Go No 159 Health cards should be issued and Medical Reimbursement,shall run parallel till 28-02-2015

HEALTH, MEDICAL & FAMILY WELFRE (I.1) DEPARTMENT of AP issued Go NO 159 Dated 22-12-2014 the details of Go Health, Medical & Family welfare – Employees Health scheme – Further clarification - Orders – Issued.
Go No 159 Health cards should be issued and Medical Reimbursement,shall run parallel till 28-02-2015
Read the following:
1. G.O.Ms.No.174 HM&FW (M2) Dept dated 01-11-2013.
2. G.O.Ms.No.175 HM&FW (M2) Dept dated 01-11-2013.
3. G.O.Ms.No.176 HM&FW (M2) Dept dated 01-11-2013.
4. G.O.Ms.No.134 HM&FW (I1.1) Dept dated 29-10-2014 .
5. G.O.Ms.No.135 HM&FW (I1.1) Dept dated 29-10-2014 .
6. G.O.Rt.No.3578 GA(SW) Dept dated 30-10-2014.
7. G.O.Ms.No.210 Fin (TFR) Dept dated 15-11-2014.
8. G.O.Ms.No.150 HM&FW (I.1) Dept dated 04-12-2014.
9. G.O.Rt.No.4092 GA (SW) Dept dated 18-12-2014.
ORDER:
1.In the Government orders 1 st and 4 th read above, orders were issued for implementing ‘Employees Health scheme’ to provide ‘cashless’ treatment to the State Government employees, pensioners and their eligible dependent family members in replacement of the medical reimbursement system under APIMA Rules, 1972.
2. The employees’ Associations and Pensioners’ Ass ociations represented certain grievances on implementation of the Employees Health scheme. After careful consideration of the grievances, Government have taken the following decisions:
a. Health cards should be issued to all eligible employees and pensioners immediately in consultation with Finance and Medical & Health Depa rtments.
b. Necessary steps should be taken by Medical & Hea lth Department and Aarogyasri Health Care Trust to ensure treatment by all NABH accredit ed hospitals and other corporate hospitals to the card holders.
c. Cashless treatment to card holders and medical r eimbursement systems should run parallel for two more months, till cards are issued to all e ligible employees and pensioners and the Employees Health scheme is established.
d. The meeting of steering committee constituted fo r this purpose be held shortly to get more feedback and suggestions from the employees and pen sioners.

3. Accordingly, in accordance with the above decisi ons Government, hereby, issue the following orders:
(i) Finance Department shall make available to Aa rogyasri Health Care Trust, the data of all the employees, including the provincialised work charge d employees, together with the details relating to their eligible dependent family members including their aadhaar data, so as to enable Aarogyasri Health Care Trust to generate hea lth cards to all the employees. In case of any delay in getting the data of employ ees through CFMS., and furnishing to the Aarogyasri Health Care Trust, the eligible employe es who have not yet got health cards may be allowed to enroll themselves and their family me mbers with Aarogyasri Health Care Trust, in the ehs-portal, as in the case of pensioners.
(ii) Finance Department, in consultation with the Director of Treasuries and Accounts, shall evolve a procedure for enrolment of the pensioners of Andhra Pradesh State who settled in the neighbouring States of Tamilnadu and Karnataka. Till such time they are issued health cards under Employees Health scheme, they will cont inue to be covered under APIMA Rules, 1972.
(iii) The Aarogyasri Health Care Trust shall take a ction, in consultation and coordination with Director of Medical Education, to negotiate with the NABH accredited hospitals and other corporate hospitals, (which have not come forward t o provide treatment to the patients under Employees Health scheme), to participate in Employees Health scheme.
(iv) Aarogyasri Health Care Trust shall take actio n for empanelment of corporate hospitals in the neighbouring States, which are already providing se rvices to the respective State Governments under the relevant health schemes. (iv) General Administration (SW) Department shall take action to convene the meeting of the Steering Committee constituted in the G.Os.6 th and 9 th read above.
(v) The Employees Health scheme and medical reimbu rsement system under APIMA Rules, 1972 shall run parallel till 28-02-2015 and the med ical claims of the employees / pensioners under reimbursement system shall be processed in ac cordance with the APIMA Rules, 1972 and the orders issued thereunder.
(vi) Staff working in A.P.Bhavan, New Delhi will, however, continue to be covered by reimbursement under the existing APIMA Rules, 1972.
(vii) Even in the case of employees / pensioners w ho are having ‘health cards’, if they avail treatment in non-empanelled hospitals, in emergency , they may be allowed reimbursement, as per the package rates of Employees Health scheme .
(viii) Employees working in Nellore, Chittoor and Anantapur, having health cards, and seek treatment in the Super Specialty hospitals in Chenn ai, Vellore and Bangalore, respectively, especially in case of complicated diseases, will be allowed reimbursement as per the package rates of Employees Health scheme.
4. This order issues with the concurrence of Finance PFS (R&E) No.10501/PFS/(R&E),Dated. 20-12-2014.

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Go No 159 Health cards should be issued and Medical Reimbursement,shall run parallel till 28-02-2015 Go No 159 Health cards should be issued and Medical Reimbursement,shall run parallel till 28-02-2015 Reviewed by Tteachers on Monday, December 22, 2014 Rating: 5