Relaxation of procedures to be followed in considering requests for medical reimbursement

Relaxation of procedures to be followed in considering requests for medical reimbursement - Clarification

No. S.11011/14/2016-EHSS
Government of India
Ministry of Health & Family Welfare
Department of Health & Family Welfare

Nirman Bhawan, New Delhi - 110 108
Dated: the 4th November, 2016

OFFICE MEMORANDUM

Subject: Relaxation of procedures to be followed in considering requests for medical reimbursement - Clarification

The undersigned is directed to state that the condition mentioned in Para 3(2)(g) of this Ministry's OM No. 4-18/2005-C&P [Vol.1I-Pt (I)], dated 20.02.2009 is modified to the extant as under:
"The treatment was obtained in private non-empanelled hospital under emergency, while on official tour to another city."

2. Further, it is also clarified that the cases, which were processed and decided earlier on the basis of OM dated 20.02.2009, should not be reopened.

3. This OM will be effective from the date of issue.

4. This issues with the approval of the Competent Authority.

(Sunil Kumar Gupta)
Under Secretary to the Govt. of India

Source: CGHS.gov.in

Reimbursement of Medical bills in r/o Defence Civilians

Reimbursement of Medical bills in r/o Defence Civilians

Important Circular

OFFICE OF THE PRINCIPAL CONTROLLER OF DEFENCE ACCOUNTS

CARIAPPA MARG LUCKNOW-226002

No. Pay/IV/Med/7007/Ord

Dt. 23.05.2014

To
The Officer-In-Charge

Sub:- Reimbursement of Medical bills in r/o Defence Civilians

 

During the audit of Medical Claims pertaining to your office some shortcomings have been noticed to your office which are appended below.

 

1. The medical claims are submitted along with the Hospital Bills without PAN,TIN,TAN printed on the Bills.

 

2, The claims/treatments of Emergency nature are submitted without any assessment from the Addition A Director of the concerned CGHS cities.

 

3. Most of the claims of more than RS,2 lacs are forwarded to this office without necessary permission from the HOD, New Delhi/Ministry of Hearth and Welfare, New Delhi.

 

4.The Medical claims are submitted in a casual nature without enclosing the BHT sheet duly verified by the treating doctor

 

5.. CGHS Hospitals are not giving 10% discount on every cash payment.

 

To avoid the return of the medical claims repeatedly and inconvenience faced by the individuals the o I/C of the units/formations you are advised to rectify the shortcomings before forwarding the claims to this office. And it has been decided by the competent authority that the units/formations may liaise with hospitals of the concerned cities for bills/documents bearing printed PAN,TAN,TIN(wherever applicable). It has also been decided that no medical claims will be entertained w.e.f 01/07/2014 if printed PAN,TIN TAN(where applicable) are not embossed on the bilis.

 

Please acknowledge receipt.

sd/-

Accounts Officer

Source: www.pcdacc.gov.in
[http://www.pcdacc.gov.in/download/circularsnew/reimbursement.pdf

Reimbursement of Medical claims in respect of service Officers/Personnel and their families for treatment in Civil Hospitals

Reimbursement of Medical claims in respect of service Officers/Personnel and their families for treatment in Civil Hospitals

No. AT/IV/4807/XVIII
Office of the C.G.D.A
Ulan Batar Road, Palam
Delhi Cantt – 10
Dated 18 Jun 2010

To
The PCDA / CDA

Sub: Reimbursement of Medical claims in respect of service Officers/Personnel and their families for treatment in Civil Hospitals.

Repeated references are received in HQrs office from Controllers as to the office which has to deal with the medical claims on account of treatment taken as indoor and OPD patients inspite of HQrs circular of even no dated 28-12-98 and subsequent clarifications issued on the subject. It is therefore once again clarified that medical claims of Service personnel and their families will be dealt as per the table appended below.

Sl.No.	Nature of Medical claims	PCDA/CDA/PAO	Authority
1.	Medical claims in respect of treatment taken as Indoor patient	Such claims are to be dealt with by Regional Controllers/PCDA (AF)/PCDA (Navy) under whose audit jurisdiction the service Hospitals nearest to The Civil Hospitals are situated.	Rule 55 FR Pt II
2.	Medical claims in respect of treatment taken as OPD patient	Such claims are to be processed by the respective CDA (O) / PCDA (Navy) / PCDA (AF) / PAOs of the concerned service personnel	Para 248 OM Pt-IX, Para 318-327 OM Pt VII, Items 18 & 27 of Annexure A to Chap VII of OM Pt III, and Chap 68 of OM Pt X
3.	Medical claims in respect of Clinical / Pathological test	If they are part of Indoor treatment the claims will be processed as per Sl. No.1 above otherwise claims on account of OPD treatment will be processed as per Sl no. 2 above	As above

Sr. Dy. CGDA (AT)

www.cgda.nic.in