CENTRAL SERVICES (MEDICAL ATTENDANCE) RULES, 1944
These rules may be called the Central Services (Medical Attendance) Rules, 1944.
They shall apply to all Government servants other than
(i) those in railway service and
(ii) those of non-Gazetted rank stationed in or passing through Calcutta, whose conditions of service are prescribed by Rules made or deemed to be made by the Central Government, when they are on duty, leave or Foreign Service in India or when under suspension
Rule 2 (a)
“Authorised Medical Attendant” means –
(i) in respect of a Government servant who belongs to a Central Service, Class I, or whose pay is not less than Rs.500 per mensem, the Principal Medical Officer of the district appointed by the Government to attend its officers in the district;
(ii) in respect of Government servant not belonging to a Central Service Class I, whose pay is less than Rs.500 but more than 150 per mensem, an assistant surgeon grade I (Medical Graduate), or other medical officer appointed by the Government to attend its officers in the station.;
(iii) in respect of any other government servant an Assistant Surgeon Grade II (Medical Licentiate), or other Medical Officer, similarly appointed.
“Districts” means the district in which the Government servant falls ill.
Rule 2(c)“The Government” means –
(i) in respect of a Part “A” or Part “B” state, the State Government; and
(ii) in respect of a Part “C” State, the Lieutenant Governor or the Chief Commissioner, as the case may be.
“Government Hospital” includes a Military Hospital, subject to the provisions of Appendix 32 to the Regulations for Medical Services of the Army in India, 1937, a hospital maintained by a local authority and any other hospital with which arrangements have been made by the Government for the treatment of government servants.
“Medical Attendance” means-
(i) in respect of a government servant specified in sub-clause(a), attendance in hospital or at the residence of government servant, including such pathological, bacteriological, radiological or other methods of examination for the purpose of diagnosis as are available in any government hospital in the district and are considered necessary by the authorised medical attendant and such consultation with specialist or other medical officer in the services of the Government stationed in the state as the authorised medical attendant certifies to be necessary, to such extent and in such manner as the specialist of medical attendant determine;
(ii) in respect of any other government servant but excluding a member of the central service class IV, attendance at a hospital or in the case of illness which compels the patient to be confined to his residence, at the residence of the government servant, including such methods of examination for purposes of diagnosis as are available in the nearest government hospital and such consultation with a specialist or other medical officer of the government stationed in the district as the authorised medical attendant certifies to be necessary to such extent and in such manner as the specialist for medical officer may, in consultation with the authorised medical attendant, determine;
(iii)
Rule 2 (f)
“Patients” means a government servant to whom these Rules apply and who has fallen ill;
“State” means the State in which a patient has fallen ill;
“Treatment” means the use of all medical and surgical facilities available at the Government hospital in which the Govt. servant is treated and includes-
(i) the employment of such pathological, bacteriological, radiological, or other methods as are considered necessary by the authorised medical attendant;
(ii) the supply of such medicines, vaccines, sera or other therapeutic substances as are ordinarily available in the hospital;
(iii) the supply of such medicines, vaccine, sera or other therapeutic substances not ordinarily so available 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;
(iv) such accommodation as is ordinarily provided in the hospital and is suited to his status; accommodation in general or free wards in the hospital being regarded as suitable for a member of the Central Services, Class IV;
(v) such nursing as is ordinarily provided to in-patients by the hospitals; and
(vi) the specialist consultation described in clause (e) but does not include diet or provision at the request of the Govt. servant or accommodation superior to that described in sub-clause (iv).
A Government servant shall be entitled, free of charge to medical attendance by the authorised medical attendant;
Where a Government servant is entitled under sub-rule (i), free of charge, to receive medical attendance, any amount paid by him on account of such medical attendance shall, on production of a certificate in writing by the authorised medical attendant in this behalf be reimbursed to him by the Central Government.
When the place at which a patient falls ill is more than five miles by the shortest route from the consulting room of the authorised medical attendant-
(a) the patient shall be entitled to traveling allowance for the journey to and from such consulting room, or
(b) if the patient is too ill to travel the authorised medical attendant shall be
entitled to traveling allowance for the journey to and from the place where the patients.
Application for traveling allowance under sub-rule (i) shall be accompanied by a certificate in writing by the authorised medical attendant stating that medical attendance was necessary and if the application is under clause (b) of that sub-rule that the patient was too ill to travel.
If the authorised medical attendant is of opinion that the case of a patient is of such a serious or special nature as to require medical attendance by some person other than himself, he may, with the approval of the Chief Administrative Medical Officer of the State (which shall be obtained beforehand unless the delay involved entails danger to the health of the patient)-
(a) send the patient to the nearest specialist or other medical officer as provided in clause (e) of Rule 2, by whom, in his opinion, medical attendance is required for the patient; or
(b) if the patient is too ill to travel, summon such specialist or other medical
officer to attend upon the patient.
A patient sent under clause (a) of sub-rule (1) shall on production of a certificate in writing by the authorised medical journeys to and from the headquarters of the specialist or other medical officer.
A specialist or other medical officer summoned under clause (b) of subrule (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.
A Government servant shall be entitled, free of charge, 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 is no such hospital as is referred to in sub-clause (a) in such hospital other than a Government hospital at or near the place as can in the opinion of the authorised medical attendant, provide the necessary and suitable treatment;
Where a Government servant is entitled under sub-rule (1), free of charge, to treatment in a hospital, any amount paid by him on account of such treatment shall, on production of a certificate in writing by the authorised medical attendant in this behalf, be reimbursed to him by the Central Government.
If the authorised medical attendant is of opinion that owing to the absence or remoteness of a suitable hospital or to the severity of the illness, a Govt. servant cannot be given treatment as provided in clause (a) of sub-rule (1) of Rule 6, the Government servant may receive treatment at his residence.
A Government servant receiving treatment at his residence under sub-rule (1) shall be entitled to receive towards the cost of such treatment incurred b him a sum equivalent of 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.
Claims for sums admissible under sub-rule (2) shall be accompanied by a certificate in writing by he authorised medical attendant stating-
(a) his reasons for the opinion referred to in sub-rule (1); and
(b) the cost of similar treatment referred to in sub-rule (2).
Charges for services rendered in connection with but not included in medical attendance on, or treatment of, a patient entitled, free of charge, to medical attendance or treatment under these Rules, shall be determined by the authorised medical attendant and paid by the patient.
If any question arises as to whether any service is included in medical attendance or treatment it shall be referred to the Government and the decision of the Government shall be final.
(a) in the case of a certificate given by the principal medical officer of a district, by the Chief Administrative Medical Officer of the State; and
(b) in the case of a certificate given by any other medical officer, by the principal medical officer of the district.
A Government Servant shall be eligible to obtain medical treatment outside India or, as the case may be, to claim reimbursement of the cost of medical treatment obtained inside or outside India in accordance with the provisions of this rule.
A Government Servant desirous of availing of medical treatment outside India may make an application through the Department/Ministry to which the Government servant is attached to the Standing Committee established under this rule in the form specified by the Standing Committee.
A Government servant desiring to avail of medical treatment outside India for himself or for a member of his family for any treatment specified in the Table below shall, subject to the other provisions of this rule, be eligible for medical treatment outside India.
Table
(1) Complex/high risk Cardio Vascular Surgery cases for treatment at Centres with extensive experience;
(2) Bone marrow Transplant;
(3) Complex Medical and Oncological Disorders, such as leukaemia and Neo-plastic conditions;
(4) Complex high risk cases in Micro Vascular and Neuro Surgery for treatment at Centres with extensive experience;
(5) Treatment of extremely complex ailments other than those mentioned above which in the opinion of Standing Committee can only be treated abroad and fall in the high risk category.
It shall be competent for the Central Government to review from time to time the list of treatment facilities as specified in the Table to sub-rule (3) and make such additions or deletions as it may deem fit by notification in the Official Gazette.
The Central Government may for purposes of this rule, constitute a Standing Committee consisting of :-
(a) the Director-General of Health Services in the Ministry of Health in the Central Government,
(b) the Director-General of Armed Forces Medical Services.
(c) the Director-General of the Indian Council of Medical Research, and
(d) the Joint Secretary in the Ministry of Health and Family Welfare (Convener), for purposes of considering and recommending to the Central Government cases for medical treatment outside India.
On receipt of an application for medical treatment outside India, the Standing Committee may, it after due consideration, satisfied that the ailment or treatment can be treated only outside India, issue a certificate to the concerned Department or Ministry to which the applicant Government
servant is attached conveying its approval of the application and the concerned Department or Ministry shall, on the strength of that certificate incur necessary expenditure in getting the Government servant concerned or the member of his family treated outside India in accordance with the procedure laid down by the Standing Committee.
It shall be competent for the Central Government to authorize reimbursement of expenditure on medical treatment obtained outside India, if it is satisfied that the prior approval could not be obtained by the
Central Government servant due to circumstances beyond control;
Provided that the Government servant fulfils all other conditions relating to medical treatment outside India under this rule.
The Standing Committee may, if it is satisfied that in the interest of the Government servant or the member of his family obtaining treatment abroad it is essential so to do, recommend one attendant to accompany the Government servant or the member of his family, as the case may be, and the expenditure so incurred shall also be eligible for reimbursement.
Where the Standing Committee, on receipt of an application for medical treatment outside India consider that adequate facility for treatment of the ailment sought to be treatment is available in any medical institution within India, it shall record such a finding and authorize treatment of such ailment in such medical institution within India whereupon the cost of such treatment shall be reimbursed.
For purposes of sub-rule(9), the Ministry of Health in consultation with the Standing Committee shall, from time to time, notify the names of such institutions along with the ailments and the types of treatment available in such institutions.
The scale of expenditure and the eligibility for treatment for which a Government servant or a member of his family shall be entitled, shall be identical to the scale of expenditure and the eligibility of an official of the Indian Foreign Service of the corresponding grade in the Ministry of external Affairs under any Assisted Medical Attendance Scheme for the time being in force.
Who are covered by CS (MA) Rules?
~ They shall apply to all Government servants other than(i) those in railway service and
(ii) those of non-Gazetted rank stationed in or passing through Calcutta, whose conditions of service are prescribed by Rules made or demand to be made by the Central Government, when they are on duty, leave or Foreign Service in India or which under suspension.
Who is an AMA?
~ Authorised Medical Attendant (AMA) is Medical Officer in the employee of Central Government or Private Medical Practitioner appointed/nominated by the Ministry/Department for providing medical attendance to its employees.What is the Reimbursement in case of treatment taken under emergency at private hospital?
• CS(MA) beneficiaries are being reimbursed as per the prevailing non-NABH CGHS as applicable to a CGHS covered city and non-NABH rates applicable to the nearest CGHS covered city in case of non-CGHS city, as the case may be, or the actuals, whichever is less, for treatment undertaken at private hospitals under emergent condition.What are the hospitals in which CS(MA) beneficiaries are entitled for treatment under normal conditions?
• CS(MA) beneficiaries and their dependent family members can get treatment from any of the Central Government hospitals/States Government hospitals/private hospitals and diagnostic centers recognized under CGHS/CS(MA) Rules as per provisions.Can a Central Government Employee gets reimbursement if treatment undertaken aboard?
• Treatment abroad is considered under CS (MA) Rules, 1944, on receipt of application in the prescribed format through the employee’s Ministry/Department. However, approval depends on the opinion of the standing Committee constituted under these rules.- Dr. Ramesh Cardiac and Multispeciality Hospital Pvt. Ltd., Guntur
- HCG Curie City Cancer Centre, Vijayawada
- Lalitha Super Specialities Hospital (P) Ltd., Guntur
- M.S. Hospital , Tirupati
- Nagarjuna Hospital, Vijayawada
- Praveen Cardiac Centre, Vijayawada
- Purnas Remedy Hospital, Tirupati
- Rainbow Children's Hospital, Vijayawada
- Sentini Hospital, Vijayawada
- Sree Ramadevi Multi Super Speciality Hospital, Tirupati
- Sri Maruthi Speciality Hospital, Tirupati
- Tirumala Hospitals Super Speciality & Laparoscopic Institute, Vizianagaram
- Krishna Sai Dental Vijayawada
- Prasad's Dental Guntur
- Sri Durga Dental Kondapalli
No.S.14025/09/2013-MS
Government of India
Ministry of Health and Family Welfare
Department of Health & Family Welfare
***********
Nirman Bhawan, New Delhi
Dated June, 2015.
OFFICE MEMORANDUM
Subject: Stoppage of Fixed Medical Allowance (FMA) being paid to the Central Government employees working in the interior/remote areas and their governance under CS(MA) Rules, 1944
*** @ ***
Reference is invited to OM No.S-14020/1/88-MS dated 17.07.1990 in which fixed medical allowance to the tune of Rs.25/- per month was granted to employee working in the interior/remote areas where no Authorized Medical Attendant was available within a radius of 5 kms, which was subsequently revised to the tune of Rs.100/- per month vide 0M F.No. 14025/33/98-MS dated 18.01.1999.
2. On receiving a proposal from Ministry of Defence on the issue of medical reimbursement to employees who are in receipt of Fixed Medical Allowance, the matter was examined in the Ministry in consultation with Department of Expenditure and Department of Personnel & Training.
3. It has now been decided to stop the above mentioned Fixed Medical Allowance. Henceforth, the Central Government employees residing in interior/remote areas will be governed by the extant rules as laid down under CS(MA) Rules, 1944.
4. This O.M. will be effective from the date of issue. After issuance of this 0M, the above mentioned O.Ms i.e. O.M. No.S-14020/1/88-MS dated 17.07.1990 and o.M. F.No. 14025/33/98-MS dated 18.01.1999, stand withdrawn.
5. This issues with the concurrence of the Department of Personnel & Training and Department of Expenditure.
(Sunil Kumar Gupta)
Under Secretary to the Govt. of India.
1 All Ministries/Departments of Government of India.
2. All States/UTs Governments.
3. Office of the Comptroller and Auditor General of India, Bahadur Shah Zafar Marg, New Delhi-110002.
4. CMO(SRA), Dte.GHS.
5. DDG(M), Dte.GHS.
6. Dte.GHS (M.G.-II Section), with 50 spare copies.
7. All officers/Sections in the Ministry of Health & FW.
8. CGHS(P) Section.
9. Internal Finance Division, M/o Health & FW
10.Swamy Publishers (P) Ltd., P.B. No.2468, R.A. Puram, Chennai-600028.
11.Swamy Publishers (P) Ltd.,4855, 24, Ansari Road, Daryaganj, New Delhi.
12. Shri Umaraomal Purohit, Secretary, Staff Side, 13-C, Ferozshah Road, New Delhi-110001.
13.All Staff Side members of National Council (JCM).
14.NIC Division, Nirman Bhavan, New Delhi, with the request that same may be put on the website of this Ministry under the link of CS(MA) Rules.
15.Guard File of M.S. Section.
No. S.14025/10/2002/MS
Government of India
Ministry of Health and Family Welfare
Department of Health & Family Welfare
***********
Nirman Bhawan, New Delhi
Dated 26th May, 2015.
OFFICE MEMORANDUM
Subject: Revision of rate and guideline for reimbursement of expenses on purchase of Hearing AIDS Under CSMA Rules,1944 and CGHS-Regarding
*** @ ***
With reference to the above mentioned subject the undersigned is directed to refer to the Office Memorandum of even no dated 21.03.2012 , 17.11.2006 and 28.10.2002 and OM No S.14025/36/93/MS dated 26.03.94 and 17.08.99 and to state that on the basis of recommendation of an Expert Committee, it has been decided to revise the rates and guidelines for hearing aids to be reimbursed under CS(MA) Rules, 1944 and CGHS.
2. The revised ceiling rates fixed for various types of hearing —aids (for one ear) are as under:-
| Body worn/Pocket type | Rs.3000/- |
| Analogue BTE | Rs. 7000/- |
| Digital BTE | Rs. 15000/- |
| Digital ITC/CIC | Rs. 20000/- |
3. Beneficiaries covered under CS (MA) Rules /CGHS shall be eligible to obtain hearing aid as per the following guidelines.
(i). Patients/Beneficiaries should be properly referred to CGHS/Govemment hospital ENT specialist from the parent CGHS wellness centre ( A computerized referral printout should be made wherever computerization has been done).
(ii). It would be mandatory to carry CGHS Beneficiary's ID card (in original) whenever the CGHS beneficiaries visit the CGHS/Government ENT specialist for consultation and Audiometric test.
(iii). The ENT specialist of CGHS /Government hospital shall then recommend a hearing aid on basis of Audiometric and Audiological assessment, specifying the type of hearing aid most suited for the Beneficiary. The `Audiogram report' shall be authenticated by the ENT specialist/Consultant of the CGHS/Government hospital.
4. The permission to procure hearing aid shall be granted by the ADDITIONAL DIRECTOR(Zonal) of CGHS-ZONAL OFFICE in case of CGHS pensioner beneficiaries, and by the HEAD OF DEPARTMENT/OFFICE in case of serving employees and CGHS beneficiaries of Autonomous bodies on the basis of Recommendation of a CGHS/Government ENT specialist, and an `undertaking' that the beneficiary has not been reimbursed the cost of hearing -aid in the preceeding five years.
5. Reimbursement claim shall be submitted to CGHS ZONAL OFFICE through the CMO —Incharge of the Concerned dispensary by CGHS Pensioner benficieries in the prescribed medical reimbursement claim fomalong with the following documents :-
a) Referral letter from parent CGHS Wellness Centre (computerized Slip where computerization is done already).
b) Copy of 'prescription' of ENT consultant (CGHS/Govt.Hospital) with the `Audiogram' report duly authenticated by the treating ENT consultant (CGHS/Govt).
c) Copy of CGHS Card.
d) Bill /Reciept (in original) carrying details of the hearing - aid seller i.e. NAME, QUALIFICATION, AND RCl/MCI REGISTRATION NUMBER of the hearing - aid seller.
e) The 'permission letter' to purchase hearing - aid (in original).
f) Empty Box/boxes or the Carton(s) with the label showing details of the hearing aid supplied.
In case of the other beneficiaries, the medical claim shall be submitted to the concerned Ministry / Department /Office . Reimbursement shall be limited to the ceiling rate or actual cost of the hearing — aid, whichever is less.
6. Records of permissions granted for procurement of hearing - aids shall be maintained by CGHS in respect of pensioner CGHS beneficiaries and by the concerned Ministry/Department /Office in respect of other beneficiaries.
7. Replacement of hearing - aid may be permitted after 5 years on the basis of condemnation certificate issued by a technical expert and on approval of CGHS/Government ENT Surgeon. Maintenance and repair will be the responsibility of the beneficiary.
8. These orders shall supercede all the earlier orders issued on the subject.
9. The revised rates and guidelines shall come into force from the date of issue and shall be valid for a period of two year or till further revision, whichever is earlier.
10. This issues with the approval of Integrated Finance Division of Ministry of Health & Family Welfare
(Sunil Kumar Gupta)
Under Secretary to the Govt. of India.
1. All Ministries/Departments of Government of India.
2. All States/UTs Governments.
3. Office of the Comptroller and Auditor General of India, Bahadur Shah Zafar Marg, New Delhi-110002.
4. CMO(SRA), Dte.GHS.
5. DDG(M), Dte.GHS.
6. Dte.GHS (M.G.-II Section), with 50 spare copies.
7. All officers/Sections in the Ministry of Health & FW.
8. CGHS(P) Section.
9. Internal Finance Division, M/o Health & FW
10.Swamy Publishers (P) Ltd., P.B. No.2468, R.A. Puram, Chennai-600028.
11.Swamy Publishers (P) Ltd.,4855, 24, Ansari Road, Daryaganj, New Delhi.
12.Shri Umaraomal Purohit, Secretary, Staff Side, 13-C, Ferozshah Road, New Delhi-110001.
13.All Staff Side members of National Council (JCM).
14.NIC Division, Nirman Bhavan, New Delhi, with the request that same may be put on the website of this Ministry under the link of CS(MA) Rules.
15.Guard File of M.S. Section. .
No.S.14025/19/2015-MS
Government of India
Ministry of Health and Family Welfare
Department of Health & Family Welfare
***********
Nirman Bhawan, New Delhi
Dated 27 May, 2015.
OFFICE MEMORANDUM
Subject: Revision of time limit for submission of final claims for reimbursement of medical expenses under CS(MA) Rules, 1944 —regarding.
*** @ ***
The undersigned is directed to refer to 0M No.F.29-40/68-MA dated 15.10.1968 in which it was laid down that submission of final claims for reimbursement of medical expenses of Central Government servants in respect of a particular spell of illness should ordinarily be prefen•ed within 3 months from the date of completion of treatment.
2. A representation was received from National Council (Staff Side) to extend the time limit for submission of such medical bills from 3 months to 6 months. The matter was examined in the Ministry and it has been decided that the period of 3 months for submission of medical claims be revised to 6 months. Henceforth, only the cases in which the bills are submitted after 6 months from the date of completion of medical treatment/discharge of the patient from the hospital are required to be taken up for condonation. The power of condonation of such delays and other terms and conditions would be same as enumerated in the 0M No.S.14025/8/99/-MS dated 25.05.1999.
3. This issue with the approval of the competent authority.
(Sunil Kumar Gupta)
Under Secretary to the Govt. of India.
1. All Ministries/Departments of Government of India.
2. All States/UTs Governments.
3. Office of the Comptroller and Auditor General of India, Bahadur Shah Zafar Marg, New Delhi-110002.
No. H.11022/01/2014-MS
Government of India
Ministry of Health & Family Welfare
Department of Health & Family Welfare
**********
Nirman Bhawan, New Delhi,
Dated the 15th July, 2014
OFFICE MEMORANDUM
Sub: Relaxation of procedures to be followed in considering requests for medical reimbursement claims in respect of CS (MA) beneficiaries.#####
Ministry of Health & Family Welfare received several representations from CGHS beneficiaries for issue of guidelines to be followed in considering requests for relaxation of procedures in considering requests for medical reimbursement over and above the approved rates. The matter was examined by the Ministry and Office Memorandum No.4-18/2005-C&P {Vol-l Pt.(l)} dated the 20th February, 2009 was issued prescribing the procedures and guidelines to be followed for consideration of requests received from CGHS beneficiaries seeking reimbursement of expenditure incurred on medical treatment over and above the approved rates. The requirement of essentiality certificate in respect of CGHS beneficiaries was also done away with.
However, no such guidelines were issued under CS(MA) Rules. In this regard Department — related Parliamentary Standing Committee on Health and Family Welfare in the seventy first report impressed upon the Department to immediately address this issue and extend same facilities to those covered under CS(MA) Rules and to issue a fresh circular clarifying the procedures in this regard and dispelling misgivings, if any. Ministry was also in receipt of representation from several quarters in this regard.
2. The matter has been examined in consultation with Dte.GHS and it has been decided to revise the guidelines for reimbursement by the competent authority to issue guidelines under CS(MA), on similar pattern as under CGHS as per the following:
(1). It has now been decided to do away with the procedure for verification of bills and issue of essentiality certificate by the treating doctor and the Medical Superintendent of the hospital. Ministries/Authorities concerned may verify and check the authenticity of the claims on the basis of the prescription slip and the diagnostic report submitted by the Government servant. In the event of any doubt, the concerned Ministry/Authority can always get verification done from the hospital concerned.
(2). It is clarified that essentiality certificate/counter signature of treating doctor in a hospital would not, henceforth, be necessary. However, essentiality certificate would be required when the treatment is taken from an AMA on OPD basis.
(3). All cases involving requests for relaxation of rules for reimbursement of full expenditure will henceforth be referred to the Technical Standing Committee, to be chaired by the DGHS/Spl.DGHS and Specialists of concerned subject as members. Addl. DDG (MG-Section), Dte.GHS shall be member secretary for organizing the meetings of Technical Standing Committee. If Technical Standing Committee recommends the relaxation of rules for permitting full reimbursement of expenditure incurred by the beneficiary, the full reimbursement may be allowed by the Secretary (Health & Family Welfare) in consultation with IFD. A check list for consideration of requests for reimbursement in excess of the approved rates may include:
a. The treatment was obtained in a private hospital not empanelled under CS(MA)/ CGHS under emergency and the patient was admitted by others when the beneficiary was unconscious or severely incapacitated and was hospitalized for a prolonged period;
b. The treatment was obtained in a private hospital not empanelled under CS(MA)/ CGHS under emergency and was admitted for prolonged period for treatment of Head injury, Coma, Septicemia, Multi-organ failure, etc.,
c. Treatment was obtained in a private hospital not empanelled under CS(MA)/ CGHS under emergency for treatment of advanced malignancy;
d. Treatment was taken in a private hospital not empanelled under CS(MA)/ CGHS under emergency in higher type of accommodation as rooms as per his/her entitlement was not available during that period;
e. Treatment was taken in higher type of accommodation under specific conditions for isolation of patients to avoid contacting infections
f. Treatment was obtained in private hospital not empanelled under CS(MA)/ CGHS under emergency while on official tour to another city;
g. Treatment was obtained in a private hospital not empanelled under CS(MA)/ CGHS under emergency when there is a strike in Govt. hospitals
h. Approval for air-fare with or without attendant on the advice of treating doctor for treatment in another city even though he is not eligible for air travel/treatment facilities are available in city of residence and
i. Any other special circumstances
4. The Office Memorandum is issued with the concurrence of IFD vide Dy.N0.C-695 dated 07.07.2014
(Arun Chowdary)
Under Secretary to the Gover ment of India
Tele: 23061436.
To:
1 . All Ministries/Departments, Government of India
2. DDG(M), Dte.GHS/CMO(SRA), Dte.GHS, Dte.GHS, MoHFW
3. Director, CGHS, Nirman Bhawan, New Delhi
4. Addl.DDG(HQ), CGHS, MoHFW, Nirman Bhawan, New Delhi
5. AD(HQ), CGHS, R.K.Puram, Sector-12, New Delhi
6. All Addl. Directors/Joint Directors of CGHS cities outside Delhi
7. Additional Director MCTC CGHS, New Delhi
8. JD(HQ), JD (Grievance)/JD (R&H), CGHS, Delhi
9. Rajya Sabha/Lok Sabha Secretariat, New Delhi
10. Registrar, Supreme Court of India, New Delhi
11 . U.P.S.C. Dholpur House, New Delhi
12. Office of the Comptroller & Auditor General of India, Bahadur Shah Zafar Marg, New Delhi
13. PPS to Secretary (H&FW)/Secretary (AYUSH)/Secretary (HR)/Secretary (AIDS Control), Ministry of Health & Family Welfare
14. PPS to DGHS/AS&DG NRHM/AS(H), MoHFW, New Delhi
15. CGHS(P) Section/ Hospital Empanelment Cell, CGHS/MG-II Section, Dte.GHS, Nirman Bhawan, New Delhi
16. CGHS-I/II/IIUIV, MoHFW, Nirman Bhawan, New Delhi
17. Estt.I/Estt.Il/Estt.Ill/Estt.IV Section, MoHFW, Nirman Bhawan, New Delhi
18. Admn.I/Admn.ll Section, Dte.GHS, MoHFW, Nirman Bhawan, New Delhi
19. Integrated Finance Division, MoHFW, Nirman Bhawan, New Delhi
20. All Officers/Sections/Desks in the Ministry
21 . Deputy Secretary (Civil Service News), Department of Personnel & Training, 5th Floor, Sardar Patel Bhawan, New Delhi
22. Shri Umraomal Purohit, Secretary, Staff Side, 13-C, Ferozshah Road, New Delhi
23. All Staff Side Members of National Council (JCM)
24. ED(H)/Planning, Railway Board, Ministry of Railways, Rail Bhawan, Rafi Marg, New Delhi - 110001
25. Central Organisation, ECHS, Department of Ex-Servicemen Welfare, Ministry of Defence, New Delhi
26. Chairman, Employees State Insurance Corporation, Ministry of Labour & Employment, Panchdeep Bhawan, C.I.G. Marg, New Delhi-110002
27. UTI-ITSL, 153/1, First Floori Old Madras Road, Ulsoor, Bengaluru560008.
28. Swamy Publishers (P) Ltd., P.B. No.2468, R.K. Puram, Chennai-600028
29. Swamy Publishers (P) Ltd., 4855, 24, Ansari Road, Dayaganj, New Delhi
30. Sr. Technical Director, NIC, MoHFW, Nirman Bhawan, New Delhi with the request to upoad this 0M on the Ministry's website under the link of CS (MA) Rules — OMs and Circulars
31 . Hindi Section, MoHFW, Nirman Bhawan, New Delhi for providing Hindi version of this 0M.
32. Guard file
FTS:206478
F.No. S. 14025/38/2014-MS
Government of India
Ministry of Health & Family Welfare
**********
Nirman Bhawan, New Delhi,
Dated the 17th September, 2014
OFFICE MEMORANDUM
Sub: Regarding tests/ investigations at private hospitals/ diagnostic laboratories/ imaging centres empanelled under CGHS/ CS(MA) Rules.#####
The undersigned is directed to say that the references for clarification of validity of the medical prescriptions, etc. issued by the Authorised Medical Attendant have been received in the Ministry.
2. The matter has been examined in the Ministry and it is clarified that in case of CS(MA) beneficiaries availing tests/investigations at private hospitals/ diagnostic laboratories/ imaging centres empanelled under CGHS/CS(MA) Rules on the recommendation of their concerned AMAs and after obtaining permission from their respective Departments/ Ministries, the medical prescription issued by an AMA/ Government Specialist prescribing diagnostic tests/ investigations shall be treated as valid for a single use within a period of two weeks from the date of prescription. However the medical prescription shall remain valid beyond two weeks for undertaking diagnostic tests/ investigations if specifically prescribed by the AMA/ Government Specialist) about the date or period by which the prescribed tests are to be conducted for a routine check up or follow up treatment. The medical prescription would require revalidation or issue of a fresh prescription from the prescribing AMA/ Government Specialist for getting the prescribed tests done after expiry of the validity period of two weeks or as prescribed by the AMA/ Government Specialist, as the case may be.
(Arun Chowdary)
Under Secretary to the Gover ment of India
To: 1. All Ministries/ Departments, Government of India< br /> 2. All States/ UTS Governments.
3. Rajya Sabha/Lok Sabha Secretariat
4. Registrar, Supreme Court of India
5. U.P.S.C. Dholpur House, Shahjahan road, New Delhi.
6. Deputy Secretary (Civil Service News), Department of Personnel & Training, 5 th floor, Sardar Patel Bhawan, New Delhi.
7. Shri Umraomal Purohit, Secretary, Staff side, 13-C, Ferozshah road, New Delhi.
8. All Staff Side Members of National Council (JCM) (as per list attached)
9. Office of the Comptroller & Auditor General of India, Bahadur Shah Zafar Marg, New Delhi.
10. DDG(M), Dte.GHS/CMO(SRA), Dte.GHS/M.G.-11 Section, Dte. GHS, MoHFW
11. CGHS(P) Division, MOHFW, Nirman Bhawan, New Delhi
12. Director, CGHS, Nirman Bhawan, New Delhi.
13. AD(HQ), CGHS, Bikaneer House, New Delhi.
14. Addl. DDG(HQ), CGHS, MOHFW, Nirman Bhawan, ND.
15. All Addl. Directors/ Joint Directors of CGHS cities outside Delhi.
16. Additional Director CGHS, New Delhi.
17. JD(Grievance)/ JD(R & H), CGHS, Delhi.
18. Hospital Empanelment Cell, CGHS, Nirman Bhawan, New Delhi.
19. CGHS-I/II/III/IV, MoHFW, Nirman Bhawan, New Delhi.
20. Estt.1/Estt.11/Estt.111/Estt.1V Section, MoHFW, Nirman Bhawan
21. Admn.I/Admn.II Section, Dte. GHS, Nirman Bhawan, New Delhi.
22. Integrated Finance Division, MoHFW, Nirman Bhawan, New Delhi.
23. PPS to Secretary (H & FW)/Secretary (AYUSH)/Secretary (HR)/Secretary (AIDS Control), Ministry of Health & Family Welfare.
24. PPS to DHGS/AS & DG (CGHS)/AS & FA/AS & MD, NRHM
25. Dr. D.P.Pande, ED(H)/Planning, Railway Board, Ministry of Railways, Rail Bhawan, Rafi Marg, New Delhi- 110001
26. Brig. S.P. Patil YSM, ODS, Central Organization, Ministry of Labour & Employees State Insurance Corporation, Ministry of Labour & Employment, Panchdeep Bhawan, C.I.G. Marg, New Delhi-110002
27. All Offices/ Sections/ Desks in the Ministry.
28. Swamy Publishers (p) Ltd., P.B. No. 2468, R.K.Puram, Chennai 600028.
29. Swamy Publisher (P) Ltd., 4855, 24, Ansari Road, Daryaganj, New Delhi.
30. Sr. Technical Director, NIC, MOHFW, Nirman Bhawan, New Delhi with the request to upload this 0M on the Ministry's website under the link of CS(MA) Rules.
31. Hindi Section for providing Hindi version of this 0M.
32. Guard File.
FTS:110238
S.14025/01/2014-MS
Government of India
Ministry of Health & Family Welfare
Department of Health and Family Welfare
**********
Nirman Bhawan, New Delhi,
Dated the 5th June, 2014
OFFICE MEMORANDUM
Sub: Delegation of powers to heads of Departments in various Ministries/Departments for settling permission cases and for approval relating to medical reimbursement under CS (MA) Rules, 1944..#####
The undersigned is directed to state that this Ministry has been receiving references from different Ministries/Departments in respect of medical claims for clarification and concurrence even when the admissible amounts calculated are as per the approved rate list. This generates extra burden in this Ministry when the matter can be settled in the referring Ministry itself.
2. The matter has been examined and it has been decided now to delegate powers as follows: .
(i). A serving Central Government employee covered under CS (MA) Rules, 1944 who is taking treatment in Government hospital and desires to obtain treatment in a private hospital recognized under CGHS/CS (MA) Rules, the Head of Department may grant him permission for indoor treatment on the basis of medical prescription issued by the concerned Authorized Medical Attendant.
(ii). The Heads of Departments may decide the cases of reimbursement of medical claims in respect of treatment obtained in emergency at private hospital/private nursing home/private clinic, subject to item-wise ceiling as per rates prescribed under CGHS/CS (MA) Rules.
3. It has been decided with the approval of the competent authority to delegate powers to Departments/Ministries to settle all cases where there is no relaxation of rules and the entitlement has been worked out with reference to the rate list prescribed. The delegation would, however, be subject to the condition that the Heads of the Departments/Ministries may settle cases upto the limit of Rs.2,00,000/-(Rupees Two Lakhs only) (worked out with reference to the prescribed rate list).
In respect of payment exceeding Rs.2,00,000/- (Rupees Two lakhs only) but as per the prescribed rate list, the Departments/Ministries concerned may settle such cases in consultation with their respective Internal Finance Division. Only in those cases where the settled rules are required to be relaxed, should the case be referred to the Ministry of Health and Family Welfare.
4. This issues with concurrence of Integrated Finance Division vide CD No.335 dated 28.05.2014
(V.P. Singh)
Director
To:
l . All Ministries/Departments, Government of India
2. DDG(M), Dte.GHS/CMO(SRA), Dte.GHS, Dte.GHS, MoHFW
3. Director, CGHS, Nirman Bhawan, New Delhi
4. Addl.DDG(HQ), CGHS, MoHFW, Nirman Bhawan, New Delhi
5. AD(HQ), CGHS, R.K.Puram, Sector-12, New Delhi
6. All Addl. Directors/Joint Directors of CGHS cities outside Delhi
7. Additional Director MCTC CGHS, New Delhi
8. JD(HQ), JD (Grievance)/JD (R&H), CGHS, Delhi
9. Rajya Sabha/Lok Sabha Secretariat, New Delhi
10. Registrar, Supreme Court of India, New Delhi
11. U.P.S.C. Dholpur House, New Delhi
12. Office of the Comptroller & Auditor General of India, Bahadur Shah Zafar Marg, New Delhi
13. PPS to Secretary (AWSH)/Secretary (HR)/Secretary
(AIDS Control), Ministry of Health & Family Welfare
14. PPS to DGHS/AS&DG NRHM/AS(H), MoHFW, New Delhi
15. CGHS(P) Section/ Hospital Empanelment cell, CGHS/MG-II Section, Dte.GHS, Nirman Bhawan, New Delhi
16. CGHS-I/II/III/IV, MoHFW, Nirman Bhawan, New Delhi
17. Estt.1/Estt.11/Estt.111/Estt.1V Section, MoHFW, Nirman Bhawan, New Delhi
18. Admn.1/Admn.11 Section, Dte.GHS, MoHFW, Nirman Bhawan, New Delhi
19. Integrated Finance Division, MoHFW, Nirman Bhawan, New Delhi
20. All Officers/Sections/Desks in the Ministry
21. Deputy Secretary (Civil Service News), Department of Personnel & Training, 5th Floor, Sardar Patel Bhawan, New Delhi
22. Shri Umraomal Purohit, Secretary, Staff Side, 13-C, Ferozshah Road, New Delhi
23. All Staff Side Members of National Council (JCM)
24. ED(H)/Planning, Railway Board, Ministry of Railways, Rail Bhawan, Rafi Marg, New Delhi - 110001
25. Central Organisation, ECHS, Department of Ex-Servicemen Welfare, Ministry of Defence, New Delhi
26. Chairman, Employees State Insurance Corporation, Ministry of Labour & Employment, Panchdeep Bhawan, C.I.G. Marg, New Delhi- 110002
27. UTI-ITSL, 153/1, First Floor, Old Madras Road, Ulsoor, Bengaluru560008.
28. Swamy Publishers (P) Ltd., P.B. No.2468, R.K. Puram, Chennai-600028
29. Swamy Publishers (P) Ltd., 4855, 24, Ansari Road, Dayaganj, New Delhi
30. Sr.Technical Director, NIC, MoHFW, Nirman Bhawan, New Delhi with the request to upoad this 0M on the Ministry's website under the link of CS (MA) Rules — OMs and Circulars
31. Hindi Section, MoHFW, Nirman Bhawan, New Delhi for providing Hindi version of this 0M.
32. Guard file
No.H.1 1022/01/2014-MS
Government of India
Ministry of Health and Family Welfare
Department of Health & Family Welfare
***********
Nirman Bhawan, New Delhi
Dated 15th July, 2014.
OFFICE MEMORANDUM
Subject: Relaxation of procedures to be followed in considering requests for medical reimbursement claims in respect of CS (MA) beneficiaries.**&**
Ministry of Health & Family Welfare received several representations from CGHS beneficiaries for issue of guidelines to be followed in considering requests for relaxation of procedures in considering requests for medical reimbursement over and above the approved rates. The matter was examined by the Ministry and Office Memorandum No.4-18/2005-C&P {Vol-l Pt.(l)} dated the 20th February, 2009 was issued prescribing the procedures and guidelines to be followed for consideration of requests received from CGHS beneficiaries seeking reimbursement of expenditure incurred on medical treatment over and above the approved rates. The requirement of essentiality certificate in respect of CGHS beneficiaries was also done away with.
However, no such guidelines were issued under CS(MA) Rules. In this regard Department — related Parliamentary Standing Committee on Health and Family Welfare in the seventy first report impressed upon the Department to immediately address this issue and extend same facilities to those covered under CS(MA) Rules and to issue a fresh circular clarifying the procedures in this regard and dispelling misgivings, if any. Ministry was also in receipt of representation from several quarters in this regard.
2. The matter has been examined in consultation with Dte.GHS and it has been decided to revise the guidelines for reimbursement by the competent authority to issue guidelines under CS(MA), on similar pattern as under CGHS as per the following:
(1). It has now been decided to do away with the procedure for verification of bills and issue of essentiality certificate by the treating doctor and the Medical Superintendent of the hospital. Ministries/Authorities concerned may verify and check the authenticity of the claims on the basis of the prescription slip and the diagnostic report submitted by the Government servant. In the event of any doubt, the concerned Ministry/Authority can always get verification done from the hospital concerned.
(2). It is clarified that essentiality certificate/counter signature of treating doctor in a hospital would not, henceforth, be necessary. However, essentiality certificate would be required when the treatment is taken from an AMA on OPD basis.
(3). All cases involving requests for relaxation of rules for reimbursement of full expenditure will henceforth be referred to the Technical Standing Committee, to be chaired by the DGHS/Spl.DGHS and Specialists of concerned subject as members. Addl. DDG (MG-Section), Dte.GHS shall be member secretary for organizing the meetings of Technical Standing Committee. If Technical Standing Committee recommends the relaxation of rules for permitting full reimbursement of expenditure incurred by the beneficiary, the full reimbursement may be allowed by the Secretary (Health & Family Welfare) in consultation with IFD. A check list for consideration of requests for reimbursement in excess of the approved rates may include:
(a). The treatment was obtained in a private hospital not empanelled under CS(MA)/ CGHS under emergency and the patient was admitted by others when the beneficiary was unconscious or severely incapacitated and was hospitalized for a prolonged period;
(b). The treatment was obtained in a private hospital not empanelled under CS(MA)/ CGHS under emergency and was admitted for prolonged period for treatment of Head injury, Coma, Septicemia, Multi-organ failure, etc.,
(c). Treatment was obtained in a private hospital not empanelled under CS(MA)/ CGHS under emergency for treatment of advanced malignancy;
(d). Treatment was taken in a private hospital not empanelled under CS(MA)/ CGHS under emergency in higher type of accommodation as rooms as per his/her entitlement was not available during that period;
(e). Treatment was taken in higher type of accommodation under specific conditions for isolation of patients to avoid contacting infections;
(f). Treatment was obtained in private hospital not empanelled under CS(MA)/ CGHS under emergency while on official tour to another city;
(g). Treatment was obtained in a private hospital not empanelled under CS(MA)/ CGHS under emergency when there is a strike in Govt. hospitals;
(h). Approval for air-fare with or without attendant on the advice of treating doctor for treatment in another city even though he is not eligible for air travel/treatment facilities are available in city of residence and
(i). Any other special circumstances.
4. The Office Memorandum is issued with the concurrence of IFD vide Dy.N0.C-695 dated 07.07.2014.
(Arun Chowdhury)
Under Secretary to the Government of India.
Tele: 23061436.
1 . All Ministries/Departments, Government of India
2. DDG(M), Dte.GHS/CMO(SRA), Dte.GHS, Dte.GHS, MoHFW
3. Director, CGHS, Nirman Bhawan, New Delhi
4. Addl.DDG(HQ), CGHS, MoHFW, Nirman Bhawan, New Delhi
5. AD(HQ), CGHS, R.K.Puram, Sector-12, New Delhi
6. All Addl. Directors/Joint Directors of CGHS cities outside Delhi
7. Additional Director MCTC CGHS, New Delhi
8. JD(HQ), JD (Grievance)/JD (R&H), CGHS, Delhi
9. Rajya Sabha/Lok Sabha Secretariat, New Delhi
10. Registrar, Supreme Court of India, New Delhi
11 . U.P.S.C. Dholpur House, New Delhi
12. Office of the Comptroller & Auditor General of India, Bahadur Shah Zafar Marg, New Delhi
13. PPS to Secretary (H&FW)/Secretary (AYUSH)/Secretary (HR)/Secretary
(AIDS Control), Ministry of Health & Family Welfare
14. PPS to DGHS/AS&DG NRHM/AS(H), MoHFW,New Delhi
15. CGHS(P) Section/ Hospital Empanelment Cell, CGHS/MG-II Section,Dte.GHS, Nirman Bhawan, New Delhi
16. CGHS-I/II/IIUIV, MoHFW, Nirman Bhawan, New Delhi
17. Estt.I/Estt.Il/Estt.Ill/Estt.IV Section, MoHFW, Nirman Bhawan, New Delhi
18. Admn.I/Admn.ll Section, Dte.GHS, MoHFW, Nirman Bhawan, New Delhi
19. Integrated Finance Division, MoHFW, Nirman Bhawan, New Delhi
20. All Officers/Sections/Desks in the Ministry
21 . Deputy Secretary (Civil Service News), Department of Personnel & Training, 5th Floor, Sardar Patel Bhawan, New Delhi
22. Shri Umraomal Purohit, Secretary, Staff Side, 13-C, Ferozshah Road, New Delhi
23. All Staff Side Members of National Council (JCM)
24. ED(H)/Planning, Railway Board, Ministry of Railways, Rail Bhawan, Rafi Marg, New Delhi - 110001
25. Central Organisation, ECHS, Department of Ex-Servicemen Welfare, Ministry of Defence, New Delhi
26. Chairman, Employees State Insurance Corporation, Ministry of Labour & Employment, Panchdeep Bhawan, C.I.G. Marg, New Delhi-110002
27. UTI-ITSL, 153/1, First Floori Old Madras Road, Ulsoor, Bengaluru560008.
28. Swamy Publishers (P) Ltd., P.B. No.2468, R.K. Puram, Chennai-600028
29. Swamy Publishers (P) Ltd., 4855, 24, Ansari Road, Dayaganj, New Delhi
30. Sr. Technical Director, NIC, MoHFW, Nirman Bhawan, New Delhi with the request to upoad this 0M on the Ministry's website under the link of CS (MA) Rules — OMs and Circulars
31 . Hindi Section, MoHFW, Nirman Bhawan, New Delhi for providing Hindi version of this 0M.
32. Guard file
No.S.14025/02/2014-MS
Government of India
Ministry of Health and Family Welfare
Department of Health & Family Welfare
Nirman Bhawan, New Delhi
Dated 19th June, 2014.
OFFICE MEMORANDUM
Subject: Extension of medical facilities to permanently disabled dependent brother of a CS (MA) beneficiary.°°°∆°°°
The undersigned is directed to state that dependent brother of a Central Government employee is presently entitled for medical facilities under CS (MA) Rules, 1944, upto the age of becoming a major. Ministry of Health and Family Welfare has been receiving requests from CS (MA) beneficiaries for removal of the upper age-limit in the case of disabled dependent brother so as to provide them the medical facilities without any age limit as has been provided to disabled son of a CS (MA) beneficiary.
2. Accordingly, with a view to assuage the hardship, it has been decided to extend the medical facilities under CS(MA) Rules, 1944 to permanently disable dependent brother of a CS(MA) beneficiary, without any age limit.
3. For availing medical facilities under this provision, the permanently disabled dependent brother of a CS (MA) beneficiary must be suffering from any one or more of the disabilities as defined in Section 2(i) of 'The persons with Disabilities (Equal opportunities, protection of Rights and Full Participation) Act, 1995 (No. 1 of 1996)' which includes;-
(i) Blindness
(ii) Low-vision
(iii) Leprosy-cured
(iv) Hearing impairment
(v) Loco motor disability
(vi) Mental retardation
(vii) Mental illness
and as per Clause (i) of Section 2 of National Trust for Welfare of Persons with Autism, cerebral Palsy, Mental Retardation and Multiple Disabilities Act, 1999 (No.44 of 1999), which presently covers a person suffering from any of the condition relating to autism, cerebral palsy, mental retardation or a combination of any two or more of such conditions and includes a person suffering from severe multiple disability. It is clarified that 'permanent disability' means a person with 40% or more of one or more disabilities.
4. The eligibility criteria for a presently disabled dependent brother to avail medical facilities under CS (MA) Rules, 1944, will be as under:-
- He must be wholly dependent on the CS (MA) beneficiary.
- He should be unmarried and should not have his own family.
- The income limit for deciding dependency shall be as prescribed by the Ministry of Health and Family Welfare from time to time and as applicable under CS (MA) Rules, 1944.
- He must be ordinarily residing with the CS (MA) beneficiary.
- All the above conditions are required to be fulfilled for availing medical facilities.
5. This Office Memorandum will be effective form the date of issue.
(V.P. Singh)
Director
Tele: 23061831
1 . All Ministries/Departments, Government of India
2. DDG(M) /CMO(SRA), Dte.GHS, MoHFW, Nirman Bhawan, New Delhi
3. Director, CGHS, Nirman Bhawan, New Delhi
4. Addl.DDG(HQ), CGI-IS, MoHFW, Nirman Bhawan, New Delhi
5. AD(HQ), CGHS, R.K.Puram, Sector-12, New Delhi
6. All Addl. Directors/Joint Directors of CGHS cities outside Delhi
7. Additional Director MCTC CGHS, New Delhi
8. JD(HQ), JD (Grievance)/JD (R&R), CGHS, Delhi
9. Rajya Sabha/Lok Sabha Secretariat, New Delhi
10. Registrar, Supreme Court of India, New Delhi
11 . U.P.S.C. Dholpur House, New Delhi
12. Office of the Comptroller & Auditor General of India, Bahadur Shah Zafar Marg, New Delhi
13. PPS to Secretary (AYUSH)/Secretary (HR)/Secretary (AIDS Control), Ministry of Health & Family Welfare
14. PPS to DGHS/AS&DG NRHWAS(H), MoHFW, New Delhi
15. CGHS(P) Section, MoHFW, Nirman Bhawan, New Delhi
16. MG-II Section, Dte.GHS, Nirman Bhawan, New Delhi
17. Hospital Empanelment Cell, CGHS, MoHFW, Nirman Bhawan, New Delhi
18. CGHS-I/II/III/IV, Dte. Gen of CGHS, MoHFW, Nirman Bhawan, New Delhi
19. Estt.l/Estt.ll/Estt.lIl/Estt.lV Section, MoHFW, Nirman Bhawan, New Delhi
20. Admn.l/Admn.ll Section, Dte.GHS, MoHFW, Nirman Bhawan, New Delhi
21 . Integrated Finance Division, MoHFW, Nirman Bhawan, New Delhi
22. All Officers/Sections/Desks in the Ministry
23. Deputy Secretary (Civil Service News), Department of Personnel & Training, 5th Floor, Sardar Patel Bhawan, New Delhi
24. Shri Umraomal Purohit, Secretary, Staff Side, 13-C, Ferozshah Road, New Delhi
25. All Staff Side Members of National Council (JCM)
26. ED(H)/Planning, Railway Board, Ministry of Railways, Rail Bhawan, Rafi Marg, New Delhi - 110001
27. Central Organisation, ECHS, Department of Ex-Servicemen Welfare, Ministry of Defence, New Delhi
28. Chairman, Employees State Insurance Corporation, Ministry of Labour & Employment, Panchdeep Bhawan, C.I.G. Marg, New Delhi-110002
29. UTI-ITSL, 153/1, First Floor, Old Madras Road, Ulsoor, Bengaluru-560008.
30. Swat-ny Publishers (P) Ltd., P.B. No.2468, R.K. Puram, Chennai-600028
31 . Swamy Publishers (P) Ltd., 4855, 24, Ansari Road, Daryaganj, New Delhi
32. Sr. Technical Director, NIC, MoHFW, Nirman Bhawan, New Delhi with the request to upoad this 0M on the Ministry's website under the link of CS (MA) Rules — OMs and Circulars
33. Hindi Section, MoHFW, Nirman Bhawan, New Delhi for providing Hindi version of this 0M.
34. Guard file
F.N0.S.14025/14/2012-MS
Government of India
Ministry of Health and Family Welfare
Nirman Bhawan, New Delhi-110108
Dated 11th June, 2014.
OFFICE MEMORANDUM
Subject: Revision of rates for reimbursement of medical expenses incurred in emergency conditions under CS (MA) Rules, 1944.°°°*°°°
The undersigned is directed to state that the issue of revision of rates for reimbursement of medical expenses incurred on availing medical treatment in emergency conditions under CS (MA) Rules, 1944, when treatment is taken in a nonempanelled private hospital, has been under consideration of the Government for some time.
2. It has now been decided that, reimbursement of medical expenses incurred by a Central Government employee covered under CS (MA) Rules, 1944 on availing medical treatment for himself and his dependent family members in emergency conditions, would be allowed as per the prevailing non-NABH CGHS rates as applicable to a CGHS covered city and non-NABH rates applicable to the nearest CGHS covered city in case of non-CGHS city, as the case may be, or the actuals, whichever is less.
3. For the medical treatment in such cases where package rates are prescribed under CGHS, the non-NABH rates of the CGHS covered city and non-NABH rates of the nearest CGHS city (in case of non-CGHS covered city) or the actuals, whichever is less, will be applicable..
4. This OM supersedes all earlier orders issued from time to time under CS(MA) Rules, 1944 on this subject for allowing reimbursement of medical expenses in emergency conditions when treatment is taken in a non-empanelled private hospital.
5. This OM will come into effect from the date of issue.
6. This issues with the concurrence of the Integrated Finance Division vide their Dy.N0.C-282 dated 22.05.2013.
(V.P. Singh)
Deputy Secretary to the Government of India
l . All Ministries/Departments, Government of India
2. All States/UTs Governments
3. Rajya Sabha/Lok Sabha Secretariat
4. Registrar, Supreme Court of India
5. U.P.S.C. Dholpur House, Shahjahan road, new Delhi
6. Deputy Secretary (Civil Service News), Department of Personnel & Training, 5th Floor, Sardar Patel Bhawan, New Delhi.
7. Shri Umraomal Purohit, Secretary, Staff Side, 13-C,Ferozshah road, New Delhi
8. All Staff Side Members of National Council (JCM) (as per list attached)
9. Office of the Comptroller & Auditor General of India, Bahadur Shah Zafar Marg, New Delhi.
10. Section,Dte.GHS, MoHFW
11. CGHS(P) Division, MoHFW, Nirman Bhawan, New Delhi
12. Director, CGHS, Nirman Bhavan, New Delhi
13. AD (Hq), CGHS, Bikaner House, New Delhi
14. Addl.DDG (HQ), CGHS, MoHFW, Nirman Bhavan, New Delhi
15. All Addl Directors/Joint Directors of CGHS cities outside Delhi
16. Additional Director (SZ)/ CGHS, New Delhi
17. CGHS, Delhi
18. Hospital Empanelment Cell, CGHS, Nirman Bhawan, New Delhi
19. CGHS -1/11/111/1V, MoHFW, Nirman Bhawan, New Delhi
20. Estt.l /Estt.11/ Esst. 111/ Estt.1V Section, MoHFW, Nirman Bhavan
21. Admn.l/ Admn.ll Section , Dte. GHS, Nirman Bhawan, New Delhi
22. Integrated Finance Division, MoHFW, Nirman Bhawan, New Delhi
23. PPS to Secretary (H&FW)/Secretary (AYUSH)/Secretary (HR)/Secretary (AIDS Control), Ministry of Health & Family Welfare
24. PPS to DGHS/AS & DG FA / AS&MD, NRHM
25. Dr. D.P. Pande, Railway Board, Ministry of Railways, Rail Bhawan, Rafi Marg, New Delhi — 110001
26. Brig. S.P. Patil YSM, ODS, Central Organization, ECHS, Department of ExServicemen Welfare, Ministry of Defence, New Delhi
27. Chairman, Employees State Insurance Corporation, Ministry of Labour & Employment, Panchdeep Bhawan, C.I.G Marg, New Delhi -110 002
28. All Offices/Sections/Desks in the Ministry
29. Swamy Publishers (P) Ltd., P.B. No. 2468, R.R. Puram, Chennai 600028.
30. Swåmy Publishers (P) Ltd.,4855, 24, Ansari Road, Daryaganj, New Delhi.
31. Sr. Technical Director, NIC, MOHFW, Niman Bhawan, New Delhi with the request to upload this 0M on the Ministry's website under the link of CS(MA) Rules.
32. Hindi Section for providing Hindi version of this 0M.
33. Guard File
No.S. 14025/8/2010-MS
Government of India
Ministry of Health and Family Welfare
313, 'D' Wing, Nirman Bhawan, New Delhi — 110108
Dated 18th January,2011.
OFFICE MEMORANDUM
Subject:- Ceiling for reimbursement of special Nursing and Ayah/Attendant charges to the employees covered under CS(MA) Rules, 1944.****
The undersigned is directed to invite reference to this Ministry's 0M No.S.14025/74/86MS dated 30.10.1991, wherein an arrangement for reimbursement for special nursing has been made which stipulates that the amount of such reimbursement is limited to the amount which is in excess of 25% of the pay of the Government servant. Keeping in view the increase in pay and allowances and wages of nurses and ayah/attendants and in order to simplify the existing procedure, it has been decided to fix ceiling rates of special nurse and ayah/attendant for reimbursement to CS(MA) beneficiaries.
2. The Ceiling rates for such reimbursement to CS(MA) beneficiary would be as follows:
Special Nurse Rs.150/- per shift of 12 hours.
Ayah/Attendant Rs.75/- per shift of 12 hours.
3. The reimbursement of special charges for nurse and ayah/attendant at above rates is subject to the condition that for such purpose a certificate from the medical officer in-charge of the case in the hospital and countersigned by the medical superintendent of the hospital should be produced in the prescribed form as enclosed at annexure.
4. This order will be effective from the date of issue.
5. This issues with the concurrence of IFD vide Dy. No. C-2200 dated 05/01/2011.
(Sanjay Pant)
Under Secretary to the Government of India.
Tele:23061521.
1. All Ministries/Departments of Government of India.
2. All States/UTs Govemments.
3. Office of the Comptroller and Auditor General of India, Bahadur Shah Zafar Marg, New Delhi-110002.
4. CMO(SRA), Dte.GHS.
5. DDG(M), Dte.GHS.
6. Dte.GHS (M.G.-II Section), with 50 spare copies.
7. All officers/Sections in the Ministry of Health & FW.
8. Section.
9. Internal Finance Division, M/o Health & FW
10. Swamy Publishers (P) Ltd., P.B. No.2468, R.A. Puram, Chennai-600028.
11. Swamy Publishers (P) Ltd.,4855, 24, Ansari Road, Daryaganj, New Delhi.
12. Shri Umaraomal Purohit, Secretary, Staff Side, 13-C, Ferozshah Road, New Delhi 110001.
13. All Staff Side members of National Council (JCM).
14. NIC Division, Nirman Bhavan, New Delhi, with the request that same may be put on the website of this Ministry under the link of CS(MA) Rules.
15. Guard File of M.S. Section.
Annexure
CERTIFICATE
I certify that ....................................employed in the ................................. has been under treatment for ........................................... disease at the ................................. Hospital and that the services of the special ayah/attendant, for which an expenditure of Rs. ............... was incurred, vide bills and receipts attached, and were essential for the recovery/prevention of serious deterioration in the condition of the patient.
Countersigned
Medical Superintendent
.............................Hospital
Signature of the medical officer
in charge of the case at the hospital
Dated:....................
Government of India
Ministry of Health and Family Welfare
Department of Health & Family Welfare
Nirman Bhawan, Maulana Azad Road
New Delhi 110 108
No: 14021/12/2007-MS Dated the 1st October, 2009
OFFICE MEMORANDUM
Subject: NABH / NABL accreditation of Hospitals / Diaqnostic Centres recoqnised under Central Services (Medical Attendance) Rules, 1944.°°°°$°°°
The undersigned is directed to state that it has now been decided that NABH accreditation is compulsory for Hospitals for empanelment under Central Services (Medical Attendance) Rules, 1944. Henceforth, only such private hospitals that have obtained accreditation from NABH or equivalent would be eligible for empanelment under Central Services (Medical Attendance) Rules, 1944.
2. The hospitals that are already empanelled under Central Services (Medical Attendance) Rules, 1944 and which are not accredited by NABH shall apply for NABH accreditation within two months of receipt of this communication, if they have not applied for the same till date. In addition, the empanelled hospitals having in-house laboratories shall also apply for NABL Certification of the laboratory. Any hospital which does not apply for NABH accreditation shall be de-empanelled under Central Services (Medical Attendance) Rules, 1944.
3. Those hospitals / diagnostic centres apply for / accreditation under NABH / NABL must inform the office of the undersigned with supportive documents, failing which their names shall stand removed from the panel.
4. The hospitals that apply for accreditation should qualify and obtain certificate of full accreditation from NABH within twelve months, failing which they shall be de-panelled.
5. This issues with the approval of competent authority.
Deputy Secretary to the Government of India
[Telefax: 2306 3483]
To:
1. All hospitals recognised under CS (MA) Rules, 1944
2. Swamy Publishers (P) Ltd., P. B. No.2468, R. A. Puram, Chennai- 600028.
3. M/S Bahri Brothers, 742 Lajpat Rai Market, Delhi 110 006
4. Shri Umraomal Purohit, Secretary, Staff Side, 13-C, Ferozshah Road, N. Delhi — 110001.
5. All Staff Side members of National Council (JCM).
6. NIC, Nirman Bhawan with the request that the Office Memorandum be uploaded in the website of CS (MA) Rules
No.S. 14025/2/2011-MS
Government of India
Ministry of Health and Family Welfare
313, 'D' Wing, Nirman Bhawan, New Delhi — 110108
Email: s02ms-mohfw@nic.in
Dated the 11th January, 2011
OFFICE MEMORANDUM
Subject: Delegation of powers of Head of Department to Head of Office for settling permission cases and post facto approvai to reimbursement in relaxation of ruies in emergent cases under CGHS/CS(MA) Rules, 1944.°°°°$°°°
The undersigned is directed to invite reference to para (ii) of this Ministry's Office Memorandum No.S.14012/9/75-MC (MS) dated 18.06.1982, as mentioned at point 4 under Appendix-Vlll of CS(MA) Rules, 1944 relating to reimbursement in relaxation of rules in emergent cases, which stipulates that powers for settling permission cases and post facto approval should not be exercised by authorities lower than Heads of Departments.
2. The Ministry of Health and Family Welfare has examined the question of further deiegation of powers to Head of Offices/officers at Under Secretary level, in such offices, which are not headed by officers equivalent to a Deputy Secretary, in the matter and it has been decided with the approval of the competent authority to delegate such powers in the following manner:-
"In case of medical reimbursement, delegation of power can be given to Under Secretaries in the Departments of Central Government declared as Heads of Offices subject to the condition that upto Rs. two thousand for taking treatment in OPD and upto Rs- Five thousand for taking treatment in IPD under CGHS/CS(MA) Rules, 1944. This delegation of powers can be exercised as per the prescribed rate list of nearest CGHS covered city or actual whichever is lower for CS(MA) beneficiaries and as per package rate for CGHS beneficiaries in CGHS cities."
3. This order is applicable to both CGHS and CS(MA) beneficiaries.
4. This Office Memorandum issues with the approval of Ministry of Finance vide ID No 14(1 )/E.llA/2010 dated 06.07.2010.
(Sanjay Pant)
Under Secretary to the Government of India.
Tele:23061521.
1 . All Ministries/Departments of Government of India.
2. A!! States/UTs Governments.
3. Office of the Comptroller and Auditor General of India, Bahadur Shah Zafar Marg, New Delhi-110002.
4. CMO(SRA), DteGHS.
5. DDG(M), Dte.GHS.
6. Dte.GHS (M.G.-II Section), with 50 spare copies.
7. All officers/Sections in the Ministry of Health & FW.
8. Director (RR) and US (CGHS); Mio Health & FW
9. CGHS(P) Section.
10. Internal Finance Division, M/o Health & FW
11. Swamy Publishers (P) Ltd., P.B. No.2468, R.A. Puram, Chennai-600028.
No: 4-24/96-C&P/CGHS/CGHS (P)
Government of India,
Ministry of Health & Family Welfare
Department of Health & Family Welfare
***
Nirman Bhawan , New Delhi
Dated the 25th Febuary, 2009.
OFFICE MEMORANDUM
Subject:- Age Limit for dependent children of Government servants and pensioners for availing medical facilities under CGHS and Central Services (Medical Attendance) Rules, 1944 - Regarding.***
The undersigned is directed to refer to this Ministry's O.M. of even number dated 31.5.2007 on the subject noted above and to say that the issue of inclusion of name of married son, aged below 25 years, in the CGHS Card of a CGHS beneficiaries and beneficiaries covered under CS (MA), 1944 come up for consideration of this Ministry. The matter has been examined in consultation with the Department of Personnel & Trainings and it is clarified that the definition of "family" for the purpose of bxtending medical facilities to a beneficiaries under CGHS/CS(MA) Rules is primarily based on the definition of "family" as indicated in the CCS(Pension) Rules, 1972, CCS(LTC) Rules etc.; which does not include a married son even when below 25 years of age in the definition of "family" of the Central Government employee/pensioner.
It is therefore, clarified that, son of the Central Government employee who is a (beneficiary under either CGHS or CS (MA) Rules, 1944)/pensioner CGHS beneficiaries who is married, cannot be included in the definition of "family" for the purpose of extending medical facilities under CGHS/CS (MA) Rules, even when he is below 25 years of age and dependent upon the Central Government employee/pensioner
(R. RAVI)
DEPUTY SECRETARY TO THE GOVERNMENT OF INDIA.
(Tel: 2306 3483)
To:
1. All Ministries/Departments of Governments of India.
2. Director, CGHS, Nirman Bhavan, New Delhi.
3. All Pay & Accounts Officers under CGHS.
4. Additional Directors of CGHS.
5. JD CGHS, Delhi.
6. CGHS Desk-I/Desk-II/CGHS-I/CGHS-II, Dte.GHS, Nirman Bhawan, New Delhi.
7. Estt.I/Estt.II/Estt.III/Estt.IV Sections, Min. of Health & Family Welfare.
8. Admn.I/Admn.II Sections of Dte.GHS.
9. M.S. Section, Ministry of Health & Family Welfare.
10. Rajya Sabha/Lok Sabha Secretariat.
11. Registrar, Supreme Court of India/Delhi High Court, Sher Shah Road, New Delhi.
12. U.P.S.C., New Delhi.
13. Finance Division, Ministry of Health & Family Welfare.
14. Deputy Secretary (Civil Service News), Department of Personnel & Training, 5th Floor, Sardar Patel Bhawan, New Delhi.
15. PPS to Secretary (H& FW), Min. of Health & Family Welfare.
16. PPS to DGHS/AS&FA/AS (J), AS NACO.
17. Swamy Publishers (P) Ltd., P.B.No.2468, R.A. Puram, Chennai 600028.
18. Swamy Publishers (P) Ltd., 4855; 24, Ansari Road, Near Sanjeevan Hospital, Daryaganj, New Delhi - 110002.
19. Shri Umraomal Purohit, Secretary, Staff Side, 13-C, Ferozshah Road, New Delhi-11OOO1.
20. All staff side members of National Council (JCM).
21. Office of the Comptroller & Auditor General of India, 10 Bahadur Shah Zafar Marg, New Delhi.
22. All Officers/Sections/Desks in the Ministry of Health & Family Welfare.
23. Office copy folder.
24. Guard file.
25. NIC for uploading in the web site of CGHS and CSMA rules 1944.
Copy forwarded, for information, to the Deputy Director (Health & Family Welfare), Railway Board, Ministry of Railways, Rail Bhawan, New Delhi, w.r.t. Office Memorandum No.2008/H-1/2/15 dated the 7th August, 2008, received in the Ministry of Health & Family Welfare from Railway Board.
(R. RAVI)
DEPUTY SECRETARY TO THE GOVERNMENT OF INDIA.
(Tel: 2306 3483)
Nos. 14025/23/2008-MS
Government of India
Ministry of Health and Family Welfare
313, 'D' Wing, Nirman Bhawan, New Delhi - 110108
Email: s02ms-mohfw@nic.in
********
Dated 30.06.2008
OFFICE MEMORANDUM
******
The undersigned is directed to invite reference to Government of India's Decision 28 (ii) below Rule 2 of CS(MA) Rules, 1944, wherein an arrangement for reimbursement for engaging special Attendant/Ayah has been made. Now on receipt of a number of requests for reimbursement of Ayah Charges, this Ministry has decided to delegate the powers to the 'Head of Office' for reimbursement of Ayah/Attendant charges for the period of stay as indoor patient in the hospitals recognized by the State Government/CGHS Rules/CS(MA) Rules, 1944, under CS(MA) Rules, 1944,
2. The Ceiling limit for such reimbursement would be Rs.2000/- only.
3. It is also mentioned that for such purpose a certificate from the medical officer incharge of the case in the hospital and countersigned by the medical superintendent of the hospital should be produced in the form appended below.
4. This Office Memorandum issues with the concurrence of IFD vide Dy. No.736 dated 23.5.2008.
CERTIFICATE FORM
I certify that ........................................ employed in the ........................ has been under treatment for ............................. disease at the Hospital ...................... and that the services of the special ayah/attendant, for which an expenditure of Rs......... was incurred, vide bills and receipts attached, and were essential for the recovery/prevention of serious deterioration in the condition of the patient.
Countersigned
Medical Superintendent
................Hospital
signature of the medical officer
in charge of the case at the hospital
Dated: ....................
(Jai Prakash)
Under Secretary to the Government of India.
Tele.•23061881.
To,
1 . All Ministries/Departments of Government of India.
2. All States/UTs Governments.
3. Office of the Comptroller and Auditor General of India, Bahadur Shah Zafar Marg, New Delhi-110002.
4. CMO(SRA), Dte.GHS.
5. DDG(M), Dte.GHS.
6. Dte.GHS (M.G.-II Section), with 50 spare copies.
7. All officers/Sections in the Ministry of Health & FW.
8. CGHS(P) Section.
9. Internal Finance Division, MIO Health & FW
10. Swamy Publishers (P) Ltd., P.B. No.2468, R.A. Puram, Chennai-600028.
11. Swamy Publishers (P) Ltd.,4855, 24, Ansari Road, Daryaganj, New Delhi.
12. Shri Umaraomal Purohit, Secretary, Staff Side, 13-C, Ferozshah Road, New Delhi- 10001,
13.A taff Side members of National Council (JCM).
14.NIC Division, Nirman Bhavan, New Delhi, with the request that same may be put on the website of this Ministry under the link of CS(MA) Rules.
15. Guard File of M.S. Section.
(Jai Prakash)
Under Secretary to the Government of India.
Tele.•23061881.
F.No.S.14025/10/2001-MS
Government of India
Ministry of Health & Family Welfare
(Department of Health)
Nirman Bhavan, New Delhi
Dated the 31 Dec., 2002.
OFFICE MEMORANDUM
Sub:- CS(MA) Rules, 1944 - Revision of consultation/Visiting/Injection fees of Authorised Medical Attendants.°°°°°
The undersigned is directed to refer to O.M.No.S.14025/14/98-MS dated 30.3.98 on the subject mentioned above and to say that the issue of further revision of consultation/visiting/injection fees of different categories of Medical Officers of various States/Uts. has been under consideration of this Ministry. It has now been decided to revise the same as indicated below:-
I.Medical Post-Graduates/Specialists
- i. Consultation Fees-
First consultation : Rs.50/-
Subsequent consultation : Rs.30/- - ii. Visiting Fees-
Day : Rs.50/-
Night : Rs.60/- - iii. Injection Fees-
Intra-muscular/Subcutaneous : Rs.10/-
Intravenous Rs.20/- -
II.Medical Licentiates and Medical Graduates
(MBBS or equivalent) - i. Consultation Fees-
First consultation : Rs.35/-
Subsequent consultation : Rs.20/- - ii. Visiting Fees-
Day : Rs.40/-
Night : Rs.50/- - iii. Injection Fees-
Intra-muscular/Subcutaneous : Rs.10/-
Intravenous Rs.20/-
2. In areas where CGHS facilities exist the rates of such consultation fees etc. under CS(MA) Rules would be at par with the CGHS rates of station concerned.
3. These orders will supersede the earlier orders issued on the subject from the date of issue.
4. This issues with the concurrence of Ministry of Finance (Deptt. of Expenditure) vide U.O.No.467/EV/2002 dated 28.10.2002.
5. In so far as persons serving in the Indian Audit and Accounts Departments are concerned this issues with the concurrence of the Office of the Comptroller and Auditor General of India vide their U.O.No.255-Audit(Rules)/77-2002 dated 18.12.2002.
(B.B.BHATTACHARJEE)
DEPUTY SECRETARY TO THE OOVf.OF INDIA.
To:
1. All Ministries, etc. as per distribution list.
2. All States/U. T. Govts.
3. Dte.GHS (MG-II Section) with 20 spare copies.
4. All Officers/Sections in the Ministry of Health and Family Welfare, Ninnan Bhavan, New Delhi.
5. The Manager, Editorial Deptt, Swamys Publishers (P) Ltd, Sandhya Mansions, 164. R.K.Mun Road,P.B.No.2468, Raja Annamaliapurarn, Chennai, 6000 028.
6. The Office of the Comptroller and Auditor General of India, Bahadur Shah Zafar Marg, New Delhi-110002.
7. Hony. Secretary, Central Govt. Employees Welfare Co-ordination Committee C/o Income Tax Department Aayakar Bhavan (Annexe), B-13, Chowringhee Saware,'Calcutm-700 069.
8. Guard File.
OMs in supersession of 14025/23/2008-MS dated 30.06.2008:
MoH and FW OM No.S. 14025/8/2010-MS dated 18.01.2011:
The Ceiling rates for such reimbursement to CS(MA) beneficiary would be as follows subject to the condition that for such purpose a certificate from the medical officer in-charge of the case in the hospital and countersigned by the medical superintendent of the hospital should be produced in the Prescribed form :
Special Nurse Rs.150/- per shift of 12 hours.
Ayah/Attendant Rs.75/- per shift of 12 hours.
Earlier OMs on the subject up to 17.01.2011
MoH and FW OM No. S.14025/23/2008-MS dt.30.06.2008:
The Ministry of Health and family welfare has decided to delegate the powers to the 'Head of Office' for reimbursement of Ayah/Attendant charges for the period of stay as indoor patient in the hospitals recognized by the State Government/CGHS Rules/CS(MA) Rules, 1944, under CS(MA) Rules, 1944, subject to:
i.The Ceiling limit for such reimbursement would be Rs.2000/- only.
ii.A certificate from the medical officer incharge of the case in the hospital and countersigned by the medical superintendent of the hospital should be in the Prescribed form :
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