G.O.MS.No. 159; Dated:22 -12-2014.: Andhra Pradesh State Government, Health Medical and Family Department – Employees Health scheme – Further clarification.
- Chitttor, Nelloore and Anathapur employees can get treatment in Chennai, Vellore and Bangalore,
- Medical Reimbursement Facility will Continue for Two more Months,
- EHS &Reimbursement Facility Run Parallel.
- In case health card employees / pensioners, if they avail treatment in non-empanelled hospitals, in emergency, they may be allowed reimbursement, as per the package rates of Employees Health scheme
- G.O.Ms.No.174 HM&FW (M2) Dept dated 01-11-2013.
- G.O.Ms.No.175 HM&FW (M2) Dept dated 01-11-2013.
- G.O.Ms.No.176 HM&FW (M2) Dept dated 01-11-2013.
- G.O.Ms.No.134 HM&FW (I1.1) Dept dated 29-10-2014.
- G.O.Ms.No.135 HM&FW (I1.1) Dept dated 29-10-2014.
- G.O.Rt.No.3578 GA(SW) Dept dated 30-10-2014.
- G.O.Ms.No.210 Fin (TFR) Dept dated 15-11-2014.
- G.O.Ms.No.150 HM&FW (I.1) Dept dated 04-12-2014.
- G.O.Rt.No.4092 GA (SW) Dept dated 18-12-2014.
Employees / Pensioners Health Cards New Guidelines
In the Government orders 1st and 4th 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.
- The employees’ Associations and Pensioners’ Associations 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 Departments.
b. Necessary steps should be taken by Medical & Health Department and Aarogyasri Health Care Trust to ensure treatment by all NABH accredited hospitals and other corporate hospitals to the card holders.
c. Cashless treatment to card holders and medical reimbursement systems should run paralle for two more months, till cards are issued to all eligible employees and pensioners and the Employees Health scheme is established.
d. The meeting of steering committee constituted for this purpose be held shortly to get more feedback and suggestions from the employees and pensioners.
Further Clarifications on AP Employees Health scheme
- Accordingly, in accordance with the above decisions Government, hereby, issue the following orders:
(i) Finance Department shall make available to Aarogyasri Health Care Trust, the data of all the employees, including the provincialised work charged 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 health cards to all the employees. In case of any delay in getting the data of employees through CFMS., and furnishing to the Aarogyasri Health Care Trust, the eligible employees who have not yet got health cards may be allowed to enroll themselves and their family members 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 continue to be covered under APIMA Rules, 1972.
(iii) The Aarogyasri Health Care Trust shall take action, 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 to provide treatment to the patients under Employees Health scheme), to participate in Employees Health scheme.
(iv) Aarogyasri Health Care Trust shall take action for empanelment of corporate hospitals in the neighbouring States, which are already providing services 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.6th and 9th read above.
(v) The Employees Health scheme and medical reimbursement system under APIMA Rules, 1972 shall run parallel till 28-02-2015 and the medical claims of the employees / pensioners under reimbursement system shall be processed in accordance 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 who 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 Chennai, Vellore and Bangalore, respectively, especially in case of complicated diseases, will be allowed reimbursement as per the package rates of Employees Health scheme.
- This order issues with the concurrence of Finance PFS (R&E) No.10501/PFS/(R&E), Dated. 20-12-2014.