Company : Sol Infotech Pvt. Ltd. Website : www.courtkutchehry.com ANDHRA PRADESH HOUSING BOARD MEDICAL REIMBURSEMENT RULES, 1975 CONTENTS 1. . 2. In these rules, unless the context otherwise requires 3. Medical attendance 4. Medical Treatment 5. Persons entitled to free medical treatment 6. Arrangements for free Medical attendance 7. . 8. . 9. Consultation with specialists or Colleagues 10. Travelling Allowance 11. Medical Attendance Charges 12. Treatment under Indian System of Medicines 13. . 14. . ANDHRA PRADESH HOUSING BOARD MEDICAL REIMBURSEMENT RULES, 1975 ANDHRA PRADESH HOUSING BOARD MEDICAL REIMBURSEMENT RULES, 1975 1. . :- These rules may be called the Andhra Pradesh Housing Board (Medical Reimbursement) Rules, 1975. 2. In these rules, unless the context otherwise requires :- (a) " Authorised Medical Attendant" means a Medical Officer attached to a Government Hospital or dispensary in the State who has been nominated by the Government from time to time to serve as an authorised Medical attendant for the employees of the Housing BoardA list of authorised Medical attendants appointed by the Government is given in Appendix 1 to these rules. (b) "Employee" means a whole time Officer and servant of the Andhra Pradesh Housing Board, but does not include part time or honorary worker. (c) "Family" means (i) in the case of male employees, his parents, wife, legitimate children, residing with and wholly dependent on him. (ii) in case of woman employees, her parents, husband and children residing with and wholly dependent on her. Explanation :- A married daughter who is under the protection of her husband does not come within the definition of Family for purpose of these rules. (ii) The deserted, divorced or widowed daughters who are residing with the entirely dependant on the employees of Local Bodies drawing salaries not exceeding Rs300 per month are eligible for medical concession allowed to the employees under these rules. (iii) The claim for reimbursement of expenses in respect in of parents should be accompanied by a declaration in the proforma given below :- PROFORMA I,..............(Full name and designation) hereby declare that my father/mother ................has no property or income of his her own and that he she is wholly dependent on me Signature and Date (d) " Government" means Government of Andhra Pradesh. (e) "Hospital" means a Government hospital and includes any particular Hospital in the state or any Medical institution recognised by the Government. (f) "Patient" means an employee of the Board or any member of his her family and to whom these rules apply to and who has fallen ill. 3. Medical attendance :- 1Medical attendance in respect of an employee whose pay is not less than Rs 500 per month means (i) Attendance in a hospital or at the consulting room of the authorised medical attendant or at the residence of the employee. (ii) All pathological, Bacteriological, Radiological and other methods of examinations for the purposes of diagnosis as are available in any Government Hospital within the State and are considered necessary by the authorised Medical Attendant. (iii) Any consultation with a Specialist in Government employment within the State or other Medical Officer, similarly in Government employment within the State or that the authorised Medical attendant may certify to be necessary to such extent and in such manner as Specialist, or Medical Officer may in consultation with authorised Medical attendant, determine. 2Medical attendance in respect of any other employee means (i) Attendance at a Government Hospital or at the consulting room of the authorised Medical attendant or in case of illness which compels the patient to be confined to his residence at the residence of the employee. (ii) All methods of examination for purpose of diagnosis that are available in the nearest Government hospital. (iii) Any consultation with a specialist or other Medical Officer stationed in the State that the authorised Medical Attendant may certify to be necessary to such extent and in such manner as the Specialist or Medical Officer may in consultation with the authorised Medical attendant determine. 3There will be cases of not infrequent occurrence in which it will be proper for the Medical Officer to visit the employees in respect of salaries under rupees one hundred at their residencesThe Board trust to the good sense and good feeling of the Medical profession in preference to laying down any precise rules for such cases. 4It should be distinctly understood that a Medical Officer will not be expected to attend an employee at his residence unless the patient is unable to wait upon the Medical Officer either at the latter s residence or his consulting room or till such time as may be appointed by the Medical Officer for the purpose. 5Medical Officers who are authorised Medical attendants to the employees should not charge any consultation or other fees for the employees for the Medical attendance rendered to them. 4. Medical Treatment :- Medical treatment means use of all medical and surgical facilities available at the Government Hospital in which the patient is treated and includes: (1) Employment of such pathological, bacteriological, radiological or other methods of investigation etc., as are considered necessary by the Authorised Medical Attendant. (2) Supply of such medicines, Special or ordinary, vaccines, sera or other therapeutic substances as are ordinarily available in Government Hospitals in the State. (3) Supply of such medicines, vaccines, sera or other therapeutic substances, as are not ordinarily available in Government Hospitals, as the Authorised Medical Attendant may certify in writing to be essential for the recovery or for the prevention of deteriorations in the condition of the patient (i) The refund of the cost of preparations which are not medicines but are primarily food, tonics, toilet preparations or disinfectants is not admissible under the rulesPrescription of expensive drugs, tonics, laxatives or other elegant and proprietary preparations for the use of employees and members of their families when drugs of equal therapeutic value are available in Hospitals and dispensaries is prohibitedList of items for which refund is not admissible under these rules shall be such as may be specified by the Director of Medical and Health Services from time to time under Andhra Pradesh Medical attendance rules. (ii) Sales tax paid by Employees while purchasing special medicines from the market is refundable under these rulesPacking and postage charges paid by employees for purchasing special medicines from out stations are not refundable. (iii) All Claims for refund of expenses incurred on account of the purchase of the special medicines should be preferred in the manner indicated in Appendix II. (4) Treatment of confinement cases of an employee and includes prenatal and post-natal treatment. (5) Such accommodation as is ordinarily provided in the Hospital and is suited to the status of an employee with reference to his salary, as indicated below:- TABLE (i) Employees drawing Rs.500/- and above per month., 'A' Class ward. In case accommodation in 'A' Class ward (Single room with/without attached bath room. ( ) Other employees drawing B-Class ward (Cement or (ii) Rs.250/- to 499/- Per month, wooden partitioned cubicles). (iii) Employees drawing Rs.100- 249 per month. C-Class ward (Curtained Cubicles). (iv) Employees drawing below Rs.100/- per month. General Ward. (6) Such nursing as is ordinarily available provided in the hospital and is suited to his status and includes such Special nursing as the Authorised Medical Attendant may certify in writing to be essential for the recovery or for the prevention of serious deterioration in the condition of the employee If at all an employee requires extra nursing he may engage an attendant at his own cost. (7) Such diet as is ordinarily provided to other patients in the hospitals: (8) Blood transfusion service. (9) Provision of ambulance service wherever necessary for the transport, of the patient to the Hospital. 5. Persons entitled to free medical treatment :- (1) All employees of Housing Board are entitled to free Medical attendance whether they are on duty or on leave. (2) All the employees drawing salaries not exceeding Rs.300 per month and members of their families when admitted to State Government Medical Institutions are exempted from payment of diet charges and the entire cost of Special and expensive drugs administered to them. 6. Arrangements for free Medical attendance :- (1) All employees are eligible for free medical attendance in the Government Hospitals in the State and to the extent specified in Rule 4 above. (2) Persons entitled to treatment free of charge in any Hospital, shall produce before the Hospital authorities an identification certificate signed by the Secretary of Housing Board or by a Gazetted Officer dealing with establishment matters or by the Head of the Office in which they are working in the following form: Andhra Pradesh Housing Board Identification Certificate Name of the Officer/Official. Designation. Accommodation to which Officer/ Official is entitled in Government Hospital. Station: Date: Signature of the Secretary of the Board The Head of Office. In emergency cases the above certificate will not be insisted upon at the time of admission, but the same should be produced within a period of one week. (3) In any station where there may be an Assistant Surgeon and where there may not be proper Hospital accommodation, the duty of such Officer should be to attend at their own residence the Upper subordinate grades of employees including Clerks whose appointment are not Gazetted the later paying conveyance hire should they reside more than two miles from the Official residence o f the Medical attendantIf the distance is such as to entitle the Medical Officer to travelling allowance, the amount is payable by the BoardShould the case be reported as serious the Civil Surgeon will visit the patient. (4) The Medical Officers employed in the following Classes of Institutions should render free medical attendance to employees at the Stations where there are no Government Medical Institutions (i) Local Fund and Municipal Medical Institutions for which a percentage contribution is given by Government to meet the pay of Medical Officer employed there. (ii) Local Fund and Municipal Medical Institutions in respect of which the Government meet one half of the annual maintenance charges. (iii) Local Fund and Municipal Taluk Head Quarters Medical Institutions in respect of which the Government meets the entire or a portion of the salaries of Government Medical Officers employed in them. (iv) In places where there are no Government Hospitals but where there are Local Fund or Private Hospitals or dispensaries, the employees drawing less than Rs.300 per mensem and their families may take treatment straightaway in such institution and that the expenditure incurred by them in that connection including the cost of special and expensive drugs purchased by them on the prescription of the Doctor in charge of the institution, be reimbursed subject to the production of relevant vouchers and subject to the scrutiny of the relative bills by the authorised Medical attendant At places where there are no Government or Non Government Medical Institutions, employees drawing less than Rs.300 per mensem and their families may avail themselves of the services of a Local private doctor in emergencies, when there is no sufficient time for them to go to the nearest Government or non Government Medical InstitutionThe expenditure incurred by them in that connection will be reimbursed to them subject to the production of relevant vouchers and subject to the scrutiny of the relative bills by the District Medical and Health Officer concerned and to his certifying that the amount claimed is reasonable and the expenditure incurred was necessaryIn non emergent cases, the entitled personnel serving in places where there are neither Government Medical Institutions nor non Government Medical Institutions go to the Government Medical Institutions of the non Government Medical Institution at the nearest station for treatment. (v) (a) Employees drawing salary not exceeding Rs.300 per mensem in stations where there are no Government or non Government Medical Institutions who seek treatment in an emergency, under local private doctors should in addition to the essentiality certificate from the private doctors produced a certificate in the form given hereunder from the nearest authorised Medical attendant immediately after they are in a fit condition to travel to the nearest Medical attendant who will judge whether the essentiality certificate issued by the Local private doctor in such cases is a genuine one or not I certify that there are no Government or non government Medical Institutions available in the..................... I also certify that I examined the patient (Name) Designation.........................(Department).................and consider that the case in question is an emergency one requiring immediate treatment under a local private Doctor . Signature of Authorised Medical Attendant. (b) The Local Private Registered Medical Practioner should prescribe the drug contained in the list in the Appendix III as far as possible. 7. . :- (1) An employee shall be entitled free of charges (i) to treatment................. (a) in such Government Hospital at or near the place where he falls ill, as can in the opinion of the authorised Medical attendant, provide the necessary and suitable treatment; (b) If there be no such Hospital as is referred to in Sub clause (a) in such Hospital, other than a Government Hospital, at or near that place as can in the opinion of the authorised Medical attendant, provide the necessary and suitable treatment; (ii) to anti rabic treatment at the nearest Government Hospital providing such treatment. (2) Where an employee is entitled under Sub rule (1) free of charge, of charge to treatment in any Hospital any amount paid by him on account of such treatment shall on production of a certificate in writing by the authorised Medical attendant in this behalf be reimbursed to him by the Board. 8. . :- (1) If the authorised medical attendant is of the opinion that owing to the absence or remotness of a suitable Hospital or to the severity of the illness, an employee cannot be given treatment as provided in Rule (6), the employee may receive treatment at his residence. (2) An employee receiving treatment at his residence under Sub rule (1), shall be entitled to receive towards the cost of such treatment incurred by him, a sum equivalent to the cost of such treatment as he would have been entitled, free of charges, to receive under these rules, if he had not been treated at his residence. (3) Claims for sums admissible under Sub rule (2) shall be accompanied by a certificate in writing by the authorised Medical attendant stating (a) his reasons for the opinion referred to in Sub rule (1), (b) the cost of similar treatment referred to in Sub rule (2). 9. Consultation with specialists or Colleagues :- (1) If the authorised Medical attendant is of opinion that the case of the patient is of such serious or special nature as to require medical attendant by some person other than himself or that the patient requires anti rabic treatment he may with the approval of the Director of Medical services (which shall be obtained before hand unless the delay involved entails danger to the health of the patient) (a) Send the patient to the nearest Specialist or other Medical Officer by whom in his opinion, Medical attendance is required for the patient on in the case of anti rabic treatment, to the nearest place where such treatment is available; or (b) If the patient is too ill to travel, summons such specialist or order medical Officer to attend upon the patient. (2) A patient sent under Clause (a) of Sub rule (1) shall on production of a certificate in writing by the authorised medical attendant in this behalf, he entitled to travelling allowance for the journeys to and from the Headquarters of the specialist or other Medical Officer or the place where he is sent for anti rabic treatment. (3) A specialist or other Medical Officer summoned under Sub rule (1) shall on production of a certificate in writing by the authorised Medical attendant in this behalf, be entitled to travelling allowance for the journey to and from the place where the patient is and also daily allowance according to rules. 10. Travelling Allowance :- (1) T.Afor journeys undertaken under Rule (9) shall be at the rates admissible to an employee when on tour. (2) A member of the family of an employee shall be entitled to travel by a class by which the employee himself is entitled to travel. 11. Medical Attendance Charges :- (1) Charges for services rendered in connection with but not included in medical attendance on or treatment of a patient entitled to free Medical attendance or treatment under these rules, shall be determined by the authorised Medical attendant and paid by the patient. (2) If any question arises as to whether any service is included in Medical attendance or treatment, it shall be referred to the Government and the decision of the Government shall be final. 12. Treatment under Indian System of Medicines :- The following procedure is prescribed for getting reimbursement of cost of medicine purchased by the persons entitled to free medical attendance or treatment when treatment is taken under the indigenous system of medicine either in the Government Institutions or Local Fund or Private Institutions or under Private Doctors (1) The bills relating to the modern medicine, if any prescribed by the Medical Officer in private or Local Fund Institutions or by the Private practitioner will be scrutinised by the authorised medical attendant of the entitled persons in cases where the treatment was received, in or local fund or private institutions or indigenous medicines, and by the District Medical Officer concerned, in cases where the treatment was received from a private practioner of indigenous medicines. (2) The bills relating to the indigenous medicine will be scrutinised by the Medical Officers or Officers concerned of the three respective system of medicines (Ayurveda, Sidha and Unani) employed in the Government Ayurvedic Hospital, Charminar, Hyderabad to be nominated by the Special Officer of the Indian Medicine Department with the approval of the Government. (3) If the bills, relate to both modern and indigenous medicine they will first be scrutinised by the authorised medical attendant, or the District Medical Officer as the case may be in regard to the modern medicine, and then by Medical Officer or Officers of the Government Ayurvedic Hospital, Hyderabad in respect of the indigenous medicine. (4) The claims in respect of treatment under Indian Medicine System be sanctioned by the Special Officer [Indian Medicine Department] after due scrutiny, wherever such claims are admissible under rules. (2) A list of items for which refund is not admissible under the rules shall be such as may be specified by the Director of Medical and Health Service, from time to time under Andhra Pradesh Medical Attendance Rules. 13. . :- Treatment for T.BRules regulating admission of T.BPatients in Government T.Binstitutions and other Government Medical Institutions where there are T.BWards as are applicable to Officers and servants of Government under Andhra Pradesh Medical Attendance Rules shall apply to Housing Board Employees. 14. . :- Medical advances to Non Gazetted Employees Non Gazetted Employees of Housing Board are eligible for advances to meet the expenses on Medical attendance and treatmentThe grant of advance shall be by the Rules given in Appendix IV.