Instructions of non availment of EHS facility certificate should submit for claiming of Medical reimbursement

 

Instructions of non availment of EHS facility certificate should submit for claiming of Medical reimbursement  


                 New instructions given by Telangana state government to all state government employees to submit non availment of EHS certificate should submit  to claim medical reimbursement.

Circular memo no: H3/2807/2018  dated: 10.12.2020

 GOVERNMENT OF TELANGANA

TREASURIES AND ACCOUNTS DEPARTMENT

Sub: P. S &T A  Dept- Medical Reimbursement claims - Forwarding of the Medical Re-imbursement claims by unit officers - Certain omissions — Reg.  

  1.  G.O.Ms. No. 74 HM & FW (K1)Dept .  dated 15.03.2005.
  2.  G.O.Ms. No. 105 HM & FW K1) Dept .dated:09.04.07.
  3.   G.O.Ms No. 68 HM & FW (Kl) Dept dated 28.03.2011.
  4.   GO.Ms. No. 103 HM & FW (K2) Dept dated 31.05.2014.
  5.   G.O.Ms. No. 17 HM & FW (A2) Dept dated 16.09.2014,
  6.   G,O.Ms.N0.32, HM&FW, (A2) Dept., dated 4.11.2014.
  7.    G.O.Ms. No.54,HM & FW (Al) Dept dated.25.11.2020

     This office circular memo even no. dated 19.072018.

Vide reference 6 cited, the Government have given orders for implementation of Employees Health Scheme w.e.f .01.11.2014 to provide cashless treatment for the listed therapies in the empanelled hospitals, to all the Government employees, pensioners and their dependent family members in replacement of the medical reimbursement system under APIMA Rules, 1972. And stated that, all cases of treatment commenced prior to 01-11-2014 shall be eligible for reimbursement as per Rules for reimbursement.

Government have issued orders time to time for extension of the period for Medical re-imbursement, latest orders are vide reference 7th cited where it was extended up to 3 1-03-2021. 

        In view of the above orders, if an employee/pensioner avails EHS for a treatment, the same is not eligible for medical re-imbursement. Hence 'NON-AVAILMENT OF EMPLOYEE HEALTH SCHEME ' certificate from the hospital, where the treatment was given, is mandatory for claiming the amount if any under Medical-re-imbursement system along with the following documents.

1. Appendix-Il Form

2. Essentiality Certificate

3. Emergency Certificate

4. Discharge Summary

5. Non- Drawl Declaration, which should be attested by Drawing and Disbursing Officer concerned.

6. Declaration of Dependence to be attested by Gazetted Officer.

7. Copy of Pension Payment Order for retired employees.

8. Non Availment of EHS certificate. 

 Absence any one of the above documents listed above will be liable to the rejection of application. 

     Further, it has been observed that the unit officers are submitting/ forwarding the proposals to Govt. for relaxation of rules in routine manner without examination at their level and without furnishing specific remarks consisting of individual's reasons for sanction of gross admissible amount beyond the ceiling limits imposed by the government. The specific remarks and recommendation of the forwarding officer are necessary for forwarding the same to the government for relaxation.

 

The JD, PPO, Hyderabad, and DDS / DTOs shall communicate these orders to all concerned.

 

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