Go No 36 EHS–Detailed guidelines on Chronic Out-patient Treatment

HEALTH, MEDICAL AND FAMILY WELFRE (A2) DEPARTMENT issued G.O.MS.No. 36. Dated: 27-11-2014 details of Go Health, Medical and family Welfare – Employees Health Scheme (EHS)– Detailed guidelines on Chronic Out-patient (OP) Treatment – Issued– Orders.
Read the following:
  1. G.O.Ms.No.174 HM&FW (M2) Dept dt: 1-11-2013
  2. G.O.Ms.No.175 HM&FW (M2) Dept dt: 1-11-2013
  3. G.O.Ms.No.176 HM&FW (M2) Dept dt: 1-11-2013
  4. G.O.Ms.No.32 HM&FW (A2) Dept dt: 3-11-2014
  5. G.O.Ms.No.33 HM&FW (A2) Dept dt: 13-11-2014
  6. From the CEO., AHCT., Hyderabad, Lr.No.AST/5111/EHS Chronic Op-TG/P&C/2014, dt: 13-11-2014
O R D E R :
  1. In the G.O. 4th read above orders were issued for implementation of ‘Employees Health Scheme’ with effect from 01.11.2014 with the modifications specified therein. In para 2.4 of the said G.O., it is mentioned that outpatient treatment for chronic diseases will be provided in the notified Government Hospitals only, and that the guidelines for Chronic OP treatment will be issued separately.
  2. Accordingly, after careful examination, Government hereby issue the following guidelines for Chronic Out-Patient treatment in notified Government Hospitals (List Annexed).
  3. Chronic Out-Patient Treatment
  4. Chronic Out Patient (OP) treatment in Area Hospital / District Hospital/ Teaching Hospital.
    i.)For Chronic OP treatment at the Area Hospitals/District Hospitals/Teaching Hospitals, there will be exclusive special clinics run for EHS patients from 2 PM to 4 PM on week days.
    ii.)During the special clinic time a consultant doctor, pharmacy radiology services, and clinical laboratory services along with sample collection will be available.
    A fee of Rs.50 for broad specialty consultant and Rs.100 for super specialty consultant will be paid for every EHS OP case which is seen and registered in the online system.
    Commissioner of TVVP in case of area hospitals/ Superintendent of District Hospital/Superintendent of the teaching hospital will provide the needed computer infrastructure, network connectivity and make arrangements for online registration of OP cases. HDS funds which include accruals from Aarogyasri revenues may be utilized for this purpose.
    v.)The standard schedule of Rates (SSR) for medical inputs to be notified every year.
    From out of the income received for items above, the hospital will pay Rs.3000 per month to the pharmacy, Rs.3000 per month to the clinical laboratory and Rs.3000 per month to radiology as incentive which in turn will be shared on pro-rate basis between those pharmacists and technicians who offered services during the special clinic days.
    Drugs will be supplied to the notified hospitals by TMSIDC as per their indent and in turn TMSIDC will receive the budget from the Government.
    In case the required investigation facilities or drugs are not available within the hospitals, the hospital is at liberty to tie-up with a private facility for supply of drugs or investigation services at rates not exceeding those under the SSR.
    Within a period of 1 year TMSIDC will set up round-the- clock laboratory services and radiology services in all the teaching hospitals and district hospitals.
    Both the hospitals and TMSIDC will ensure that generic drugs from reputed firms alone are supplied to the patients under EHS.
  5. Chronic Out-Patient (OP) drug supply
  6. i.)The notified hospitals will supply the drugs needed for chronic ailments to the EHS Patients.
    ii)Payments will be made to the notified hospitals as per the annual package rate fixed for the particular chronic ailment, which include only Investigations and consultation.
    iii) All the notified hospitals will have online connectivity through which claims will be submitted. Director of Public Health / Commissioner TVVP / Superintendent of teaching hospitals or district hospitals will make necessary arrangements.
    iv ).In case the needed drugs / investigations are not able to be provided within the package for any particular patient a request for inclusion of additional drugs clearly specifying the ATC code and investigation need to be placed. AHCT will finalise the price for such items and notify in the SSR based on which payments will be made.
  7. Yearly Medical Check-up
  8. i) All the employees above 40 years will be eligible for a free medical check up in any of the ‘notified Government hospitals’ once in a year consisting of the following services, and payments will be made as per the package rates.
    ii.)The Medical Check-up will consists of :
    ¾ Lab investigations :
    o Haematology : Blood grouping & Ph typing, Hb, PCV, RBC, MCHC, MCV, MCH, Total WBC, Differential Count, ESR PLT, Peripheral smear, Complete Urine Analysis & Stool examination ;
    o Histophathology : Pap smear ;
    o Biochemistry : GTT, Serum creatinine, Urea and Uric acid, Lipid Profile (Total cholesterol, HDL Cholesterol, LDL Cholesterol, Triglycerides, Cardiac risk ration), Liver Function Test (Total protein, Albumin, Globulin, ALT, AST, GGTP), Prostate Specific Antigen (if needed), Serum Calcium ;
    o Microbiology : Test for HIV, HbsAg
    ¾ Radiology investigations :
    o ECG, Tread Mill Test, 2D Echo
    o X-Ray (Chest), Ultrasound (whole abdomen)
    ¾ Eye Examination :
    o Visual acuity, eye pressure, fundoscopy, refraction
    ¾ Others
    o Pulmonary Function Test and Diet Counselling
    o Consultation by physician, gynaecologist, ophthalmologist other specialists as required.
    ¾ For women Employees
    o Gynaecological
    o Pap smear
    o Mammogram
  9. The expenditure towards ‘chronic OP treatment’ would be met from the Employees Health Scheme budget.
  10. This order issues with the concurrence of Finance Department vide their U.O.No.6437/188/A1/EBS.V/2014, dated 21.11.2014.

Important Feature Posts Details

Go No 36 EHS–Detailed guidelines on Chronic Out-patient Treatment Go No 36 EHS–Detailed guidelines on Chronic Out-patient Treatment Reviewed by Tteachers on Thursday, November 27, 2014 Rating: 5