Government Medical Attendance Rules 1944 and Reimbursement Guidelines
Learn about the Medical Attendance Rules of 1944 applicable to Central Government employees, covering free medical treatment under CGHS/CSMA rules, treatment options for those residing within or outside CGHS covered areas, authorized hospitals, reimbursement procedures, annual medical examinations, dependency criteria, special treatment cases, and more.
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Presentation Transcript
MEDICAL ATTENDANCE RULES.1944 1. All central Government employees are entitled to get free medical treatment as per CGHS/CSMA Rules. 2. Government servants who reside in the CGHS covered area are entitled to get CGHS facility and are governed by the CGHS rules. 3. The government servants who reside outside of CGHS covered area are entitled to get treated under CSMA rule for which certain doctors have been nominated for areas specified. These doctors are functioning as Authorised Medical Attendants (AMA) for treatment up to 10 days.
Medical Reimbursement 4. Cases which require specialized treatment are referred to government hospitals by AMA. Medical advances are authorized upto maximum limit of 90% of the treatment cost based on the estimates prepared by hospital. 5. The treatment can be obtained from all the Government /CGHS approved hospitals. 6. In addition to CGHS approved hospitals, certain private labs have been authorized for undertaking tests and for treatment on grant of permission by the competent authority to the employees. Authorized Hospitals :- 1. All State Govt. Hospitals (2) All Hospitals attached to PSUs / Projects / Port Trusts. (3) All Maternity & Child welfare centres recognized by State Govt. (4) Cantonment Hospitals (5) Railway Hospitals
1. Annual Medical Examination for Group-A Oficers of 40 years of age and above. Male employee 2,000 Female Employee 2,200 2. When both Husband & wife are employed :- A joint declaration to be furnsihed as to who will be preferring the claim. 3. Dependancy :- The income limit for dependency of family members (other than spouse) is Rs.9,000/- plus the amount of Dearness Relief admissible.
Salient Features :- 1. No treatment from AMA when the latter is on regular leave. 3. Cash Memo to be countersigned by the doctor prescribing the medicines and the Essentiality Certificate must contain the name of the medicines prescribed and amount incurred on the purchase of each medicine. 4. Designation and degree of the doctor to be indicated on Essentiality Certificates, bills etc. 5. Time Limit for submission of medical bills 6 months 6. Individual employees-wise Medical Reimbursement Register to be maintained. 7. Medical Advance may be paid 90% of he approved CGHS package rates for all kinds of indoor treatments irrespective of Major and Minor diseases.
Age limit of dependants : Son Till starts earning or attains the age of 25 years. Daughter Till starts earning or gets married, irrespective of the age-limit, whichever is earlier. PH Son Irrespective of age limit. Divorced / separated /widowed daughters - Irrespective of age limit. Minor Brothers Upto the age of becoming major PH dependant brother - Irrespective of age limit. Features :- 1. CS(MA) rules 1944 is applicable to adoptive parents. 2. Also applicable for parents-in-law of female Govt. servants.
Revised Rate of consultation / visiting/ Injection Fees of AMAs Consultation with Medical Oist gradute / Specialists :- Consultation Fees : 1. First Consultation 100 2. Subsequent Consultation 60 Injection Fees : 1. Intramuscular / Subcutaneous 20 2. Intravenous - 40 Consultation with MBBS (Medical Graduates) Consultation Fees : 1. First Consultation 70 2. Subsequent Consultation 40 Injection Fees : 1. Intramuscular / Subcutaneous 20 2. Intravenous - 40
Revision of Celling rates for reimbursement of cost of Cardiac Pacemakers etc. 1 Single Chamber Cardiac Pacemaker (Without Rate response) 34,840 + GST 2 Single Chamber Cardiac Pacemaker (Without Rate response) 44,928 + GST 3 Dual Chamber Cardiac Pacemaker 83,200 + GST 4 Bi-Ventricular Cardiac Pacemaker 1,95,000 + GST 5 Implantable Cardioverter Defibrillator (Single Chamber0 1,75,786 + GST 6 Implantable Cardioverter Defibrillator (Dual Chamber) 3,75,000 + GST
