GO No 32 Employees Health Scheme Providing Cashless medical treatment in Telangana
Telangana State Government Health, Medical & Family Welfare Department issued Go No32 dated 03-04-2014.As per Go Employees Health Scheme – Providing Cashless medical treatment to the State Government Employees, Pensioners and their dependent family members
- The erstwhile Government of Andhra Pradesh have formulated Employees Health Scheme 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. In the G.O.2nd read above operational guidelines for issue of health cards were issued and in the G.O.3rd read above, the package prices for the listed therapies were notified.
- Consequent on reorganization of Andhra Pradesh into the States of Telangana and Andhra Pradesh, the Chief Minister of Telangana reviewed the implementation of the Employees Health Scheme in the meeting held on 21-10-2014 in the light of the representations made by the representatives of Employees / Pensioners Associations and decided that the Scheme be implemented with the following modifications:
(A)The total cost on implementation of Employees Health Scheme shall be borne by the Government and no contribution will be collected from the employees/ pensioners.
(B)There shall be no upper limit on the financial coverage and the total cost of treatment of the patient for the enlisted therapies will be covered under the Scheme.
(C)Treatment for all the enlisted procedures will be provided in all the network hospitals (both private and Government) empanelled with Aarogyasri Health Care Trust. However position will be reviewed after six months so as to ensure a minimum of 60% participation by Government Hospitals in terms of amount. To achieve that, if required, certain procedures may be reserved for Government hospitals which have required infrastructure for such procedures.
(D)Out patient for Chronic Diseases will be provided in the notified Government Hospitals only and the guidelines for chronic OP treatment shall be issued separately.
(E)There is no need for ‘steering committee’ for the Scheme.
(F)Inclusion of other categories of employees will be examined after implementation of the Scheme for six months.
- Accordingly Government hereby direct that the “Employees Health Scheme” shall be implemented with effect from 01-11-2014 with the modifications mentioned in para-2 above.
- Accordingly all fresh cases of treatments with effect from 01-11-2014 shall be governed by above scheme and all such cases shall not be eligible for any reimbursement. However all cases of treatment commenced prior to 01-11-2014 shall be eligible for reimbursement as per Rules for reimbursement.
- This order issues with the concurrence of Finance Department vide their No.388/PFS/14, dt.24-10-2014.
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