BPMS published DOP&PW order regarding Fixed Medical Advance to the employees working in interior where AMA not available...
No.4/4/2013 -P&PW-(D)
Government of India
Ministry of Personnel, Public Grievances & Pensions
Department of Pension & Pensioners Welfare
Lok Nayak Bhavan, Khan Market,
New Delhi,
Dated the 6th December, 2013
OFFICE MEMORANDUM
Sub:-
Reimbursement
of medical expenses where payment of FMA is allowed to staff working in
the interior where AMA not available - request of Shri Mukesh Singh.The
undersigned is directed to forward herewith a representation dated
27/6/2013 of Shri Mukesh Singh in original received through Deptt. of
Expenditure vide letter No.164/EV/2013- Hindi dated 7.10.2013 for
considering the grievances raised therein expeditiously in accordance
with the extant rules/instructions under intimation to the
representationist to whom a copy of this communication is also being
endorsed.
Encl: As above.
sd/-
(Deepa Anand)
Under Secretary to the Govt. of India
BHARATIYA PRATIRAKSHA MAZDOOR SANGH
Ref: BPMS / CSMA / 156 (8/1/L)
Dated: 27.06.2013
To,
Smt. Sudha Krishnan,
Joint Secretary (Pers),
Govt of India, Min of Finance,
Department of Expenditure,
Room No. 39-A, North Block,
New Delhi – 110001
Subject:
Reimbursement of Medical Expenses where Payment of Fixed Medical
Allowance is allowed to staff working in the interior where AMA not
available.
Respected Madam,
With due regards, it is submitted
that this Federation has raised the subject matter before the
Secretary, MOH&FW and Min of Defence on 05.07.2011 and reminded from
time to time that Fourth Central Pay Commission (04th CPC) recommended
in Para 16.9 as under;
“We recognize that employees
covered by Medical Reimbursement Scheme (MRS) under the Central Services
(Medical Attendance) Rules, 1944 are experiencing difficulties as
regards the treatment and reimbursement of expenses incurred by them.
There is also considerable administrative and accounting work involved
in the settlement of claims. Various kinds of malpractices in the scheme
have also brought to our notice. We, therefore, recommend grant of a
Fixed Medical Allowance of Rs. 25/- per month for outdoor treatment to
all employees covered by MRS. The expenses incurred on special diseases
(cancer, diabetes, mental diseases, poliomyelitis, tubercular diseases
and leprosy) and hospitalization may continue to be reimbursed to all
employees as at present under the scheme”.Thereupon
Govt issued instructions vide G.O.I., M.H., O.M. No. S-14020/1/88-MS,
dated 17th July, 1990, 28th Sep, 1991, that quantum of medical
allowance of Rs. 25/- per month per employee working in interior may be
granted where no Authorized Medical Attendant is available within a
radius of 05 km, and if available, he is not willing to be appointed as
AMA.
It is worth to mention here that the reimbursement of
medical expenses for indoor treatment were allowed by the concerned
authorities though the employee was drawing Rs. 25/- per month FMA.
Subsequently, Fifth Central Pay Commission (5thCPC) also recommended in Para 114.24 on the subject matter as under;
“We
are in favour of a greater freedom of choice in obtaining medical aid
and advice, where Central Government is unable to organize its own
facilities for employees. Such a freedom, while aiming at development of
employees within their own responsibilities, will reduce much of
clerical work involved in medical reimbursement claims for day-to-day
need. For serious ailments and hospitalizations, however, we still do
not see any justification for removal of restrictions. Accordingly,
we recommend that in areas presently covered by Medical reimbursement
Scheme for outpatient purposes a medical allowance of Rs. 100/- per
month per employee may be granted only for outpatient facilities, not
provided by either CGHS or any departmental medical facilities.”
Thereupon
Govt issued instructions to enhance the quantum of FMA to Rs. 100/-
from Rs. 25/- per month per employee vide G.O.I., M.H., O.M. No.
S-14020/1/88-MS, dated 18th Jan, 1999, for employee working in interior
where no Authorized Medical Attendant is available within a radius of
05 km, and if available, he is not willing to be appointed as AMA.
But
this O.M. does not prohibit for reimbursing the medical expenses in
case the Government Employee or his dependant is being treated as
‘indoor patient’ because the employee is being granted the Fixed Medical
Allowance for the reimbursement of consultation fees paid to any doctor
available in the interior areas. Even the employee has to bear the cost
of medicines prescribed by such doctors and in such circumstances he is
authorized for reimbursement of cost of medicines, any pathological
test etc. as ‘Out Door Patient’.
Simultaneously, on the
recommendation of 5th CPC, Govt introduced Fixed Medical Allowance of
Rs. 100/- per month from 01.12.1997 to Central Government
Pensioners/family Pensioners not covered under CGHS vide DOP&PW,
O.M. No. 45/57/97-P&PW, dated 19.12.1997. According to this scheme, a
pensioner/family pensioner may opt either CGHS facility or Fixed
Medical Allowance of Rs. 100/ which has been enhanced to Rs. 300/- vide
your O.M. No. 390/2010-MS, Dated 14th July, 2010. Since the issuance of
the O.M. dated 19.12.1997 the medical reimbursement of the Govt
employee and their family members has been discontinued.
It is
to be kept in the mind that the DOP&PW, O.M. No. 45/57/97-P&PW,
dated 19.12.1997 is concerned with the payment of Fixed Medical
Allowance to the pensioners/family pensioners, where CGHS facility is
not available, on the recommendation of 5th CPC, whereas this federation
is raising the issue of Fixed Medical Allowance being granted to
serving employees residing in the interior area and who are under the
purview of CS (MA) Rules, 1944 and have been granted Rs. 25/ per month
vide G.O.I., M.H., O.M. No. S-14020/1/88-MS, dated 17th July, 1990, 28th
Sep, 1991 and the quantum enhanced to Rs. 100/- per month vide G.O.I.,
M.H., O.M. No. S-14020/1/88-MS, dated 18th Jan, 1999.
The
employee residing in the interior area has no option to avail outpatient
medical facility from any source of Central Government/State
Government/Local Municipality/Private Medical practitioner appointed as
Authorized Medical within a radius 05 km, hence he has been
compelled/granted by Central Government to accept Rs. 25/- or 100/- as
FMA and whenever such medical facility will be provided to him, this FMA
will be discontinued forthwith.
Therefore you are requested to
issue necessary directives to the authorities to reimburse the medical
claims for indoor treatment where the serving employees are getting FMA
Rs. 100/- per month. Further, you are requested to make an arrangement
for meeting with the reps of this federation and concerned authorities
of MOH&FW according to your own convenient.
Thanking you.
Sincerely yours
sd/-
(MUKESH SINGH)
Secretary
BHARATIYA PRATIRAKSHA MAZDOOR SANGH
Ref: BPMS / CSMA / 156 (8/1/L)
Dated: 15.10.2013
To,
Smt. Sudha Krishnan,
Joint Secretary (Pers),
Govt of India, Min of Finance,
Department of Expenditure,
Room No. 39-A, North Block,
New Delhi – 110001
Subject:
Reimbursement
of Medical Expenses where Payment of Fixed Medical Allowance is allowed
to staff working in the interior where AMA not available. Reference: 1. Your letter No. 164 / E V / 2013, dated 07.10.2013
2. This Federation’s letter of even no. dated 27.06.2013
Respected Madam,
Kindly accept our thanks
for initiating the action on the subject matter and communicating the
same to this recognized Federation vide letter cited under reference
(1).
But, it is worth to mention here that the
‘Department of Pension & Pensioners’ Welfare’ has nothing to do with the matter because the issue is not related to the pensioners.
It is a matter of reimbursement of medical expenses where payment of Fixed Medical Allowance is allowed @ Rs.100/ per month to
the staff working in the interior where AMA is not available.
Therefore, you are requested to issue necessary directives to the authorities of
‘Ministry of Health & Family Welfare, Govt of India’ to redress the genuine grievances of serving employees (not pensioners), which is pending since long.
Thanking you.
Sincerely yours
sd/-
(MUKESH SINGH)
Secretary
Source : www.bpms.org.in
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http://bpms.org.in/documents/fma-2-7w3v.pdf]
