(11)   From Sri N. Narasimhaiah. MLA. reptn Dt. 29-11 -2004.

(12)   From the DME, A.P., Hyd.. Lr.Rc.No.20866/MA-A/03. Dt. 28-12-04.

Order :-

(1)     Government have issued Andhra Pradesh Integrated Medical Attendance Rules, 1972, applicable to State Government employees and their dependents, employees of local bodies, students of Medical Colleges, members of State Legislature, A.l.S. Officers. A.P. State Higher Judicial officers etc. Many private hospitals both in the State and out side the State have been recognised as referral hospitals, for the treatment to the above category of persons on reimbursement basis. There is no uniform rates being charged from the patients by these private hospitals. In Government hospitals, various medical facilities are provided with latest equipments for the treatment to general public and also to the employees. Since the issue of the rules. Government have issued amendments /orders /Clarifications from time to time to the said rules. Therefore, some of the provisions in the said rules became outdated. Due to the above position. Government felt that there is a need to review all the provisions in Andhra Pradesh Integrated Medical Attendance Rules. 1972 and modification and re-issue the rules. Accordingly in the G.O. first read above. Government have appointed a committee under the chairmanship of Director General of Medical and Health Services and Commissioner. A. P. Vaidya Vidhana Parishad for revision of Andhra Pradesh Integrated Medical Attendance Rules. 1972 and to submit report to Government. Various terms of reference was specified thereon. In the G.O. seventh read above, the Director of Medical Education has been appointed as Chairman of the said Committee, due to resignation of the Director General Medical and Health Services and Commissioner, A.P. Vaidya Vidhana Parishad. As per the terms of the reference of the committee. Government have referred various issues relating to medical reimbursement. In the reference fifth read above, the President, Andhra Pradesh Secretariat Association has also represented for reimbursement facility for Out Patient treatment at Nizam's Institute of Medical Sciences, Hyderabad / private recognised hospitals, removal of 20% cut on the claim and extend credit facility for obtaining treatment under emergency conditions in private recognised hospitals. This representation was also referred to the Committee.

(2)     In the reference 11th read above, Sri N.Narasimhaiah M.L.A. has represented that Out Patient treatment to M.L.A.s may also be allowed on credit basis, to enable to get tests like M.R.I., C.T. Scan etc. and save the health of V.V.I.Ps.

(3)     In the letter 12th read above, Chairman of the Committee for revision of Andhra Pradesh Integrated Medical Attendance Rules, 1972 and Director of Medical Education has submitted the recommendations of the committee and its report to Government. The Director of Medical Education has stated that the committee has met on 24-10-03. 25-11-03. 23-12-03, 25-2-04. 12-8-04. 19-10-04 and 16-11-04 and examined various issues. A sub committee was constituted for finalisation of package rates.

(4)     The Director of Medical Education has also stated that the following nine service associations have been requested to give suggestions on Andhra Pradesh Integrated Medical Attendance Rules:

(1)     A.P. Secretariat Employees Association, Hyderabad.

(2)     A.P. Non-Gazetted Officers Association, Hyderabad

(3)     A.P. Teachers Federation, Hyderabad

(4)     The Secretary, A.P. Revenue Employees Association.

(5)     A.P.T.N.G.O. Association

(6)     A.P.U.T.F Association.

(7)     A.P.P.R.T. Union, Hyderabad.

(8)     A.P. State Government Retired Employees Association.

(9)     A.P. Secretariat Women Employees Welfare Association.

(5)     The General Secretary, A.P. State Government (Retd.) Employees Association and Organising Secretary of A.P. State Government Employees. Association have attended the meeting of the committee held on 8-12-2003. The Director of Medical Education has also stated that the service associations have been reminded on 11-12-2003 to submit their views regarding revision of Andhra Pradesh Integrated Medical Attendance Rules 1972. The following service associations have sent their suggestions in the matter:-

(1)     A.P. State Government Retired Employees Association.

(2)     A.P. Secretariat Employees Association, Hyderabad.

(3)     A.P. Secretariat Women Employees Welfare Association.

(4)     P.R.T.U. & UTF (Teacher Associations)

(6)     The Director of Medical Education has stated that the sub-committee has recommended that the rates prescribed by Central Government Health Scheme may be adopted by State Government also for sanctioning reimbursement. The recommendations of sub committee have been accepted by the committee. He has furnished the recommendations for incorporation and revision of Andhra Pradesh Integrated Medical Attendance Rules rules, 1972.

(7)     The Director of Medical Education has requested the Government to consider and issue necessary orders in the matter at an early date.

(8)     The recommendations of the Committee includes adoption of Central Government Health Scheme package rates for the reimbursement of medical expenses incurred by State Government employees, their dependents, retired State Government pensioners and their family members etc., allowing medical reimbursement for the treatment obtained at Nizam's Institute of Medical Sciences, Hyderabad, Sri Venkateswara Institute of Medical Sciences, Tirupati and all Government Hospitals as Out-Patients and follow-up treatments. As regards recognised private hospitals, medical reimbursement for the treatment obtained as outpatients may be allowed for the treatment of Chemotherapy, radiotherapy for cancer, regular dialysis for Kidney, Cardinal cases like cardiac cases, sever neurological problems and A.I.Ds subject to recommendation by the specialist doctor for the length of the treatment, consideration of medical reimbursement in accident cases under emergency conditions for the treatment obtained in unrecognised private hospitals by relaxing relevant rules by Government, conducting of health camps for master health checkup, delegation of powers for scrutiny and sanction of medical reimbursement upto Rs.25,000/- to various district level officers, referring of patients by District/ Area Hospitals to private recognised hospitals, reducing imposition of cut of 20% on the admissibility amount to 10%, when the treatment obtained in Private Hospitals recognised by Government without referral letter, extending medical reimbursement fecilities for the treatment obtained in Sri Venkateswara Institute of Medical Sciences, Tirupati on par with Nizam's Institute of Medical Sciences, Hyderabad etc.. The Committee after examination of the merits of the representations received from various associations has also recommended to accept certain demands and to reject certain demands.

(9)     Government have examined the matter carefully and decided to accept the recommendations of the Committee for revision of Andhra Pradesh Integrated Medical Attendance Rules, 1972 constituted in the Government Orders first and seventh read above. Accordingly, in modification of the existing orders on Andhra Pradesh Integrated Medical Attendance Rules, 1972, Government hereby issue the following orders with immediate effect :-

[7][(1) (a) The rates prescribed in the Central Government Health Scheme (C.G.H.S.) package by Government of India, Ministry of Health and Family Welfare Affairs. New Delhi for Central Government Health Scheme, Hyderabad are adopted in the State for the purpose of reimbursement of medical expenditure incurred by the State Government employees both in service/retired and their dependents; family pensioners, M.L.As and their family members and all other eligible categories who are entitled for free medical treatment as mentioned in Andhra Pradesh Integrated Medical Attendance Rules, 1972, when the treatment was taken in the private hospitals recognised by the State Government within the State. If medical treatment is taken outside the State, the rates of Central Government Health Scheme, Delhi shall be applicable.

[8][(b) The maximum ceiling limit of Rs.2.00 lakhs (Rupees two lakhs only) is fixed for the major ailments of Bypass Heart surgery, CABGS, Double valve replacement. Open Heart procedure, Aortic valve replacement, Kidney Transplantation, Cancer and Neuro-Surgery to Brain irrespective of package rates of CGHS for the treatment obtained in private hospitals, and also for the treatment obtained in NIMS. Hyderabad and SVIMS. Tirupati or actual cost which ever is less. This ceiling limit of Rs. 2.00 lakhs is applicable to the retired employees (pensioners) and their dependents also on par with serving employees for these ailments, as per the recommendations of P.R.C. 2005 read with the recommendations of Anomalies Committee.]

(c) In the conditions, procedures, surgeries where C.G.H.S package rates are available, the CGHS tariff is the ceiling limit and shall be followed for the treatment obtained in Private Hospitals except for the major ailments mentioned in point 1 (b) above. The Private Hospitals recognised as referral hospitals should abide and follow CGHS package rates and Government orders while giving treatment to the employee and their dependents as per APIMA Rules. They shall not charge excess amount over the package rates mentioned in CGHS package rates.

(d) Where package rates in CGHS, NIMS / SVIMS are not available for certain treatments other than Dental ailments, the ceiling limit as prescribed in G.O. Ms. No. 58, HM & FW (Kl) Department, Dt. 05-05-2000 shall be followed for scrutiny and reimbursement purpose, duly modifying the orders issued in G.O. Ms. No. 180, HM & FW (Kl) Department, dated 11-05-2006, viz. the ceiling limit will be Rs.1.00 lakh (Rupees one lakh only) for serving employees and their dependents and in respect of retired employees and their dependents and family pensioners, it shall be Rs.75,000/- (Rupees seventy five thousand only).]

(2)   For the expenditure incurred towards the treatment obtained in Nizam's Institute ofMedical Sciences, Hyderabad / Sri Venkateswara Institute of Medical Sciences, Tirupati. their package rates respectively be followed for sanctioning advance, scrutiny and Medical reimbursement purpose. Facilities of paying room as per the entitlement of indoor treatment as prescribed in Central Government Health Scheme package system is extended and the State Government Employees are categorized as three categories based on their scales of pay as mentioned below:-

(3)   In respect of treatments/ operations obtained for cataract and other eye ailments, and dental diseases/treatments in Government or private hospitals recognised by State Government, the scrutinising authority need not insist for submission of Emergency Certificate. In modification of the orders issued in G.O.Ms.No.276, HM&FW (Kl) Department, Dt. 11-5-1993 and subsequent orders issued thereon and on Eye ailments and Dental diseases /treatments, it is ordered that the reimbursement shall be made as per the package rates prescribed by Government for various eye ailments and Dental procedures/ diseases, after duly scrutinising the bills by the Director of Medical Education, A.P. or other scrutinising authorities. The package rates prescribed for Eye ailments are mentioned in Annexure-I [9][xxx], (Deleted by G.O. Ms. No. 105, H.M. & F.W. (Kl) Dept., dated 9-04-2007) In respect of Dental treatment cases, the following procedure shall be followed:-

(a)      The employee should approach Government Hospital, i.e. Teaching Hospital or District Headquarters Hospital or APVVP Area Hospital for Dental treatment or where facilities not available, obtain referral letter before approaching any recognised Dental Hospital for treatment. With prior permission of the concerned Government hospital only, one should obtain dental treatment in recognised dental hospitals. -

(b)      Reimbursement in respect of treatment for dental diseases to each of the employee or their dependents separately in the entire service or life as the case may be, shall be limited to three times and the ceiling limit shall be Rs. 10,000/- (Rupees ten thousand only) for each time.

(i)       No relaxation of rules be accepted for sanction of claim beyond Rs. 10,000/-(Rupees ten thousand only) in any case.

(ii)      With regard to cosmetic dental surgery, claims regarding Cosmetic dental surgery are not eligible for any medical reimbursement, except in case of Road Traffic accidents involving upper and low jaws.

(4)   All types of out patient including diagnostics, and follow up treatments including Chemotherapy, Radiotherapy, Regular Dialysis for Kidney are allowed for reimbursement when the treatment obtained at Nizam's Institute of Medical Sciences, Panjagutta, Hyderabad and Sri Venkateswara Institute of Medical Sciences, Tirupati and all Government Hospitals. In respect of the treatment obtained as Out-Patients in private hospitals recognised by State Government, medical reimbursement is allowed for chemotherapy and radiotherapy for Cancer, and regular dialysis for Kidney and also Out patient treatment for Cardinal diseases like cardiac diseases and severe neurological problems and A.I.D.S. are included. The length of out patient treatment period should be recommended by the specialist doctor concerned and shall be scrutinised by the Director of Medical Education, Nizam's Institute of Medical Education, Nizam's Institute of Medical Sciences, Hyderabad, Sri Venkateswara Institute of Medical Sciences. Tirupati or other scrutinising authorities as prescribed.

(5)   In respect of life long follow up treatment to certain diseases, for every follow up treatment for post operative cases, who requires life long treatments, the concerned patient has to get revalidation of prescriptions once in six months from the specialist Government doctor and reimbursement be allowed on submission of scrutiny report of the Director of Medical Education or other scrutinising authorities concerned.

(6)   The Superintendents of Teaching hospitals and the Superintendents of District Hospitals, Civil Surgeon Specialist of the Civil Dispensary, A.P. Secretariat, Hyderabad, Medical Officers of the rank of Civil Assistant Surgeons of Unit Medical Hospitals of Grey Hounds, Hyderabad, High Court of Andhra Pradesh, Hyderabad, Commissioner of Police. Hyderabad, and Medical Officer attached to Government Civil Dispensary, A.P. Bhavan, New Delhi are authorised to scrutinise the medical reimbursement claims up to a value of Rs.25,000 (Rupees twenty five thousand only), of State Government Employees, retired employees, their dependent family members and family pensioners and other categories of persons entitled for medical reimbursement as per of Andhra Pradesh Integrated Medical Attendance Rules, 1972 received from District level officers from their respective region/ Districts and Offices concerned in partial modification of the orders issued in G.O.Ms.No.471, H.M.&F.W. (Kl) Department, dated 19-12-2001, G.O.Ms.No.674, HM&FW(K1) Deptt, dated 15-11-2003 and G.O.Ms.No.37, HM&FW(K1) Deptt., dated 31-1-2004. These scrutnising authorities should scrutinise the bills in terms of Andhra Pradesh Integrated Medical Attendance Rules, 1972 and as amended from time to time.

[10][(6-A) In respect of claims of medical reimbursement relating to M.L.As, Ex-M.L.A.s and their family members, and officers, staff and retired persons, and their dependents of Legislature Department, irrespect of the value of the bill including below Rs. 25,000/-(Rupees twenty five thousand only), the Director of Medical Education shall scrutinise the bills in terms of the rules. He shall make necessary arrangements for scrutiny of the bills accordingly and ensure that there will not be any delay in scrutiny.]

(7)   Powers are delegated to all the district level officers of all the Departments in the State to sanction the medical reimbursement claims up to a value of Rs.25,000/- (Rupees twenty five thousand only), subject to scrutiny done by the District Medical Board/ District Hospital Superintendent/ Superintendent of Teaching Hospitals. If the claim is over and above of Rs.25,000/-, the claim should be referred by the concerned Department in the districts to Director of Medical Education, A.P., Hyderabad for scrutiny, and the sanctioning authorities for sanction of claims of medical reimbursement over and above Rs.25,000/- are Heads of Departments /District Collectors, after getting scrutiny report of Director of Medical Education, or Nizam's Institute of Medical Sciences, Hyderabad or Sri Venkateswara Institute of Medical Sciences, Tirupati, as the case may be and where relaxation of rules are not involved.

(8)   Powers are also delegated to the Director of Health, A.P.. Hyderabad to scrutinise the Medical Reimbursement claims in respect of the employees working under his administrative control on par with the Commissioner of A.P.Vaidya Vidhana Parishad. duly following the procedure adopted by the Director of Medical Education in scrutinising the bills, as per the existing orders on Andhra Pradesh Integrated Medical Attendance Rules, 1972 as modified from time to time.

(9)   In respect of road accidental cases, if the employee or his dependents and other categories of persons mentioned in rule 6 of Andhra Pradesh Integrated Medical Attendance Rules are admitted in nearby private hospitals which are not recognised as referral hospitals under emergency conditions to save the life of the patient, in such cases the claim can be considered for reimbursement of medical expenses up to a limit of Rs.25,000 (Rupees twenty five thousand only) and the Heads of Departments/ District Collectors are authorised to sanction the claim after getting the scrutiny of bills from the Director of Medical Education or other scrutinising authorities as the case may be. Such claims over and above Rs.25,000 shall be referred by the Heads of Departments/ District Collectors concerned after duly getting scrutiny of the bills etc., to the concerned administrative Department in Secretariat for obtaining relaxation of rules and duly consulting Finance Department.

[11][Provided scrutiny of medical bills of Government employees and their dependents of Raj Bhavan is entrusted to the Civil Surgeon Specialist, Civil Dispensary, A.P. Secretariat, Hyderabad upto claim of Rs.25,000/- (Rupees twenty five thousand only)].

(10) In G.O. Ms. No. 175, H.M.&F.W. (Kl) Department, Dt.29-5-1997, 20% cut is prescribed on the eligible amount in cases of treatment obtained under emergency condition in private hospitals recognised by Government without referral letter from Government Hospitals or Nizam's Institute of Medical Sciences, Hyderabad, or Sri Venkateswara Institute of Medical Sciences, Tirupati. In partial modification of the orders issued in G.O.Ms.No.175, H.M.&F.W. (Kl) Department, Dt.29-5-1997, the 20% cut prescribed therein is reduced to 10%, on the eligible amount after scrutiny of bills by the Director of Medical Education or other scrutinising authority as per the package rates, when the treatment was obtained under emergency conditions in private hospitals recognised by Government without referral letter from any Government hospital or Nizam's Institute of Medical Sciences, Hyderabad, or Sri Venkateswara Institute of Medical Sciences, Tirupati.

[12][In respect of treatment obtained in un-recognised private hospitals for treatment / surgeries under emergency conditions, as stipulated in G.O. Ms. No. 175, HM & FW(K1) Dept., Dt 29-5-1997.

(i)       Such claims shall be examined by Head of the Department concerned and if it is found genuine, then the proposal shall be referred to their concerned administrative Department in A.P. Secretariat, Hyderabad with specific recommendations justifying for relaxation of rules, together with scrutiny report of the DME or NMS or SVIMS or other scrutinizing authority as the case may be.

(ii)      The concerned Administrative Department in Secretariat shall examine the proposal in consultation with Finance Department for relaxation of rules and take a decision for sanction of medical reimbursement based on scrutiny report as per the business rules. In such cases, the Administrative Department concerned shall not refer files to Health, Medical & Family Welfare Department for remarks / opinion.

(iii)     While referring for any specific clarification / proposal to Government in their concerned Administrative Department, the Head of the Department shall obtain and enclose the scrutiny report of Director of Medical Education or Nizam's Institute of Medical Sciences (NIMS) / Sri Venkateshwara Institute of Medical Sciences (SVIMS) or other scrutining authority as may be applicable to each case, to avoid unnecessary and avoidable correspondence.] 

(11) In respect of medical reimbursement to the employees under suspension, the following two points be added to rule 6 (i) of Andhra Pradesh Integrated Medical Attendance Rules, 1972 :-

(a)      Provided dismissed or removed Government servants and their dependents are not entitled for reimbursement of medical expenses.

(b)      As far as retired and re-employed pensioners are concerned, for persons who were convicted by the court of law for offence or involved in moral turpitude and punishment was imposed under A.P. Revised Pension Rules, 1980, he and his family members should not be entitled for any free medical treatment in Government hospital or medical reimbursement. Provided that the retired persons who were punished for any administrative lapses for which the punishment was given, which is not a 100% cut in his pension, can be allowed for free medical treatment/ medical reimbursement as the case may be.

(12) As per G.O.Ms.No.445, HM & FW (E2) Department, Dt. 19-07-1991, the medical advance facility is extended to four earmarked diseases i.e. l)Acute Mycardial Infracture 2) Acute Coronary Disease, Acute Renal Failure 3) Severe Cases of Head and Spinal injury, Road accident and 4) In cases of Coma only, if the treatment is to be obtained in Nizam's Institute of Medical Sciences, Hyderabad. The following more major diseases are added for sanction of advance to be included in the said G.O. :-

"(1) PTCA+STENT (2) Open Heart Surgery (3) Pace Maker (4) All organ transplants (5) Plastic Surgery done for accident cases and burns, (6) Mitral Valve replacement, based on package rates of Nizam's Institute of Medical Sciences and Sri Venkateswara Institute of Medical Sciences based onestimation given by them".

(13) In G.O.Ms. No. 134, HM & FW (Kl) Department, Dt. 9-4-2001, Government employees both in service and retired and their dependents are permitted to secure treatment for all diseases at Nizam's Institute of Medical Sciences, Hyderabad directly without referral letter under emergency circumstances. Since Out Patient treatment is allowed for medical reimbursement at Nizam's Institute of Medical Sciences, Hyderabad and Sri Venkateswara Institute of Medical Sciences, Tirupati, the condition of "emergency circumstances" prescribed in G.O.Ms.No.134, HM&FW (Kl) Department, dated 9-4-2004 is hereby deleted. All the reimbursement facilities available in Nizam's Institute of Medical Sciences, Hyderabad as per the orders issued in G.O.Ms.No.134, HM&FW (Kl) Department, Dt.9-4-2001, as modified now, be extended to Sri Venkateswara Institute of Medical Sciences, Tirupati on par with Nizam's Institute of Medical Sciences, Hyderabad.

[13][(13-A) NIMS, Hyderabad and SVIMS, Tirupati while issuing final bills to the employee, etc. they should also issue a separate scrutiny certificate on the net admissibility of the claim in terms of APIMA Rules 1972, simultaneously as amended from time to time to avoid delays. Based on the scrutiny certificate, the concerned Department shall take necessary action for sanction of claims as per the procedure.]

(14) All the Heads of Departments and Regional and District Level officers can issue letter of credit (L.O.C.) to private hospitals recognised by State Government for treatment/ operations to their employees and their dependents for major ailments of CABG, Kidney transplantation, Cancer, Neuro Surgery Open Heart Surgery, all organ transplants, PTCA+STENT, Pace Maker, Plastic Surgery done secondary to accident, and burns cases, based on submission of estimation, and acceptance of the credit from the concerned recognised private hospital, subject to ceiling limit as per the package rates prescribed by the Government. Expeditious steps may be taken by all the departments to issue I.D. cards to all the eligible State Government employees and their dependents for availing of Letter of Credit facility. The referral private hospitals shall also provide treatment immediately after admission of the patient, on production of identity card in emergency situation.

(15) Medical Reimbursement facility be allowed only to adopted son or daughter, and it is restricted to the family as defined under rule 3 (7) of Andhra Pradesh Integrated Medical Attendance Rules, 1972.

(16) Specific drugs for the specialised treatment should be prescribed by the specialist doctors only, in both private hospitals recognised by Government, and Primary Health Centres, Community Health Centres, and other Government Hospitals.

[14][(17) The State Government employees both in service and retired and their dependents, and all other eligible categories are allowed to secure treatment under emergency cases, in the A.P. State Government recognised private hospitals outside the State with 10% cut on the eligible amount and as per CGHS rates. ]

(18) The powers are delegated to Superintendents of Area Hospitals and the Superintendent of District Headquarters Hospitals under the control of A.P. Vaidya Vidhana Parishad to refer the patients to Private recognised hospitals for specialised treatment.

(19) Since user charges are abolished for the treatment in Government hospitals, vide G.O.Ms.No.163, HM&FW(M1) Department, dated 14-6-2004, no user charges should be collected from the State Government employees and their dependents including from the pensioners and their dependents and family pensioners in Government hospitals for their treatment both for outpatient and inpatient.

(20) As per note (3) of Appendix-Ill, under rule 5 (3) (iii) of Andhra Pradesh Integrated Medical Attendance Rules, 1972 for belated claim, the existing condition that preferring the claim for medical reimbursement should be within a period of six months from the date of discharge of the patient from the hospital but not from the last date of treatment is continued, except for the Coma, expiry cases and accidental cases. In such cases, the claim may be preferred within eight months from the last date of discharge from the hospital /expiry of concerned patient.

(21) For scrutiny of bills, the following original documents should be submitted along with the claim :-

(1)     Discharge Summary

(2)     Emergency Certificate (Except for dental and Eye ailments)

(3)     Essentiality Certificate

(4)     Appendix-II Form

(5)     Declaration of dependence to be attested by Gazetted Officer)

(6)     Non drawl declaration, which should be attested by Drawing and Disbursing Officer concerned.

The Xerox copies of documents shall not be accepted.

(22) In G.O.Ms.No.601, HM&FW(K1) Department, Dt, 15-10-2003. orders have been issued allowing medical reimbursement for three spells during the life time for the same ailments for claiming reimbursement for three spells when treatment obtained in recognised private hospitals. In modification of the said orders, it is ordered that no restriction is imposed for the treatments obtained in private recognised hospitals for different ailments operations/treatments. Medical Reimbursement facility for major ailments i.e. CABGS, kidney transplantation, cancer, neurosurgery, PTCA STENT be restricted to three spells for each of these diseases. Three spells means, three surgeries for the same ailments, expect for Orthopedic and Plastic Surgeries, where more number of operations are warranted for the treatment of the same cause. A Justification Certificate issued by the concerned specialist treating doctor of the private hospital recognised by Government / Government hospital should be submitted for the second and third spell claims.

(23) Reimbursement of medical treatment taken by employees in foreign countries under emergency conditions be allowed, only if they are on official visit to that foreign country. The treating doctor of the concerned hospital has to issue certificate about the nature of the Emergency, Essentiality Certificate and detailed bill, provided that they are not paid any amount towards the said treatment by any other authority including insurance company.

(24) Master Health Checkup be conducted to all the Government employees who crossed the age of 40 years and before retirement form service. Master Health checkup will be allowed only three times with an interval of one year, between each checkup, and by duly fixing the package rates and can be obtained in all the Government hospitals, Nizam's Institute of Medical Sciences, Hyderabad, Sri Venkateswara Institute of Medical Sciences, Tirupati and recognised private hospitals.

[15][(24-A) In respect of Master Health Checkup for employees who crossed 40 years as per above sub-para, the concerned employee shall submit application to the concerned HOD / Regional Office / District Office for his checkup to a particular recognized hospital, SVIMS/NIMS. The concerned HOD / Regional Office / District Offices as the case may be refer the employee concerned to that hospital for Master health Checkup on Letter of Credit (L.O.C.) basis and the departments should obtain bills from the hospitals and send for scrutiny and arrange payment to the hospital as per CGHS rates, NIMS rates / SVIMS rates respectively.

(24-B) The Ceiling limit for reimbursement to Master Health Check up is fixed at Rs. 3000/- (Rupees three thousand only) and Master Health Checkup shall include, (1) Haemogram (CBP, ESR, Plate count), (2) complete Urine examination, (3) Biochemistry: Serum Uric Acid, Lipid Profile, LFT, Blood Sugar, Fasting and Post Prandial Blood Urea and Serum Creatinine, (4) Cardiology ECG, 2D, ECHO Tread mill test whenever necessary (5) Radiology chest X-Ray, Ultra sound Exam Abd., (6) PAP Smear (HP) for ladies, (7) Micro Biology: HIV, HBs Ag., (8) Blood Grouping Rh. Typing, (9) Eye checkup and consultation with physician, (10) Thyroid Test and T3, T4, TSH.]

(25) Medical reimbursement for deliveries and tubectomy to the Women Employees be allowed reimbursement up to two deliveries and with two living children as per the package rates. Hysterectomy operations shall be reimbursable as per package rates.

(26) If the claimant has claimed his medical reimbursement from the Insurance Company, under Health Insurance Scheme by paying premium on his own, reimbursement also be allowed from Govt, as per Central Govt. Health Scheme package rates.

(10)   The above orders will be applicable to all State Government employees, their dependents, retired State Government pensioners and their dependents, family pensioners, M.L.A's and other categories of persons who are entitled for free medical treatment as specified in Andhra Pradesh Integrated Medical Attendance Rules, 1972. Suitable amendments to Andhra Pradesh Integrated Medical Attendance Rules, 1972 will be issued separately on the above orders.

(11)   The Director of Medical Education shall take necessary action in the matter accordingly.

 

ANNEXURE – I

to G.O.Ms.No.74, HM&FW (Kl) Dept., Dt. 15-3-2005 PACKAGE RATES FOR EYE AILMENTS

Code	Description	Care Type Total Rs.
ACOR010	THERAPUETIC PENETRATING KERATOPLASTY	DELUXE	12,000
ACOR010	THERAPUETIC PENETRATING KERATOPLASTY	PRIVATE	10,000
ACOR010	THERAPUETIC PENETRATING KERATOPLASTY	S-PRIVATE	8,000
ACOR011	ROTATION AUOTGRAFT	DELUXE	8,000
ACOR011	ROTATION AUOTGRAFT	PRIVATE	6,000
ACOR011	ROTATION AUOTGRAFT	S-PRIVATE	4,000
ACOR012	LAMELLAR KERATOPLASTY	DELUXE	12,000
ACOR012	LAMELLAR KERATOPLASTY	PRIVATE	10,000
ACOR012	LAMELLAR KERATOPLASTY	S-PRIVATE	8,000
ACOR013	REMOVAL OF CALCIFIED DEPOSIT (CORNEA)	OPD	800
ACOR014	PERIPHERAL CORNEAL GRAFT	DELUXE	8,000
ACOR014	PERIPHERAL CORNEAL GRAFT	DELUXE	6,000
ACOR014	PERIPHERAL CORNEAL GRAFT	S-PRIVATE	4,000
ACOR015	ASTIGMATIC ANNULAR KERATOTOMY	OPD	1,000
ACOR029	PUPILLOPLASTY	OPD	1.000
ACOR030	AC REFORMATION	DELUXE	3.000
ACOR030	AC REFORMATION	PRIVATE	2.000
ACOR030	AC REFORMATION	S-PRIVATE	1.000
ACOR031	RELEASE SYMBLEPHARON	OPD	27.000
ACOR034	CORNEAL PATCH GRAFT	DELUXE	8,000
ACOR034	CORNEAL PATCH GRAFT	PRIVATE	6.000
ACOR034	CORNEAL PATCH GRAFT	S-PRIVATE	4,000
AIOL001	EXCHANGE OF IOL	DELUXE	12.000
AIOLOOl	EXCHANGE OF IOL	PRIVATE	8.000
AIOL00I	EXCHANGE OF IOL	S-PRIVATE	4.500
AIOL002	REMOVAL OF IOL	DELUXE	10.000
AIOL002	REMOVAL OF IOL	PRIVATE	6.000
IOL002	REMOVAL OF IOL	S-PRIVATE	3.000
AIOL003	SECONDARY IOL	DELUXE	10,000
AIOL003	REMOVAL OF IOL	PRIVATE	6.000
AIOL003	REMOVAL OF IOL	S-PRIVATE	3.000
AIOL004	IOL EXPLANTATION	DELUXE	10.000
AIOL004	IOL EXPLANTATION	PRIVATE	6,000
AIOL004	IOL EXPLANTATION	S-PRIVATE	3.000
AOTHOOI	SECLERAL PATCH GRAFT	DELUXE	8.000
AOTH001	SECLERAL PATCH GRAFT	PRIVATE	6.000
AOTHOOI	SECLERAL PATCH GRAFT	S-PRIVATE	4.000
AOTH002	ANTERIOR SEGMENT RECONSTRUCTION (AC FORMATION)
		DELUXE	9.000
AOTH002	ANTERIOR SEGMENT RECONSTRUCTION (AC FORMATION)
		S-PRIVATE	1.000
AOTH002	ANTERIOR SEGMENT RECONSTRUCTION (AC FORMATION)
		S-PRIVATE	1.000 '
AOTH003	REPAIR OF IRIS PROLAPSE	DELUXE	4.000
AOTH003	REPAIR OF IRIS PROLAPSE	PRIVATE	2.000
AOTH003	REPAIR OF IRIS PROLAPSE	S-PRIVATE	1.000
AOTH004	SCLERAL WOUND REPAIR	DELUXE	4.000
AOTH004	SCLERAL WOUND REPAIR	PRIVATE	3.000
AOTH004	SCLERAL WOUND REPAIR	S-PRIVATE	1.000
AOTH005	PTERYGIUM EXCISION WITH CONJUNTIVAL AUTO GRAFT
		OPD	1.000
AOTH006	CONJUNTIVAL FLAP/CONJUNTIVAL PLASTY	OPD	800
AOTH007	IRIDECTOMY	OPD	1.000
AOTH008	SYNECHIOTOMY (OR) SYNECHILOGYSIS	OPD	1.000
AOTH009	ANTERIOR V1TECTOMY	OPD	1,250
AOTH010	ANTERIOR CHAMBER WASH & INTRA CAMERAL ANTIBIOTIC
		OPD	1,250
AOTH011	EXCISION OF LIMBAL TUMOR	OPD	1,100
AOTH012	TARSORRAPHY	OPD	1,250
AOTH014	REMOVAL OF BLOOD CLOT (HYPHEMA)	OPD	1,000
AOTH015	BANDAGE CONTACT LENS WITH GLUE APPLICATION
		OPD	1,000
ACAT001	ICCE	DELUXE	4,500
ACAT001	ICCE	PRIVATE	3,000
ACAT001	ICCE	S-PRIVATE	2,000
ACAT002	ECCE	DELUXE	5,000
ACAT002	ECCE	PRIVATE	4,000
ACAT002	ECCE	S-PRIVATE	2,600
ACAT003	PHACO EMULSIFICATION/SICS	DELUXE	12,000
ACAT003	PHACO EMULSIFICATION/SICS	PRIVATE	7,000
ACAT003	PHACO EMULSIFICATION/SICS	S-PRIVATE	5,000
ACAT004	YAG CAPSULOTOMY (UNDER GA) (NLVP)	OPD	1,150
ACAT005	YAG CAPSULOTOMY (UNDER GA) LVP	OPD	650
ACAT006	POSTERIOR CAPSULOTOMY	OPD	700
ACAT007	REMOVAL OF LENS MATERIAL LENS ASPIRATION	DELUXE	3,500
ACAT007	REMOVAL OF LENS MATERIAL LENS ASPIRATION	PRIVATE	2,000
ACAT007	REMOVAL OF LENS MATERIAL LENS ASPIRATION	S-PRIVATE	1,500
ACAT008	BOWMAN'S CAUTARY	OPD	800
ACAT009	POSTERIOR CAPSULE POLISING	OPD	650
ACATOIO	ECCE (OR) ICCE WITH IOL	DELUXE	10,000
ACAT010	ECCE (OR) ICCE WITH IOL	PRIVATE	6,000
ACATOIO	ECCE (OR) ICCE WITH IOL	S-PRIVATE	4,000
ACATOll	AC (OR) PC IOL	DELUXE	8,500
ACATOll	AC (OR) PC IOL	PRIVATE	5,500
ACATOll	AC (OR) PC IOL	S-PRIVATE	2,950
ACAT015	DERMOID CYST EXCISION	OPD	1,000
ACAT016	WOUND RVISION	OPD	1,000
ACAT018	PHACOEMULSIFICATION+IOL+TRABECULECTOMY	DELUXE	14,000
ACAT018	PHACOEMULSIFICATION+IOL+TRABECULECTOMY	PRIVATE	8,000
ACAT018	PHACOEMULSIFICATION+IOL+TRABECULECTOMY	S-PRIVATE	6,000
ACAT019	PHACO+TRABECULECTOMY	DELUXE	10,000
ACAT019	PFIACO+TRABECULECTOMY	PRIVATE	7,000
ACAT019	PHACO+TRABECULECTOMY	S-PRIVATE	5,000
ACAT019	PHACO+TRABECULECTOMY	PRIVATE	7,000
ACAT019	PHACO+TRABECULECTOMY	S-PRIVATE	5.000
ACAT020	ECCE +IOL+TRABECULECTOMY	DELUXE	11.000
ACAT020	ECCE +IOL+TRABECULECTOMY	PRIVATE	6,000
ACAT020	ECCE +IOL+TRABECULECTOMY	S-PRIVATE	5.000
ACAT021	ECCE+TRABECULECTOMY	DELUXE	6.000
ACAT021	ECCE+TRABECULECTOMY	PRIVATE	5,500
ACAT021	ECCE+TRABECULECTOMY	S-PRIVATE	4,000
ACAT022	SCLERAL FIXATED IOL	DELUXE	12,000
ACAT022	SCLERAL FIXATED IOL	PRIVATE	8,000
ACAT022	SCLERAL FIXATED IOL	S-PRIVATE	4,000
ACAT023	PHACO FOLDABLE	DELUXE	14.000
ACAT023	PHACO FOLDABLE	PRIVATE	10,000
ACAT023	PHACO FOLDABLE	S-PRIVATE	7.000
ACOR001	PENETRATING KERATOPLASTY	DELUXE	12,000
ACOR001	PENETRATING KERATOPLASTY	PRIVATE	9,000
ACOR001	PENETRATING KERATOPLASTY	S-PRIVATE	8,000
ACOR002	CORNEAL WOUND REPAIR	DELUXE	6,000
ACOR002	CORNEAL WOUND REPAIR	PRIVATE	3,000
ACOR002	CORNEAL WOUND REPAIR	DELUXE	4,000
ACOR003	RADIAL KERATOTOMY	OPD	4.000
ACOR005	REMOVAL OF CORNEAL PLAQUE (OR) FB	OPD	1,000
ACOR006	COMPRESSION SUTURES	OPD	1.000
ACOR007	RELAXING INCISION	OPD	1.000
ACOR008	SUPERFICAL KERATOCTOMY	OPD	1.000
ACOR009	CHELATION (WITH EDTA APPLICATION)	OPDQ	1.000
GOCP010	REPAIR OF COLOBOMA	PRIVATE	7.000
GOCP010	REPAIR OF COLOBOMA	S-PRIVATE	5.000
GOCPO11	DOUBLE Z-PLASTY	DELUXE	6.000
GOCPOll	DOUBLE Z-PLASTY	PRIVATE	6.000
GOCPO 11	DOUBLE Z-PLASTY	S-PRIVATE	4.000
GOCPO 12	SKIN GRAFT	DELUXE	7.000
GOCP012	SKIN GRAFT	PRIVATE	7,000
GOCPO 12	SKIN GRAFT	S-PRIVATE	5,000
GOCP013	SOCKET RECONSTRUCTION	DELUXE	7,000
GOCPO 13	SOCKET RECONSTRUCTION	PRIVATE	7.000
GOCPO 13	SOCKET RECONSTRUCTION	S-PRIVATE	5.000
GOCPO 14	FASANELLA SERVAT	DELUXE	6.000
GOCPO 14	FASANELLA SERVAT	PRIVATE	6.000
GOCP015	WEDGE RESECTION	PRIVATE	5,500
GOCP015	WEDGE RESECTION	S-PRIVATE	4,200
GOCP016	ENTROPION	OPD	3,500
GOGP017	ENTROPION	OPD	3,500
GOCP018	ELCTRO EPILATION (electrolysis)	OPD	750
GOCP019	FORNIX FORMING SUTURES	OPD	1,000
GOGP020	CANTHOPLASTY	DELUXE	3,000
GOCP020	CANTHOPLASTY	PRIVATE	3,000
GOCP020	CANTHOPLASTY	S-PRIVATE	1,000
GOCP021	VUKATERAK FASCIOLOTA SLING	DELUXE	12,000
GOCP021	VUKATERAK FASCIOLOTA SLING	PRIVATE	12,000
GOCP021	VUKATERAK FASCIOLOTA SLING	S-PRIVATE	9,500
GOCP022	BILATERAL SILICON ROD SLING (OR) ETHIBOND SLING (0
		DELUXE	8,000
GOCP022	BILATERAL SILICON ROD SLING (OR) ETHIBOND SLING (0
		PRIVATE	8.000
GOCP022	BILATERAL SILICON ROD SLING (OR) ETHIBOND SLING (0
		S-PRIVATE	6,000
GOCP023	BILATERAL LPS RESECTION	DELUXE	9,000
GOCP023	BILATERAL LPS RESECTION	PRIVATE	9,000
GOCP023	BILATERAL LPS RESECTION	S-PRIVATE	6,000
GOCP025	EPICANTHUS REPAIR	DELUXE	5,000
GOCP025	EPICANTHUS REPAIR	PRIVATE	5,000
GOCP025	EPICANTHUS REPAIR	S-PRIVATE	3,000
GOCP026	LID RECONSTRUCTION (FLAPS) CUTTER BEARD 2ND STAGE
		DELUXE	2,500
GOCP026	LID RECONSTRUCTION (FLAPS) CUTTER BEARD 2ND STAGE
		PRIVATE	2,500
GOCP026	LID RECONSTRUCTION (FLAPS) CUTTER BEARD 2ND STAGE
		S-PRIVATE	1,500
GOCP029	DEBULKING OF MASS	DELUXE	7,000
GOCP029	DEBULKING OF MASS	PRIVATE	7,000
GOCP029	DEBULKING OF MASS	S-PRIVATE	5,000
GOCP030	EXCENTRATION OF DISTRICHIASIS LASHES	DELUXE	5,000
GOCP030	EXCENTRATION OF DISTRICHIASIS LASHES	PRIVATE	5,000
GOCP030	EXCENTRATION OF DISTRICHIASIS LASHES	S-PRIVATE	3,000
GOTH001	EXCISION BIOPSY OF MASS (<l/2 HR)	O.P.	3,000
GOTH001	EXCISION BIOPSY OF MASS (<l/2 HR)	S-PRIVATE PRIVATE	5,000 6,000
GOTH001	EXCISION BIOPSY OF MASS (<l/2 HR)	DELUXE	7000
		PRIVATE	6.000
GOTH001	EXCISION BIOPSY OF MASS (<l/2 HR)	DELUXE	7000
GOTH002	EXCISION BIOPSY OF MASS (>l/2 HR - 1 HR)	S-PRIVATE	6000
GOTH002	EXCISION BIOPSY OF MASS (>l/2 HR - 1 HR)	PRIVATE	7000
GOTH002	EXCISION BIOPSY OF MASS (>l/2 HR - 1 HR)	DELUXE	9000
GOTH003	EXCISION BIOPSY OF MASS (>l/2 HR - 2 HR)	S-PRIVATE	8000
GOTH003	EXCISION BIOPSY OF MASS (>l/2 HR - 2 HR)	PRIVATE	10000
GOTH003	EXCISION BIOPSY OF MASS (>l/2 HR - 2 HR)	DELUXE	12000
GOTH004	EXCISION BIOPSY OF MASS (>l/2 HR - 2 HR)	S-PRIVATE	6000
GOTH004	EXCISION BIOPSY OF MASS (>l/2 HR - 2 HR)	PRIVATE	7000
GOTH004	EXCISION BIOPSY OF MASS (> 2HR)		7000
GOTH005	EXPLORATION OF SINUS	DELUXE	10500
GOTH005	EXPLORATION OF SINUS	PRIVATE	6800
GOTH005	EXPLORATION OF SINUS	S-PRIVATE	2200
GTRB001	TRABECULECTOMY	DELUXE	6000
GTRBOOl	TRABECULECTOMY	PRIVATE	6000
GTRBOOl	TRABECULECTOMY	S-PRIVATE	6000
GTRB002	TRABECULECTOMY	DELUXE	18400
GTRB002	TRABECULECTOMY	PRIVATE	11000
GTRB002	TRABECULECTOMY	S-PRIVATE	5775
GTRB003	MOLTENO IMPLANT	DELUXE	15000
GTRB003	MOLTENO IMPLANT	PRIVATE	9500
GTRB003	MOLTENO IMPLANT	S-PRJVATE	5775
GTRB004	CYCLOCRYOTHERPAY	OPD	4200
GTRB005	DIURNAL IOP VARIATION	OPD	750
GTRB006	PUNCTUAL OCCLUSION	OPD	750
GTRB007	ENUCLEATION WITH IMPLANT (OR) WITHOUT (NON TUMOUR)
		DELUXE	7000
GTRB007	ENUCLEATION WITH IMPLANT (OR) WITHOUT (NON TUMOUR)
		PRIVATE	7000
GTRB007	ENUCLEATION WITH IMPLANT (OR) WITHOUT (NON TUMOUR)
		S-PRIVATE	5000
GTRB008	LID TUMOUR EXCISION AND RECONSTRUCTION	DELUXE	21000
GTRB008	LID TUMOUR EXCISION AND RECONSTRUCTION	PRIVATE	15000
GTRB008	LID TUMOUR EXCISION AND RECONSTRUCTION	S-PRJVATE	8400
GTRB009	BLEPHAROPHIMOSIS CORRECTION	DELUXE	21000
GTRB009	BLEPHAROPHIMOSIS CORRECTION	PRIVATE	15000
GTRB009	BLEPHAROPHIMOSIS CORRECTION	S-PRIVATE	8400
GTRBOIO	LPS EXPLORATION & REATTACHMENT	DELUXE	7000
GTRB011	MEDICAL CANTHAL RECONSTRUCTION	DELUXE	5000
GTRBOl 1	MEDICAL CANTHAL RECONSTRUCTION	PRIVATE	5000
GTRBOll	MEDICAL CANTHAL RECONSTRUCTION	S-PRIVATE	3000
GTRBOl 2	BLEPHAROPLASTY	DELUXE	7000
GTRBOl 2	BLEPHAROPLASTY	PRIVATE	7000
GTRB012	BLEPHAROPLASTY	S-PRIVATE	5000
GTRB013	FIVE NEEDLE ASPIRATION CYTOLOGY	OPD	1100
GTRBOl 4	SYSMBLEPHARON RELEASE & FORNIX RECONSTRUCTION
		DELUXE	19000
GTRBOl4	SYSMBLEPHARON RELEASE & FORNIX RECONSTRUCTION
		PRIVATE	12600
GTRBOl4	SYSMBLEPHARON RELEASE & FORNIX RECONSTRUCTION
		S-PRIVATE	6300
GTRBOl 5	MARCUS GUNNTOSIS	DELUXE	19000
GTRBOl5	MARCUS GUNNTOSIS	PRIVATE	12600
GTRBOl5	MARCUS GUNNTOSIS	S-PRIVATE	6300
GTRBOl 6	TARSAL STRIP PROCEDURE	DELUXE	3000
GTRBOl 6	TARSAL STRIP PROCEDURE	PRIVATE	3000
GTRBOl 6	TARSAL STRIP PROCEDURE	S-PRIVATE	2000
GTRBOl 7	LATERAL CANTHOPLASTY	DELUXE	3000
GTRB017	LATERAL CANTHOPLASTY	PRIVATE	3000
GTRBOl 7	LATERAL CANTHOPLASTY	S-PRIVATE	2000
GTRBOl8	LID RETRACTION SURGERY MULLLERECTOMY LPS TENOTOMY
		DELUXE	6000
GTRBOl8	LID RETRACTION SURGERY MULLLERECTOMY LPS TENOTOMY
		PRIVATE	6000
GTRBOl 8	LID RETRACTION SURGERY MULLLERECTOMY LPS TENOTOMY
		S-PRIVATE	4000
GTRBOl 9	EXENTERATION	DELUXE	8000
GTRBOl 9	EXENTERATION	PRIVATE	8000
GTRBOl 9	EXENTERATION	S-PRIVATE	6000
GTRB020	TRANS SCLERAL CYCLOPHOTOCOAGULATION (TSCPC)
		OPD	5250
GTRB021	MONO CANALICULAR STENT (INCLUDING STENT COST Rs. 40)
		DELUXE	7000
GTRB021	MONO CANALICULAR STENT (INCLUDING STENT COST Rs. 40)
		PRIVATE	7000
GTRB021	MONO CANALICULAR STENT (INCLUDING STENT COST Rs. 40)
		S-PRIVATE	5000
GTRB022	CANALICULAR REPAIR	DELUXE	6000
GTRB022	CANALICULAR REPAIR	PRIVATE	6000
GTRB022	CANALICULAR REPAIR	DELUXE	6000
GTRB022	CANALICULAR REPAIR	PRIVATE	6000
GTRB022	CANALICULAR REPAIR	S-PRIVATE	4000
MCD0001	INTENSIVE MEDICAL CARE	DELUXE	2100
MCDOOOl	INTENSIVE MEDICAL CARE	PRIVATE	1600
MCDOOOl	INTENSIVE MEDICAL CARE	S-PRIVATE	750
MENCOOl	ENUCLEATION FOR TUMOURS WITH OR WITHOUT IMPLANT
		DELUXE	7000
VIENCOOl	ENUCLEATION FOR TUMOURS WITH OR WITHOUT IMPLANT
		PRIVATE	4200
MENCOOl	ENUCLEATION FOR TUMOURS WITH OR WITHOUT IMPLANT
		S-PRIVATE	2600
MENC002	EVICERATION	OPD	2625
MOTHOOl	CHALAZION EXCISION	OPD	500
MOTH002	STERIOD INJECTION	OPD	1000
MOTH003	EXAMINATION UNDER ANAESTEISA - (EUA)	OPD	1300
MOTH004	INCISION & DRAINAGE	OPD	1000
MOTH005	SUTURE REMOVAL	OPD	750
MOTH006	SPHINCTEROTOMY	OPD	1575
MOTH007	REPAIR OF FRACTURE	DELUXE	26000
MOTH007	REPAIR OF FRACTURE	PRIVATE	16000
MOTH007	REPAIR OF FRACTURE	S-PRIVATE	9500
MOTH008	LID FOLD FORMATION	DELUXE	13000
MOTH008	LID FOLD FORMATION	PRIVATE	8400
MOTH009	ORBITAL DECOMPRESSION	DELUXE	10000
MOTH009	ORBITAL DECOMPRESSION	PRIVATE	8000
MOTH009	ORBITAL DECOMPRESSION	S-PRIVATE	7000
MOTHOIO	SCLERAL GRAFT	DELUXE	2000
MOTH010	SCLERAL GRAFT	PRIVATE	2000
MOTHOIO	SCLERAL GRAFT	S-PRIVATE	2000
MOTHOll	AMNIOTIC MEMBRANE GRAFT <1 HOUR	OPD	4000
MOTH012	AMNIOTIC MEMBRANE GRAFT >1 HOUR	OPD	6500
MOTH013	STEM CELL TRANSPLANT	OPD	5500
MOTH014	FISTULECTOMY	DELUXE	13000
MOTH014	FISTULECTOMY	PRIVATE	8400
MOTH014	FISTULECTOMY	S-PRIVATE	4200
MOTH015	DIVERTICULECTOMY	DELUXE	13000
MOTH015	DIVERTICULECTOMY	PRIVATE	8400
MOTH015	DIVERTICULECTOMY	S-PRIVATE	4200
OPOD001	CHALAZION INCISION & CURETTAGE	OPD	500
OPOD001	CHALAZION INCISION & CURETTAGE	OPD	500
OPOD001	CHALAZION INCISION & CURETTAGE	OPD	500
OPOD001	CHALAZION INCISION & CURETTAGE	OPD	500
OPOD002	INTRALESIONAL STERIOD INJECTION	OPD	1000
		GA	3000
OPOD002	INTRALESIONAL STERIOD INJECTION	OPD	1000
		GA	3000
OPOD002	INTRALESIONAL STERIOD INJECTION	OPD	1000
		GA	3000
OPOD003	TARSORRAPHY	OPD	1500
OPOD003	TARSORRAPHY	PRIVATE	1500
OPOD003	TARSORRAPHY	S-PRIVATE	1000
OPOD004	BLEPHAROPLASTY (PER EYE)	DELUXE	3000
OPOD004	BLEPHAROPLASTY (PER EYE)	PRIVATE	300
AOTH016	PTERYGIUM EXCISION WITH CONJUNTIVAL AUTO GRAFT
		OPD	800
AOTH017	OPTICAL/BROAD/CIRCULAR/PERIPHERiAL/IRIDEC	OPD	1,000
AOTH018	IRIS ABCISION	OPD	1,000
AOTH019	IRIDOPLASTY	OPD	1,000
AOTH020	PARACENTESIS	DELUXE	2,000
AOTH020	PARACENTESIS	PRIVATE	1,000
AOTH020	PARACENTESIS	S-PRIVATE	1,000
AOTH021	PTK/PRK	OPD	5,000
AOTH025	LASIK.	OPD	8,000
GCXP001	PUNCTOPLASTY	OPD	1,000
GDCR001	DACRYOCYSTORHINOSTOMY/ CONJUNCTIVAL DCR/CANAL1C
		DELUXE	18,000
GDCR001	DACRYOCYSTORHINOSTOMY/ CONJUNCTIVAL DCR/CANALIC
		PRIVATE	6,000
GDCR001	DACRYOCYSTORHINOSTOMY/ CONJUNCTIVAL DCR/CANALIC
		S-PRIVATE	6,000
GDCR002	DACRYOCSTECTOMY (SAC EXCISION)	DELUXE	16,000
GDCR002	DACRYOCSTECTOMY (SAC EXCISION)	PRIVATE	4,000
GDCR002	DACRYOCSTECTOMY (SAC EXCISION)	S-PRIVATE	5,250
GDCR003	SYRINGING & PROBING (ONE EYE)	OP	1,000
GDCR004	SYRINGING & PROBING WITH SILICION TUBE INSERTION
		DELUXE	3,000
GDCR004	SYRINGING & PROBING WITH SILICION TUBE INSERTION
		PRIVATE	3,000
GDCR004	SYRINGING & PROBING WITH SILICION TUBE INSERTION
		PRIVATE	3.000
GDCR004	SYRINGING & PROBING WITH SILICION TUBE INSERTION
		S-PRIVATE	3.000
GDCR005	SILICON TUBE INSERTION	DELUXE	2.500
GDCR005	SILICON TUBE INSERTION	PRIVATE	2.500
GDCR005	SILICON TUBE INSERTION	S-PRIVATE	2.500
GDCR006	SYRINGING	OPD	100
GDCR007	DCR WITH SILICON TUBE	.DELUXE	8.000
GDCR007	DCR WITH SILICON TUBE	PRIVATE	8.000
GDCR007	DCR WITH SILICON TUBE	S-PRIVATE	8.000
GDCR008	SYRINGING & PROBING (BOTH EYES)	OPD	1.500
GOCP001	LPS RESECTION	DELUXE	7.000
GOCP001	LPS RESECTION	PRIVATE
GOCP001	LPS RESECTION	S-PRIVATE	5.000
GOCP002	MUCOUS MEMBRANE GRAFT (OR) AMNIOTIC MEMBRANE GRAT
		DELUXE	9.000
GOCP002	MUCOUS MEMBRANE GRAFT (OR) AMNIOTIC MEMBRANE GRAT
		PRIVATE	9.000
GOCP002	MUCOUS MEMBRANE GRAFT (OR) AMNIOTIC MEMBRANE GRAT
		S-PRIVATE	5.000
GOCP003	ORBITOTOMY	DELUXE	12.000
GOCP003	ORBITOTOMY	PRIVATE	12.000
GOCP003	ORBITOTOMY	S-PRIVATE	8.000
GOCP004	DERMIS FAT GRAFT	DELUXE	9.000
GOCP004	DERMIS FAT GRAFT	PRIVATE	9.000
GQCP004	DERMIS FAT GRAFT	S-PRIVATE	7.000
GOCP005	LID RECONSTRUCTION (DIRECT)	DELUXE	7.000
GOCP005	LID RECONSTRUCTION (DIRECT)	PRIVATE	7.000
GOCP005	LID RECONSTRUCTION (DIRECT)	S-PRIVATE	5.000
GOCP006	LID RECONSTRUCTION (TENZEL)	DELUXE	8.000
GOCP006	LID RECONSTRUCTION (TENZEL)	PRIVATE	8,000
GOCP006	LID RECONSTRUCTION (TENZEL)	S-PRIVATE	6.000
GOCP007	LID RECONSTRUCTION (FLAPS) (CUTTER BEARD 1ST STAGE)
		DELUXE	9.000
GOCP007	LID RECONSTRUCTION (FLAPS) (CUTTER BEARD 1ST STAGE)
		PRIVATE	9,000
GOCP007	LID RECONSTRUCTION (FLAPS) (CUTTER BEARD 1ST STAGE)
		S-PRIVATE	7.000
GOCP008	UNILATERAL FACIOLATA SLING	DELUXE	7,000
GOCP008	UNILATERAL FACIOLATA SLING	PRIVATE	7.000
GOCP009	UNILATERAL SILICON ROD SLING	DELUXE	6,000
GOCP009	UNILATERAL SILICON ROD SLING	PRIVATE	6,000
GOCP009	UNILATERAL SILICON ROD SLING	S-PRIVATE	3,700
GOCP010	REPAIR OF COLOBOMA	DELUXE	7,000
OPOD004	BLEPHAROPLASTY (PER EYE)	S-PRIVATE	3000
OPOD005	CORRECTIONOF EYE LID RETRACTION (PER EYE)
			3000
		DELUXE	24000
OPOD005	CORRECTIONOF EYE LID RETRACTION (PER EYE)	OPD	6000
OPOD005	CORRECTIONOF EYE LID RETRACTION (PER EYE)	PRIVATE	12000
OPOD005	CORRECTIONOF EYE LID RETRACTION (PER EYE)	S-PRIVATE	6000
OPOD006	LPS RESECTION	DELUXE	10000
OPOD006	LPS RESECTION	PRIVATE	10000
OPOD006	LPS RESECTION	S-PRIVATE	8000
OPOD007	LPS EXPLORATION & REINSERTION	DELUXE	32000
OPOD007	LPS EXPLORATION & REINSERTION	PRIVATE	16000
OPOD007	LPS EXPLORATION & REEMSERTION	S-PRIVATE	8000
OPOD008	EYELID FOLD FORMATION	DELUXE	12000
OPOD008	EYELID FOLD FORMATION	OPD	3000
OPOD008	EYELID FOLD FORMATION	PRIVATE	6000
OPOD008	EYELID FOLD FORMATION	S-PRIVATE	3000
OPOD009	TARSOFRONTAL SLING (ONE EYE)	DELUXE	20000
OPOD009	TARSOFRONTAL SLING (ONE EYE)	PRIVATE	10000
OPOD009	TARSOFRONTAL SLING (ONE EYE)	S-PRIVATE	5000
OPOD010	TARSOFRONTAL SLING (BOTH EYE)	DELUXE	40000
OPOD010	TARSOFRONTAL SLING (BOTH EYE)	PRIVATE	20000
OPOD010	TARSOFRONTAL SLING (BOTH EYE)	S-PRIVATE	10000
OPOD011	FASANELLA SERVANT PROCEDURE	DELUXE	20000
OPOD011	FASANELLA SERVANT PROCEDURE	OPD	5000
OPOD011	FASANELLA SERVANT PROCEDURE	PRIVATE	10000
OPOD011	FASANELLA SERVANT PROCEDURE	S-PRIVATE	5000
OPOD012	BLEPHAROPHIMOSIS CORRECTION	DELUXE	15000
OPOD012	BLEPHAROPHIMOSIS CORRECTION	PRIVATE	20000
OPOD012	BLEPHAROPHIMOSIS CORRECTION	S-PRIVATE	10000
OPOD013	MEDICAL CANTHOPLASTY (PER EYE)	DELUXE	16000
OPOD013	MEDICAL CANTHOPLASTY (PER EYE)	OPD	4000
OPOD013	MEDICAL CANTHOPLASTY (PER EYE)	PRIVATE	8000
OPOD013	MEDICAL CANTHOPLASTY (PER EYE)	S-PRIVATE	4000
OPOD014	LATERAL CANTHPLASTY (PER EYE)	DELUXE	16000
OPOD014	LATERAL CANTHPLASTY (PER EYE)	DELUXE	16000
OPOD014	LATERAL CANTHPLASTY (PER EYE)	OPD	4000
OPOD014	LATERAL CANTHPLASTY (PER EYE)	PRIVATE	8000
OPOD014	LATERAL CANTHPLASTY (PER EYE)	S-PRIVATE	4000
OPOD015	EPICANTHUS REPAIR (PER EYE)	DELUXE	16000
OPOD015	EPICANTHUS REPAIR (PER EYE)	OPD	2500
OPOD015	EPICANTHUS REPAIR (PER EYE)	PRIVATE	8000
OPOD015	EPICANTHUS REPAIR (PER EYE)	S-PRIVATE	4000
OPOD016	Y - PLASTYOR Z-PLASTY	DELUXE	20000
OPOD016	Y - PLASTYOR Z-PLASTY	OPD	2500
OPOD016	Y - PLASTYOR Z-PLASTY	PRIVATE	10000
OPOD016	Y - PLASTYOR Z-PLASTY	S-PRIVATE	5000
OPOD017	ENTROPION CORRECTION	DELUXE	16000
OPOD017	ENTROPION CORRECTION	OPD	4000
OPOD017	ENTROPION CORRECTION	PRIVATE	8000
OPOD017	ENTROPION CORRECTION	S-PRIVATE	4000
OPOD018	ENTROPION CORRECTION	DELUXE	16000
OPOD018	ENTROPION CORRECTION	OPD	4000
OPOD018	ENTROPION CORRECTION	PRIVATE	8000
OPOD018	ENTROPION CORRECTION	S-PRIVATE	4000
OPOD019	TARSAL STRIP PROCEDURE	DELUXE	16000
OPOD019	TARSAL STRIP PROCEDURE	OPD	2000
OPOD019	TARSAL STRIP PROCEDURE	PRIVATE	8000
OPOD019	TARSAL STRIP PROCEDURE	S-PRIVATE	4000
OPOD020	ELECTROLSIS (PER EYE)	DELUXE	2000
OPOD020	ELECTROLSIS (PER EYE)	OPD	500
OPOD020	ELECTROLSIS (PER EYE)	PRIVATE	1000
OPOD020	ELECTROLSIS (PER EYE)	S-PRIVATE	500
OPOD021	EYELID TUMOR EXCISION	DELUXE	12000
OPOD021	EYELID TUMOR EXCISION	OPD	3000
OPOD021	EYELID TUMOR EXCISION	PRIVATE	6000
OPOD021	EYELID TUMOR EXCISION	S-PRIVATE	3000
OPOD022	EYELID RECONSTRUCTION (DIRECT REPAIR < 30 MIN
		DELUXE	12000
OPOD022	EYELID RECONSTRUCTION (DIRECT REPAIR < 30 MIN
		OPD	3000
OPOD022	EYELID RECONSTRUCTION
OPOD022	EYELID RECONSTRUCTION (DIRECT REPAIR < 30 MIN
		S-PRIVATE	3000
OPOD022	EYELID RECONSTRUCTION (DIRECT REPAIR < 30 MIN
		DELUXE	24000
OPOD023	EYELID RECONSTRUCTION (DIRECT REPAIR < 30 MIN
		OPD	5000
OPOD023	EYELID RECONSTRUCTION (DIRECT REPAIR < 30 MIN
		PRIVATE	12000
OPOD023	EYELID RECONSTRUCTION (DIRECT REPAIR < 30 MIN
		S-PRIVATE	6000
OPOD024	EYELID RECONSTRUCTION (FLAP)	DELUXE	32000
OPOD024	EYELID RECONSTRUCTION (FLAP)	PRIVATE	16000
OPOD024	EYELID RECONSTRUCTION (FLAP)	S-PRIVATE	8000
OPOD025	EYELID RECONSTRUCTION (CULTER BEARD STAGE 1)
		DELUXE	48000
OPOD025	EYELID RECONSTRUCTION (CULTER BEARD STAGE 1)
		PRIVATE	24000
OPOD025	EYELID RECONSTRUCTION (CULTER BEARD STAGE 1)
		S-PRIVATE	12000
OPOD026	POSTERIOR LAMELLA EXCISION	DELUXE	12000
OPOD026	POSTERIOR LAMELLA EXCISION	OPD	3000
OPOD026	POSTERIOR LAMELLA EXCISION	PRIVATE	2000
OPOD026	POSTERIOR LAMELLA EXCISION	S-PRIVATE	3000
OPOD027	TENSILON TEST	DELUXE	4000
OPOD027	TENSILON TEST	OPD	500
OPOD027	TENSILON TEST	PRIVATE	2000
OPOD027	TENSILON TEST	S-PRIVATE	1000
OPOD028	FNAC	DELUXE	4000
OPOD028	FNAC	OPD	1000
OPOD028	FNAC	PRIVATE	2000
OPOD028	FNAC	S-PRIVATE	1000
OPOD029	USG - GUIDED FNAC	DELUXE	8000
OPOD029	USG - GUIDED FNAC	OPD	2000
OPOD029	USG - GUIDED FNAC	PRIVATE	4000
OPOD029	USG - GUIDED FNAC	S-PRIVATE	2000
OPOD030	ORBITAL DECOMPRESSION (PER EYE)	DELUXE	40000
OPOD030	ORBITAL DECOMPRESSION (PER EYE)	PRIVATE	20000
OPOD030	ORBITAL DECOMPRESSION (PER EYE)	S-PRIVATE	10000
OPOD031	ORBITAL FACTURE REPAIR	DELUXE	12000
OPOD031	ORBITAL FACTURE REPAIR	PRIVATE	10000
OPOD031	ORBITAL FACTURE REPAIR	S-PRIVATE	9000
OPOD031	ORBITAL FACTURE REPAIR	S-PRIVATE	9000
OPOD032	ORBITOTOMY	DELUXE	12000
OPOD032	ORBITOTOMY	PRIVATE	10000
OPOD032	ORBITOTOMY	S-PRIVATE	9000
OPOD033	EXCISION BIOPSY (<15 MIN)	DELUXE	8000
OPOD033	EXCISION BIOPSY (<15 MIN)	OPD	2000
OPOD033	EXCISION BIOPSY (<15 MIN)	PRIVATE	4000
OPOD033	EXCISION BIOPSY (<I5 MIN)	S-PRIVATE	2000
OPOD034	EXCISION BIOPSY (<30 MIN)	DELUXE	12000
OPOD034	EXCISION BIOPSY (<30 MIN)	OPD	3000
OPOD034	EXCISION BIOPSY (<30 MfN)	PRIVATE	6000
OPOD034	EXCISION BIOPSY (<30 MIN)	S-PRIVATE	3000
OPOD035	EXCISION BIOPSY (<1H0UR)	DELUXE	20000
OPOD035	EXCISION BIOPSY (< 1 hour)	OPD	5000
OPOD035	EXCISION BIOPSY (< 1 hour)	PRIVATE	10000
OPOD035	EXCISION BIOPSY (.< 1 hour)	S-PRIVATE	5000
OPOD036	EXCISION BIOPSY (< 2 hour)	DELUXE	32000
OPOD036	EXCISION BIOPSY (< 2 hour)	OPDE	8000
OPOD036	EXCISION BIOPSY (< 2 hour)	PRIVATE	16000
OPOD036	EXCISION BIOPSY (< 2 hour)	S-PRIVATE	8000
OPOD037	EXCISION BIOPSY (> 2 hour)	DELUXE	40000
OPOD037	EXCISION BIOPSY (> 2 hour)	PRIVATE	20000
OPOD037	EXCISION BIOPSY (> 2 hour)	S-PRIVATE	10000
OPOD038	ENUCLEATION	DELUXE	32000
OPOD038	ENUCLEATION	PRIVATE	7000
OPOD038	ENUCLEATION	S-PRIVATE	5000
OPOD039	ENUCLEATION + IMPLANT (GLASS)	DELUXE	40000
OPOD039	ENUCLEATION + IMPLANT (GLASS)	PRIVATE	20000
OPOD039	ENUCLEATION + IMPLANT (GLASS)	S-PRIVATE	10000
OPOD040	ENUCLEATION + IMPLANT (POREX)	DELUXE	12000
OPOD040	ENUCLEATION + IMPLANT (POREX)	PRIVATE	10000
OPOD040	ENUCLEATION + IMPLANT (POREX)	S-PRIVATE	9000
OPOD041	TUMOR ENUCLEATION + IMPLANT (GLASS)	DELUXE	11000
OPOD041	TUMOR ENUCLEATION + IMPLANT (GLASS)	PRIVATE	9000
OPOD041	TUMOR ENUCLEATION + IMPLANT (GLASS)	S-PRIVATE	8000
OPOD042	TUMOR ENUCLEATION + POREX IMPLANT	DELUXE	12000
OPOD042	TUMOR ENUCLEATION + POREX IMPLANT	PRIVATE	10000
OPOD042	TUMOR ENUCLEATION + POREX IMPLANT	S-PRIVATE	9000
OPOD043	EVISCERATION	DELUXE	5000
OPOD043	EVISCERATION	S-PRIVATE	4000
OPOD044	EVISCERATION + IMPLANT	DELUXE	12000
OPOD044	EVISCERATION + IMPLANT	PRIVATE	10000
OPOD044	EVISCERATION + IMPLANT	S-PRIVATE	9000
OPOD045	EVISCERATION + POREX IMPLANT	DELUXE	13000
OPOD045	EVISCERATION + POREX IMPLANT	PRIVATE	11000
OPOD045	EVISCERATION + POREX IMPLANT	S-PRIVATE	10000
OPOD046	ORBITAL EXENTERATION	DELUXE	15000
POD046	ORBITAL EXENTERATION	PRIVATE	15000
OPOD046	ORBITAL EXENTERATION	S-PRIVATE	12000
OPOD047	EUA	DELUXE	2400
OPOD047	EUA	OPD	1300
OPOD047	EUA	PRIVATE	2000
OPOD047	EUA	S-PRIVATE	1500
OPOD048	EUA (FOLLOW-UP)	DELUXE	1750
OPOD048	EUA (FOLLOW-UP)	OPD	750
OPOD048	EUA (FOLLOW-UP)	PRIVATE	1250
OPOD048	EUA (FOLLOW-UP)	S-PRIVATE	1000
OPOD049	CHEMOTHERAPHY (PER CYCLE OF 2 DAYS)	DELUXE	16000
OPOD049	CHEMOTHERAPHY (PER CYCLE OF 2 DAYS)	OPD	4000
OPOD049	CHEMOTHERAPHY (PER CYCLE OF 2 DAYS)	PRIVATE	8000
OPOD049	CHEMOTHERAPHY (PER CYCLE OF 2 DAYS)	S-PRIVATE	4000
OPOD050	CRYOTHERAPHY	DELUXE	4000
OPOD050	CRYOTHERAPHY	OPD	1000
OPOD050	CRYOTHERAPHY	PRIVATE	2000
OPOD050	CRYOTHERAPHY	S-PRIVATE	1000
OPOD051	LASER PHOTOCOAGULATION	DELUXE	4000
OPOD051	LASER PHOTOCOAGULATION	OPD	1000
OPOD051	LASER PHOTOCOAGULATION	PRIVATE	2000
OPOD051	LASER PHOTOCOAGULATION	S-PRIVATE	1000
OPOD052	LASER TTT	DELUXE	6000
OPOD052	LASER TTT	OPD	1500
OPOD052	LASER TTT	PRIVATE	3000
OPOD052	LASER TTT	S-PRIVATE	1500
OPOD053	PLAQUE BRACHYTHERAPHY	DELUXE	15000
OPOD053	PLAQUE BRACHYTHERAPHY	PRIVATE	15000
OPOD053	PLAQUE BRACHYTHERAPHY	S-PRIVATE	12000
OPOD054	SYRINGING & PROBING (ONE EYE)	DELUXE	3000
OPOD054	SYRINGING & PROBING (ONE EYE)	OPD	1500
OPOD054	SYRINGING & PROBING (ONE EYE)	OPD	1500
OPOD054	SYRINGING & PROBING (ONE EYE)	PRIVATE	3000
OPOD054	SYRINGING & PROBING (ONE EYE)	S-PRIVATE	1500
OPOD055	SYRINGING & PROBING (BOTH EYE)	DELUXE	10000
OPOD055	SYRINGING & PROBING (BOTH EYE)	OPD	2500
OPOD055	SYRINGING & PROBING (BOTH EYE)	PRIVATE	5000
OPOD055	SYRINGING & PROBING (BOTH EYE)	S-PRIVATE	2500
OPOD056	SYRINGING & PROBING WITH SILICONE TUBE (PER E)
		DELUXE	3000
OPOD056	SYRINGING & PROBING WITH SILICONE TUBE (PER E)
		OPD	1500
OPOD056	SYRINGING & PROBING WITH SILICONE TUBE (PER E)
		PRIVATE	2500
OPOD056	SYRINGING & PROBING WITH SILICONE TUBE (PER E)
		S-PRIVATE	2000
OPOD057	SYRINGING UNDER ANESTHESIA	DELUXE	2400
OPOD057	SYRINGING UNDER ANESTHESIA	OPD	600
OPOD057	SYRINGING UNDER ANESTHESIA	PRIVATE	1200
OPOD057	SYRINGING UNDER ANESTHESIA	S-PRIVATE	600
OPOD058	PUNCTOPLASTY	PRIVATE	2000
OPOD058	PUNCTOPLASTY	S-PRIVATE	1500
OPOD059	PUNCTAL OCCLUSION	DELUXE	3200
OPOD059	PUNCTAL OCCLUSION	OPD	500
OPOD059	PUNCTAL OCCLUSION	PRIVATE	1600
OPOD059	PUNCTAL OCCLUSION	S-PRIVATE	800
OPOD060	CANALICULAR REPAIR	DELUXE	16000
OPOD060	CANALICULAR REPAIR	OPD	4000
OPOD060	CANALICULAR REPAIR	PRIVATE	8000
OPOD060	CANALICULAR REPAIR	S-PRIVATE	4000
OPOD061	CANALICULAR REPAIR WITH MONOCANALICULAR STENT
		DELUXE	5000
OPOD061	CANALICULAR REPAIR WITH MONOCANALICULAR STENT
		OPD	4000
OPOD061	CANALICULAR REPAIR WITH MONOCANALICULAR STENT
		PRIVATE	5000
OPOD061	CANALICULAR REPAIR WITH MONOCANALICULAR STENT
		S-PRIVATE	4500
OPOD062	DCR	DELUXE	24000
OPOD062	DCR	OPD	5000
OPOD062	DCR	PRIVATE	12000
OPOD062	DCR	S-PRIVATE	6000
OPOD063	DCR WITH SILICON TUBE	OPD	7000
OPOD063	DCR WITH SILICON TUBE	PRIVATE	20000
OPOD063	DCR WITH SILICON TUBE	S-PRIVATE	10000
OPOD064	DCR-CONJUNCTIVAL	DELUXE	48000
OPOD064	DCR-CONJUNCTIVAL	PRIVATE	24000
OPOD064	DCR-CONJUNCTIVAL	S-PRIVATE	12000
OPOD065	DCR-CANALICULAR	DELUXE	32000
OPOD065	DCR-CANALICULAR	PRIVATE	16000
OPOD065	DCR-CANALICULAR	S-PRIVATE	8000
OPOD066	DCR-ENDONASAL	DELUXE	48000
OPOD066	DCR-ENDONASAL	OPD	7000
OPOD066	DCR-ENDONASAL	PRIVATE	24000
OPOD066	DCR-ENDONASAL	S-PRIVATE	12000
OPOD067	DCT	DELUXE	20000
OPOD067	DCT	OPD	3000
OPOD067	DCT	PRIVATE	10000
OPOD067	DCT	S-PRIVATE	5000
OPOD068	FISTULECTOMY	DELUXE	12000
OPOD068	FISTULECTOMY	OPD	3000
OPOD068	FISTULECTOMY	PRIVATE	6000
OPOD068	FISTULECTOMY	S-PRIVATE	3000
OPOD069	DIVERTICULECTOMY	DELUXE	12000
OPOD069	DIVERTICULECTOMY	OPD	3000
OPOD069	DIVERTICULECTOMY	PRIVATE	6000
OPOD069	DIVERTICULECTOMY	S-PRIVATE	3000
OPOD070	INCISION & DRAINAGE	DELUXE	3200
OPOD070	INCISION & DRAINAGE	OPD	800
OPOD070	INCISION & DRAINAGE	PRIVATE	1600
OPOD070	INCISION & DRAINAGE	S-PRIVATE	800
OPOD071	CANALICULAR CURETTAGE	DELUXE	4000
OPOD071	CANALICULAR CURETTAGE	OPD	1000
OPOD071	CANALICULAR CURETTAGE	PRIVATE	2000
OPOD071	CANALICULAR CURETTAGE	S-PRIVATE	1000
OPOD072	MEDICAL CANTHAL RECONSTRUCTION	DELUXE	20000
OPOD072	MEDICAL CANTHAL RECONSTRUCTION	OPD	5000
OPOD072	MEDICAL CANTHAL RECONSTRUCTION	PRIVATE	10000
OPOD072	MEDICAL CANTHAL RECONSTRUCTION	S-PRIVATE	5000
OPOD073	LATERAL CANTHAL RECONSTRUCTION	DELUXE	20000
OPOD073	LATERAL CANTHAL RECONSTRUCTION	OPD	5000
OPOD073	LATERAL CANTHAL RECONSTRUCTION	OPD	5000
OPOD073	LATERAL CANTHAL RECONSTRUCTION	PRIVATE	10000
OPOD073	LATERAL CANTHAL RECONSTRUCTION	S-PRIVATE	5000
OPOD074	SOCKET RECONSTRUCTION	DELUXE	32000
OPOD074	SOCKET RECONSTRUCTION	PRIVATE	7000
OPOD074	SOCKET RECONSTRUCTION	OPD	3000
OPOD074	SOCKET RECONSTRUCTION	S-PRIVATE	3000
OPOD075	SYMBLEPHARON RELEASE	DELUXE	20000
OPOD075	SYMBLEPHARON RELEASE	OPD	8000
OPOD075	SYMBLEPHARON RELEASE	PRIVATE	10000
OPOD075	SYMBLEPHARON RELEASE	S-PRIVATE	5000
OPOD076	FORNIX FORMATIN	DELUXE	1200
OPOD076	FORNIX FORMATIN	OPD	300
OPOD076	FORNIX FORMATIN	PRIVATE	600
OPOD076	FORNIX FORMATIN	S-PRIVATE	300
OPOD077	AMNIOTIC MEMBRANE GRAFT	DELUXE	3200
OPOD077	AMNIOTIC MEMBRANE GRAFT	PRIVATE	1600
OPOD077	AMNIOTIC MEMBRANE GRAFT	S-PRrVATE	800
OPOD078	MUCUS MEMBRANE GRAFT	DELUXE	3200
OPOD078	MUCUS MEMBRANE GRAFT	PRIVATE	1600
OPOD078	MUCUS MEMBRANE GRAFT	S-PRIVATE	800
OPOD079	DERMIS FAT GRAFT	DELUXE	8000
OPOD079	DERMIS FAT GRAFT	PRIVATE	8000
OPOD079	DERMIS FAT GRAFT	S-PRIVATE	6000
OPOD080	SKIN GRAFT	DELUXE	40000
OPOD080	SKIN GRAFT	PRIVATE	20000
OPOD080	SKIN GRAFT	S-PRIVATE	10000
OPOD081	SCLERAL GRAFT	DELUXE	24000
OPOD081	SCLERAL GRAFT	PRIVATE	12000
OPOD081	SCLERAL GRAFT	S-PRIVATE	6000
OPOD082	EYELID RECONSTRUCTION (CUTTER BEARD STAGE 2)
		DELUXE	24000
OPOD082	EYELID RECONSTRUCTION (CUTTER BEARD STAGE 2)
		PRIVATE	12000
OPOD082	EYELID RECONSTRUCTION (CUTTER BEARD STAGE 2)
		S-PRIVATE	6000
OPOD082	EYELID RECONSTRUCTION (CUTTER BEARD STAGE 2)
		OPD	2000
OPOD083	ORBITAL FRACTURE REPAIR WITH POREX SHEET
		PRIVATE	8000
OPOD083
	ORBITAL FRACTURE REPAIR WITH POREX SHEET	S-PRIVATE	7000
OPOD084	CUSTOM-MADE PROSTHESIS	DELUXE	10000
OPOD084	CUSTOM-MADE PROSTHESIS	PRIVATE	5000
OPOD084	CUSTOM-MADE PROSTHESIS	S-PRIVATE	5000
OPOD085	STANDARD PROSTHESIS FITTING FROM SETS	DELUXE	500
OPOD085	STANDARD PROSTHESIS FITTING FROM SETS	PRIVATE	500
OPOD085	STANDARD PROSTHESIS FITTING FROM SETS	S-PRIVATE	500
OPOD086	CUSTOM-MADE CONFORMERS & SOCKET EXPANDERS
		DELUXE	2000
OPOD086	CUSTOM-MADE CONFORMERS & SOCKET EXPANDERS
		PRIVATE	1000
OPOD086	CUSTOM-MADE CONFORMERS & SOCKET EXPANDERS
		S-PRIVATE	1000
OPOD087	CHEMOTHERAPHY	DELUXE	4000
OPOD087	CHEMOTHERAPHY	OPD	4000
OPOD087	CHEMOTHERAPHY	PRIVATE	4000
OPOD087	CHEMOTHERAPHY	S-PRIVATE	4000
OPOD088	TRABECULECTOMY (G)	DELUXE	6000
OPOD088	TRABECULECTOMY (G)	PRIVATE	6000
OPOD088	TRABECULECTOMY (G)	S-PRIVATE	6000
OPOD089	TRABECULOTOMY (G)	DELUXE	18400
OPOD089	TRABECULOTOMY (G)	PRIVATE	11000
OPOD089	TRABECULOTOMY (G)	S-PRIVATE	5775
OPOD090	RE SUTURING	OPD	650
OPOD091	PPC + AV	OPD	3500
OPOD092	CORNEAL SCRAPING	OPD	110
OPOD093	METHANE PREDIEM INJ (250 mg)	OPD	475
OPOD094	METHANE PREDIEM INJ (500 mg)	OPD	750
OPOD095	METHANE PREDIEM INJ (1000 mg)	OPD	1150
OPOD096	MINMYCIN	OPD	75
OPOD097	PHACO + PC IOL (hsm lens)	OPD	1500
OPOD098	CORNEAL FOREIGN BODY REMOVAL	OPD	110
OPOD099	ENDOXIN INJ (1000 mg)	OPD	270
OPOD100	ENDOXIN INJ (500 mg)	OPD	130
OPOD101	BONE MARROW BIOPSY	OPD	320
OPOD102	BONE MARROW ASPIRATION	OPD	210
OPOD103	LIO (ONE EYE)	OPD	1250
OPOD104	ENDO CAPOSULAR RING	OPD	2500
OPOD103	LIO (ONE EYE)	OPD	1250
OPOD104	ENDO CAPOSULAR RING	OPD	2500
OPOD105	HSM LENS	OPD	1500
PHDT001	PHOTO DYNAMIC THERAPHY	DELUXE	45000
PHDTOOl	PHOTO DYNAMIC THERAPHY	PRIVATE	45000
PHDTOOl	PHOTO DYNAMIC THERAPHY	S-PRIVATE	45000
PHDT002	ARGON LASER	DELUXE	1000
PHDT002	ARGON LASER	PRIVATE	800
PHDT002	ARGON LASER	S-PRIVATE	500
RBUKOOl	SCLERAL BUCKLING	DELUXE	10000
RBUKOOl	SCLERAL BUCKLING	PRIVATE	7000
RBUKOOl	SCLERAL BUCKLING	S-PRIVATE	5000
RBUK002	BELT BUCKLE	DELUXE	1500
RBUK002	BELT BUCKLE	PRIVATE	800
RBUK002	BELT BUCKLE	S-PRIVATE	500
RBUK003	BUCKLE REMOVAL	DELUXE	2000
RBUK003	BUCKLE REMOVAL	PRIVATE	1000
RBUK003	BUCKLE REMOVAL	S-PRIVATE	500
RBUK004	BUCKLE REMOVAL(LVP	DELUXE	2000
RBUK004	BUCKLE REMOVAL(LVP	PRIVATE	1500
RBUK004	BUCKLE REMOVAL(LVP	S-PRIVATE	500
ROTHOOl	INTRA OCULAR FOREIGN BODY REMOVAL	DELUXE	3500
ROTHOOl	INTRA OCULAR FOREIGN BODY REMOVAL	PRIVATE	2500
ROTHOOl	INTRA OCULAR FOREIGN BODY REMOVAL	S-PRIVATE	? 2000
ROTH002	LENSECTOMY	DELUXE	4500
ROTH002	LENSECTOMY	PRIVATE	3500
ROTH002	LENSECTOMY	S-PRIVATE	2500
ROTH003	MEMBRANECTOMY	DELUXE	4500
ROTH003	MEMBRANECTOMY	PRIVATE	3000
ROTH003	MEMBRANECTOMY	S-PRIVATE	2500
ROTH004	CRYOPEXY	DELUXE	700
ROTH004	CRYOPEXY	PRIVATE	700
ROTH004	CRYOPEXY	S-PRIVATE	400
ROTH005	ANTERIOR RETINAL CRYOPEXY (ARC)	DELUXE	1000
ROTH005	ANTERIOR RETINAL CRYOPEXY (ARC)	PRIVATE	800
ROTH005	ANTERIOR RETINAL CRYOPEXY (ARC)	S-PRIVATE	500
ROTH006	ENDO LASER	DELUXE	900
ROTH009	INDIRECT LASER OPHTHALMOSCOPY	OPD	400
ROTH012	DESCEMETOPEXY	DELUXE	1500
ROTH012	DESCEMETOPEXY	PRIVATE	1500
ROTH012	DESCEMETOPEXY	S-PRIVATE	1200
RVITOOl	VITRECTOMY	DELUXE	7000
RVITOOl	VITRECTOMY	PRIVATE	6000
RVITOOl	VITRECTOMY	S-PRIVATE	4000
RVIT002	VITRECTOMY (ENDOPHTHALMITIS)	DELUXE	7000
RVTT002	VITRECTOMY (ENDOPHTHALMITIS)	PRIVATE	6000
RVIT002	VITRECTOMY (ENDOPHTHALMITIS)	S-PRIVATE	4000
RV1T003	VITREOUS LAVAGE	DELUXE	3000
RVIT003	VITREOUS LAVAGE	PRIVATE	2000
RVIT003	VITREOUS LAVAGE	S-PRIVATE	1000
RVIT004	SILICONE OIL INJECTION	DELUXE	4000
RVIT004	SILICONE OIL INJECTION	PRIVATE	3000
RVIT004	SILICONE OIL INJECTION	S-PRIVATE	2000
RVIT005	SILICONE OIL REMOVAL	DELUXE	3000
RVIT005	SILICONE OIL REMOVAL	PRIVATE	2000
RVIT005	SILICONE OIL REMOVAL	S-PRIVATE	1000
RVIT006	FLUID GAS EXCHANGE	DELUXE	1000
RVIT006	FLUID GAS EXCHANGE	PRIVATE	700
RVIT006	FLUID GAS EXCHANGE	S-PRIVATE	500
RVIT007	FLUID AIR EXCHANGE	DELUXE	1000
RVIT007	FLUID AIR EXCHANGE	PRIVATE	700
RVIT007	FLUID AIR EXCHANGE	S-PRIVATE	500
RVIT008	PERFLORD CARBON LIQUID INJECTION	DELUXE	5000
RVIT008	PERFLORD CARBON LIQUID INJECTION	PRIVATE	4000
RVIT008	PERFLORD CARBON LIQUID INJECTION	S-PRIVATE	3000
RVIT009	MEMBRANE PEELING	DELUXE	800
RV1T009	MEMBRANE PEELING	PRIVATE	700
RVIT009	MEMBRANE PEELING	S-PRIVATE	500
RVITOIO	INTRA OCULAR ANTI - BIOTIC (IOAB)	DELUXE	800
RVITOIO	INTRA OCULAR ANTI - BIOTIC (IOAB)	PRIVATE	700
RVITOIO	INTRA OCULAR ANTI - BIOTIC (IOAB)	S-PRIVATE	500
RVITOl 1	PNEUMORETINOPEXY	OPD	500
RVIT012	VITREOUS BIOPSY	DELUXE	5000
RVITOl 2	VITREOUS BIOPSY	PRIVATE	4000
RVIT012	VITREOUS BIOPSY	DELUXE	5000
RVIT012	VITREOUS BIOPSY	PRIVATE	4000
RVIT012	VITREOUS BIOPSY	S-PRIVATE	2500
RVIT013	NUCLEUS REMOVAL	DELUXE	7000
RVIT013	NUCLEUS REMOVAL	PRIVATE	4000
RVIT013	NUCLEUS REMOVAL	S-PRIVATE	3000
SQIT001	RECTUS SURGERY (ONE MUSCLE)	DELUXE	8000
SQITOOl	RECTUS SURGERY (ONE MUSCLE)	PRIVATE	6000
SQITOOl	RECTUS SURGERY (ONE MUSCLE)	S-PRIVATE	4000
SQIT002	OBLIQUE MUSCLE SURGERY (ONE MUSCLE)	DELUXE	10000
SQIT002	OBLIQUE MUSCLE SURGERY (ONE MUSCLE)	PRIVATE	8000
SQIT002	OBLIQUE MUSCLE SURGERY (ONE MUSCLE)	S-PRIVATE	5000
SQIT003	RECTUS SURGERY (TWO MUSCLE)	DELUXE	12000
SQIT003	RECTUS SURGERY (TWO MUSCLE)	PRIVATE	10000
SQIT003	RECTUS SURGERY (TWO MUSCLE)	S-PRIVATE	8000
SQIT004	OBLIQUE MUSCLE SURGERY (TWO MUSCLE)	DELUXE	18000
SQIT004	OBLIQUE MUSCLE SURGERY (TWO MUSCLE)	PRIVATE	12000
SQIT004	OBLIQUE MUSCLE SURGERY (TWO MUSCLE)	S-PRIVATE	10000
SQIT005	RECTUS SURGERY (THREE MUSCLE)	DELUXE	20000
SQIT005	RECTUS SURGERY (THREE MUSCLE)	PRIVATE	15000
SQIT005	RECTUS SURGERY (THREE MUSCLE)	S-PRIVATE	12000
SQIT006	OBLIQUE MUSCLE SURGERY (THREE MUSCLE)	DELUXE	25000
SQIT006	OBLIQUE MUSCLE SURGERY (THREE MUSCLE)	PRIVATE	20000
SQIT006	OBLIQUE MUSCLE SURGERY (THREE MUSCLE)	S-PRIVATE	15000
SQIT007	RECTUS SURGERY (FOUR MUSCLE)	DELUXE	25000
SQIT007	RECTUS SURGERY (FOUR MUSCLE)	PRIVATE	20000
SQIT007	RECTUS SURGERY (FOUR MUSCLE)	S-PRIVATE	15000
SQIT008	OBLIQUE MUSCLE SURGERY (FOUR MUSCLE)	DELUXE	30000
SQIT008	OBLIQUE MUSCLE SURGERY (FOUR MUSCLE)	PRIVATE	25000
SQIT008	OBLIQUE MUSCLE SURGERY (FOUR MUSCLE)	S-PRIVATE	20000-

 

ANNEXURE – II

 

(25)   Sanction of Medical reimbursement to Government employees, retired employees and their dependents upto third spell - Orders - Issued.

(G.O. Ms. No. 601, HM & FW (Kl) Dt. 1510-2003)

Ref. : 

(1)     G.O.Ms.No.223, HM&FW (Kl) Dept, Dt. 23-4-1994.

(2)     From the Vice President, State Govt. Pensioner's Assn., 151, Sripuram Colony, Hyd- 500 036. repn. Dt. 24-12-2002.

(3)     Govt.Memo.No.28003/Kl/02-l, Dt. 22-1-03.

(4)     From the DME, A.P., Hyd., Lr. Re. No. 2438/MAA/03, Dt. 31-3-03.

Order :

(1)     In the G.O. first read above, orders were issued that the Government officials shall be allowed reimbursement or advance as the case may be according to rules for the second and subsequent operations even including the operations for the same ailments.

(2)     In their representation, second read above, the Vice-President, State Govt. Pensioners Association, Hyderabad has represented that orders were issued allowing reimbursement for second spell for the same ailment in G.O.Ms. No. 223 H.M. & F.W.(Kl) Department, dated 23-4-1994 and the same facilities are not extended to retired Govt, employees. He has requested the Govt, to include the retired government officials also to enable them to get reimbursement for the second and subsequent treatments.

(3)     The matter has been referred to the Director of Medical Education for report.

In the letter fourth read above, the Director of Medical Education has stated that the Government may issue an amendment to G.O. Ms. No. 223, H.M. & F.W.(Kl) Department, dated 23-4-1994 to insert the words "retired Government officials".

(4)     Government have examined the matter and observe that as per G.O. Ms. No. 223, H.M.&F.W.(K1) Department Dt. 23-4-1994, reimbursement of expenditure is being allowed for two spells only for the same ailment and claim for the 3rd spell for the same disease is not being allowed, when treatment was obtained in private hospitals recognised by Government. The Director of Medical Education, Hyderabad while scrutinising the bills in such cases stated that the relaxation of rules is required for payment for the 3rd spell.

Many cases are coming from other departments to Government for relaxation of rules for sanction of claim for the 3rd spell.

(5)     Government after careful examination of the mater and in partial modification of the orders issued in G.O.Ms.No. 223, H.M. & F.W.(Kl) Department, dated 23-4-1994 hereby direct that "retired State Govt, employees" and their dependents shall also be eligible for the reimbursement of expenditure for the second spell and third spell during their life time for the treatment obtained in the recognised private hospitals for the same ailment, subject to other conditions specified on the subject from time to time. Government also direct that medical reimbursement for the third spell treatment /operations including for the same ailment be allowed, to State Government Employees, retired employees and their dependents, subject to fulfilling other conditions.

(6)     The Director of Medical Education shall take necessary action in the matter accordingly.

(26)   APIMA Rules, 1972 - Recommendation of the Committee for revision of the Rules - Accepted - Orders - Issued Certain Clarification / modification - Reg.

(Memo. No. 7099/K1/2005-1, HM&PW(K1) Dept, Dt. 14-06-2005)

Ref. :-

(1)     G.O.Ms. No. 74, HM&PW(K1) Dept, Dt. 15-03-2005

(2)     From the DME, AP, Hyd. Lr. Re. No. 6236/MA.(l)B/05. Dt. 30-03-2005.

Order :-

(1)     The attention of the Director of Medical Education is invited to the references cited. In the G.O. 1st cited, revised orders have been issued regarding medical reimbursement to State Government employees, and other category of persons as mentioned in A.P.I.M.A. Rules, 1972. The Director of Medical Education has sought for clarifications on the said orders.

(2)     Accordingly, Govt, hereby issued the following clarifications on point wise :-

(3)     It is also clarified that if the package rates of the private hospitals are less than the package rates of CGHS, the claim for medical reimbursement shall be scrutinised and sanctioned based on the actuals of hospitals.

(4)     The Director of Medical Education is requested communicate this memo, to all the concerned and take further action accordingly.

 

PART 8

MEDICAL FACILITIES TO PENSIONERS

(1)     Facilities of admission and treatment to pensioners - Consolidated Orders -Issued

[G.O.Ms.No. 35, M&H (Kl), Dt. 26-1-1981J

Ref. :

(1)     G.O.Ms.No. 2121, Health, Dt. 16-11-1970.

(2)     G.O.Ms.No. 259, Health. Dt. 16-2-1972.

(3)     Govt. Memo. No. 2830/EE2/72, Health Dt. 11-2-1972.

(4)     G.O.Ms.No.685, Health, Dt. 6-4-1972.

(5)     G.O.Ms.No. 1660, Health, Dt. 9-11-1972.

(6)     G.O.Ms.No. 219, Health, Dt. 16-3-1973.

Order :

(1)     Retired Government Employees in the State are entitled to free medical attention in all Government Institutions. These facilities are spelt out in the G.Os. referred to above. Many Pensioners are either not aware of these orders or there is lack of proper appreciation of the facilities they are entitled to. In Andhra Pradesh there are at present, Teaching Hospitals, 19 Specialist Hospitals, 16 District Head-Quarters Hospitals, 180 Taluk Head-Quarters Hospitals, 420 Primary Health Centres and 653, Rural dispensaries at which the pensioners can avail of the attention they require.

(2)     Under Rule 6 (i) of the Andhra Pradesh Integrated Medical Attendance Rules, 1972, the retired and re-employed pensioners (both Gazetted and Non-Gazetted) are entitled to free medical treatment in all the Government Hospitals listed above. All State Government pensioners including pensioners of All India Service and their families as defined under Rule 3 (7) of Andhra Pradesh Integrated Medical Attendance Rules, 1972 are eligible for the following medical facilities as are applicable to the Government Servants.

(A)     Free Accommodation in the hospitals as per eligibility indicated below

(a)      Pensioners who retired before 1-1-1974, shall be eligible for hospital accommodation based on the pay last drawn by them before retirement, as under Column (1) of the above statement.

(b)      Pensioners who retired after 1-1-1974 and before 1-4-1978 shall be eligible for hospital accommodation as under Column (2) of the above Statement.

(c)      Pensioners who retired after 1-4-1978 shall be eligible for hospital accommodation as per Column (4) of the Statement.

(B)     Free supply of medicines available in the hospitals.

(C)     Free supply of diet as per rules.

(D)     Free medical advice and treatment including operations.

(3)     The pensioners shall have to produce their identity certificate from the concerned pension disbursing Officers or some other identity card that may be prescribed, while seeking treatment at Government Hospitals, For this purpose, the pensioners and their families should get themselves registered at any Government Hospital of their choice where they wish to be attended normally. But this would not prevent them from getting medical attention and treatment from any other hospitals in the State, (i.e.,) other than the one at which they stand registered.

(4)     The Pensioners shall not be eligible to claim reimbursement of medical expenses and for medicines purchased in the open market, if any, on the prescription even of the Government Medical Officers. But the medicines which are not available in the Hospitals shall be purchased by the concerned Medical Officers incharge of Hospitals and dispensaries and supplied to the pensioners and their families, as per orders issued in the G.O. sixth cited. The total amount thus incurred in this regard shall be consolidated once in a quarter, and after approval by the Director of Medical and Health Services, shall be reported to the Government in the Finance Department who will provide the same to the Medical Department over and above the budget provision. The provision for purchase of medicines for pensioners and their families will be made over and above the normal department budget provision for purchase of drugs, etc.

(5)     Whenever pensioners and their families are admitted in the Government Hospitals they shall be provided with accommodation on the basis of pay last drawn by the retired Government Servants before their retirement as per Para 2 (A) above. When they are not able to get accommodation to which they are entitled, they can be given higher category of accommodation by collecting the difference of charges leviable for that higher category and the category to which they are eligible.

(6)     The pensioners and their families shall not be eligible for admission into the wards reserved under the 'Three Tier Systems' of treatment in Osmania General Hospital, Hyderabad and other District Head Quarters Hospitals, etc., introduced in G.O.Ms.No. 431, M&H, dated 5-7-1978 and G.O.Ms.No. 728, M&H, dated 19-6-1980.

(2)     Facilities of admission and treatment to pensioners at Government Hospitals -Consolidated orders - Modifications - Orders Issued

[G.O.Ms.No. 718, M&H (Kl), Dt. 26-11-1981]

Ref. :

(1)     G.O.Ms.No. 219, Health, Dt. 16-3-1973.

(2)     G.O.Ms.No. 35, M. & H. (Kl), Dt. 26-1-1981.

Order :

(1)     In the Government order first read above consolidated orders have been issued spelling out the facilities available to the pensioners of this State with regard to admission and treatment in the hospitals of this State including pensioners of All India Services and their families as defined under Rule 3(7) of Andhra Pradesh Integrated Medical Attendance Rules, 1972. According to Para 4 of the said order the pensioner shall not be eligible to claim reimbursement of medical expenses and for medicines purchased in the open market, if any, on the prescriptions even of the Government Medical Officers. But the medicines which are not available in the hospitals shall be purchased by the J concerned Medical Officers in charge of hospitals and dispensaries and supplied to the pensioners and their families as per the orders issued in the G.O. second cited.

(2)     It is felt that this provision relating to the Medical Officer purchasing and supplying the medicines required by the pensioners may not be fully acted upon by the concerned Medical Officers for various reasons putting the pensioners consequently to hardship. Therefore, if the hospitals are not able to get the medicines and supply them to the pensioners when they are not available in stock in the hospitals, the Medical Officers of the concerned hospitals may be permitted to allow the pensioners to purchase the medicines themselves and to reimburse the amount to them subject ot the condition that the Medical Officer of the concerned Government Hospital certifies that the medicine is essential for recovery from the disease, that the medicine prescribed is not available for supply free of cost with the Government Hospital.

(3)     For purposes of reimbursement of the cost of medicines so purchased by the pensioners the following procedure may be adopted :

(i)       when the Medical Officer of the Government Hospital concerned is not able to supply the medicines prescribed by him to the pensioner free of cost and is not able to purchase and supply them to him free of cost, he should certify that the medicines prescribed are essential for recovery from the disease and that the medicine prescribed is not available for supply free of cost in stock with the hospital and that the pensioner may purchase them ;

(ii)      after obtaining a certificate to this effect the pensioner should purchase the medicines to the extent of quantities prescribed and submit the cash memos together with a formal application to the Medical Officer in the Government Hospital concerned for reimbursement of the amount spent by him ;

(iii)     the Medical Officer should countersign the cash memos and pass them for payment and forward the papers to the appropriate authority in the hospital for preferring the claim at the concerned Treasury ;

(iv)    on the bill being passed by the Treasury and on receipt of the amount the authority concerned should pay the money to the pensioner and obtain proper acknowledgement for the amount so paid.

(4)     There should be no delay in either giving the certificate referred to above for purchase of the medicines locally by the pensioner or in the matter of reimbursement of the amount to him. A time limit should be fixed by the Hospital concerned for this purpose. It should also be ensured that if the Medical Officers who prescribe the medicines are transferred after prescribing the medicines the successors in office countersign without any delay the cash memos when submitted by pensioners along with the prescription. Any delay in either giving the certificate or reimbursing the amount should be viewed seriously. The expenditure on the reimbursement of cost of medicines purchased by the pensioners may be debited to the detailed head "190 Materials and supplies" under the respective hospital heads of accounts under "280 Medical A. Allopathy".

(5)     The Director of Medical Education may provide necessary provision for meeting this expenditure to all the Hospitals and Dispensaries. In cases where the expenditure is in excess of the provision by the Director of Medical Education before the end of the financial year either by way of reappropriation, reallocation or supplementary grant. In any case want of provision shall not be an excuse to deny or delay reimbursement of expenditure incurred by the pensioner on purchase of medicines which are not stocked or are not in stock in the Hospital for supply free to the pensioner.

(6)     For purposes of the above order the pensioner should necessarily go to one of the Government hospitals indicated in the G.O. 1st cited and the treatment should be obtained at one of the said hospitals and the certificate prescribed above should also be given by a serving Medical Officer of the hospital. No certificate given by any other authority shall be accepted for this purpose.

(3)     Facilities for treatment to the Pensioners and Members of their families - Reimbursement of medical expenditure incurred by them - Further instructions.

(Memo. No. 525/SC. F/99-3, Law (LA. & J.S.C.F) Dept, dated 24-01-2000)

Ref. :

From the Registrar (Admn.), High Court of A.P., Lr. Roc. No. 1753/98-B3 dated: 10-06-1999.

Order :

With reference to the letter cited, the Government have carefully examined the proposal of the Registrar, High Court of A.P. and issue the following further instructions for sanction of medical reimbursement of medical expenditure to the pensioners for the medical expenses incurred by them as out-patients:-

(1)     Pensioners Retiring in One District and Settling in the same District :

The Principal District Judge of that particular District is authorised to sanction the medical claims of pensioners for the medical expenditure incurred by them as out-patients, when the treatment is taken by them from the Government Doctor/Government Hospital/ Dispensary.

(2)     Pensioners Retiring in One District and Settling in another District/ Pensioners Retiring from one of the Units in the twin Cities of Hyderabad/Secunderabad and Settling in one of the Districts in Andhra Pradesh :

The Principal District Judge of that particular District is authorised to sanction such medical claims, irrespective of the fact that pensioners retired from one District and settled in another District so as to see that the Pensioners, considering their age, need not be forced to approach the District Judge of the Unit from where the Pensioners retired.

(3)     Pensioners Retiring from one of the Units in the twin Cities of Hyderabad/ Secunderabad and Settling in Hyderabad and Secunderabad/ Pensioners Retiring from one of the Districts in A.P. and Settling in Twin Cities of Hyderabad and Secunderabad :

The Chief Judge, City Small Causes Court, Hyderabad is authorised to sanction such claims preferred by the Pensioners for the treatment taken as out-patients.

(4)     Pensioners Retired from High Court of A.P. :

The Registrar, High Court of A.P. is authorised to sanction such claims in respect of the Pensioners settled at Hyderabad after retirement. In respect of the Pensioners of the High Court of A.P. settling at a different place other than Hyderabad, the Pri. District Judge of that particular District is authorised to sanction such medical claims.

The expenditure of such reimbursement claims should be debited to the salary head of account under "016 - Medical Reimbursement - Advance" under the concerned Departmental Head of Account from where the employee retired from service.

(4)     Medical Reimbursement of Retired Government employees and their dependents in the office where they last worked or in the District Office of the Department concerned where they have settled after retirement - Permission - Orders - Issued.

(G.O.Ms. No. 16, H. M. & F. W. (Kl) Dept, dated 10-01-200J)

Ref. :

(1)     G.O. Ms. No. 718, H. M. & F. W. (Kl) Dept., dated 26-11-1981.

(2)     G.O. Ms. No. 401, H. M. & F. W. (Kl) Dept., dated 25-06-1991.

(3)     G.O. Ms. No. 38, H. M. & F. W. (Kl) Dept, dated 23-01-1996.

Order :

(1)     In Government Order first read above, it was ordered among others that the retired Government Employees are entitled to free medical treatment in all the Government Hospitals in the State and that they are not eligible to claim reimbursement of medical expenses and for medicines purchased in the open market, if any, on the prescription of the Government Medical Officers.

(2)     Subsequently, in G. O. Ms. No. 41, Health, Medical and Family Welfare (K.l) Department, dated 25.06.1991 all retired Government employees and their dependents were permitted to obtain medical treatment at NIMS for the serious ailments on the authorisation of the Autiiorised Medical Attendant of Teaching Hospital on par with serving Government employees and to reimburse the cost of the treatment at NIMS. The expenditure on this account should be met from the concerned Office/Department from where the pensioner worked last and retired on attaining the age of superannuation and shall be debited to the "Salaries Head", as in the case of regular Government employees.

(3)     Government have further extended reimbursement facilities to the retired employees on par with serving Government employees in the Private Referral Hospital also vide G. O. Ms. No. 38, Health, Medical and Family Welfare (Kl) Department, dated 23.01.1996.

(4)     The retired employees are claiming medical reimbursements from where they worked and retired last. An instance has come to the notice of this Department that the Pay and Accounts Officer has returned the medical bills pertaining to some retired judges stating that the procedure prescribed in G.O. Ms. No. 7l8, Medical and Health (Kl) Department, dated 25.11.1981 may be followed and that the G.O.Ms.No. 401, Health, Medical and Family Welfare (Kl) Department, dated 25.06.1991 takes in exclusively cases of medical treatment in NIMS, Hyderabad. It is observed that when the treatment facility has been extended even in Referral Private Hospital, the reimbursement in terms of G. O. Ms. No. 718, Medical and Health (Kl) Department dated 25.11.1981 may be difficult. Asking the pensioner to submit the bills at the office where he last worked may also be impracticable because the person might have settled somewhere else after retirement. To ease the hardship, it is decided that the pensioners may be permitted to prefer the claims of medical reimbursement in the office where the employee last worked or in the District Office of the department concerned or where he has settled after retirement.

(5)     After careful consideration of the matter in consultation with the Finance and Planning (FW) Department, the Government hereby permit all the retired Government employees and their dependents to avail the option of drawing medical reimbursement amount in the office where the employee last worked or in the District Office of the Department concerned where the retired employee has settled after his Retirement. The expenditure on medical reimbursement of retired Government employees and their dependents shall, however, be debited to the same Head of A/c to which his salary was being debited while he was in service.

(6)     These orders shall come into force with effect from the date of issue of this G.O.