Reimbursement of medical expenses to All India Service Officers

GOVERNMENT OF ANDHRA PRADESH
ABSTRACT

All India Services – Medical Attendance – Reimbursement of medical expenses to All India Service Officers borne on the cadre of Andhra Pradesh (both serving and retired) – Orders – Issued.

GENERAL ADMINISTRATION (SC.E) DEPARTMENT
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G.O. Ms. No. 189 Dated 19 -12-2017

ORDER:

Time and again representations are received from the All India Service Officers and All India Service Pensioners that they are facing difficulty in getting reimbursement for the expenses incurred by them on medical treatment and requested for removal of monetary limits for reimbursement and simplification of the procedures for seeking reimbursement.

2. Rule 7 of All India Services (MA) Rules, 1954 states that every member of service shall be entitled free of charge to treatment in a Government hospital in headquarters or a hospital other than Government hospital in headquarters or anywhere in the State or outside the State and all the expenses shall be reimbursed upon certification by the Authorised Medical Attendant. Rule 4 of All India Services (MA) Rules, 1954 states that members of the family of the Member of Service shall also be entitled to medical attendance and treatment. In Government of India, Ministry of Home Affairs letter No. 7/2/65-AIS (III), dated 20.4.1965 no limit on the amount of reimbursement by the controlling officer is prescribed. In Government of India, Ministry of Home Affairs Letter No. 7/10/63-AIS (III), dated 10.08.1964 it is clarified that cost of medical treatment taken from a private practitioner can be allowed by the State Governments. However, in the orders issued by the State Government, certain ceiling limits have been fixed on the treatment received by the State Government employees and the same limit was extended to AIS Officers also.

3. After careful examination of the matter, in supersession of all the orders issued in the matter till date in the erstwhile State of Andhra Pradesh and amendments thereon relating to application of APIMA Rules, 1972, definition of Authorised Medical Attendant, procedure for claiming reimbursement bills, scrutinizing authority and bill sanctioning authority for claiming reimbursement of medical expenses by All India Service Officers and Pensioners, Government hereby issue the following orders called “Andhra Pradesh AIS Medical Attendance Regulations” (hereinafter called regulations) for the new State of Andhra Pradesh for serving and retired All India Services Officers and their families:-

(1) Eligibility:

(i) Applicability of APIMA Rules, 2917: The APIMA Rules, 1972 will be applicable to All India Service (AIS) Officers and pensioners only to the extent to which those rules are not inconsistent with the AIS (MA) Rules, 1954 or these regulations.

(ii) Eligible hospitals: All India Service officers and pensioners and their family members shall be eligible for taking treatment in any private hospital or clinic registered in respective State under the Clinical Establishment (Registration and Regulation) Act or recognized by the State, including Eye and Dental treatment without the need for any prior referral from any State Government hospital.

(iii) Ceiling limits not applicable: Ceiling limits for various treatments including Eye and Dental treatment shall not be applicable to AIS Officers and Pensioners and their family members.

(iv) Entitlement for full reimbursement: All India Service Officers and pensioners and their family members will be entitled for full reimbursement of medical treatment including dental and eye care treatment.

(v) Family members: the words Officers and Pensioners shall also include their family members.

(2) Bill Scrutiny Authority (Authorised Medical Attendant):

(i) The Government authorize the following Medical Officers to scrutinize the Medical Bills and certify the reimbursement amount for treatment in respect of AIS Officers and Pensioners and their family members working with the affairs of the State and AIS Pensioners:

Category of Officers		At State Capital		In Districts		In Divisions
AIS Officers working in Secretariat		-Medical Officer in Secretariat Dispensary -Any Civil Surgeon at Headquarters hospital		NA		NA
AIS Officers working in Heads of Departments		-Medical Officer in Secretariat Dispensary. -Any Civil Surgeon at Headquarters Hospital -Police Medical Officer in any Battalion		NA		NA
AIS Officers working outside State capital	NA		-Any Civil Surgeon at District Head-quarters hospital. -Police Medical Officer for IPS Officers		Any Civil Surgeon at Division Headquarters hospital.
AIS Officers working in Autonomous Organizations	-Any Civil Surgeon at Headquarters hospital -Medical Officer attached to the Organization.		-Any Civil Surgeon at District Headquarters hospital. -Medical Officer attached to the Organization		Any Civil Surgeon at Division Headquarters hospital. -Medical Officer attached to the Organization
Retired AIS Officers	-Medical Officer in Secretariat Dispensary -Any Civil Surgeon at Headquarters hospital -Medical Officer attached to the Organization -Police Medical Officer in any Battalion for IPS Officers		-Any Civil Surgeon at District Headquarters hospital -Medical Officer attached to the Organization.		Any Civil Surgeon at Division Headquarters hospital -Medical Officer attached to the Organization.

(ii) In case of treatment received under Indian System of medicine, viz., Homeopathy, Ayurveda, Unani etc., Authorised Medical Attendant shall be the Medical Superintendent of the hospital concerned.

(iii) NTR Vaidyaseva Trust may also scrutinize any of the medical bills in the table above and certify the reimbursement amount without the need for a Medical Officer.

(iv) The Chief Secretary to Government may time to time notify additional Medical Officers within the State or outside the State for scrutiny and certification of bills. He may also issue guidelines for ease of reimbursement procedure from time to time.

(3) Sanctioning authority:

(i) The sanctioning authorities shall be as follows:-

Category of Officers	Sanctioning Authority
Category of Officers	No Relaxation of Rule	Relation of Rule
-AIS Officers working in · Secretariat · Heads of Departments · Autonomous Organizations. -Heads of Police Force, Forest Force and Autonomous Organizations	Secretary to Government in-charge of OP of the Secretariat Department concerned.	(1) Secretary to Govt. (Political), G.A.D. upto Rs. 25,000/- (2) Chief Secretary to Government – More than RS. 25,000/- and upto Rs. 1.00 lakh (3) Chief Minister – More than Rs. 1.00 lakh
AIS Officers working outside State capital in the districts.	District Collectors concerned.
-IPS Officers working at Head of the Department Office or Regional Offices or Range Offices other than DGP (HoPF). -Retired IPS Officers	Director General of Police (HoPF)
-IFS Officers working at Head of the Department Office or Regional Offices or Zonal Offices other than PCCF (HoFF). -Retired IFS Officers.	Principal Chief Conservator of Forests (HoFF)
Retired IAS Officers	Secretary to Government (Political), G.A.D.

(ii) There shall be no monetary limit for sanction by any Sanctioning Authority.

(4) Procedure for processing medical claims:

(i) Upon receipt of claim from the officer or pensioner, the Sanctioning Authority shall refer the medical claim within three days to a Bill Scrutiny Authority.

(ii) The Bill Scrutiny Authority shall scrutinize and return the Bill within 7 days from the date of receipt of the claim.

(iii) Alternatively, the Officer or Pensioner may get their medical bill scrutinized on their own from a Bill Scrutiny Authority and submit to the Sanctioning Authority.

(iv) The Sanctioning Authority shall issue the orders within seven days of submission by the Officers or Pensioner where there is no relaxation of rules. In cases where relaxation of rule is involved, orders shall be issued within 30 days.

(v) Exclusive Section (s) will be created for this purpose if the volumes are high in number such as in General Administration Department, Offices of the Director General of Police / Principal Chief Conservator of Forests.

(vi) The Chief Secretary to Government may from time to time amend the procedure to enable easy processing and settlement of claims.

4. These orders shall come into force with immediate effect.

5. This order issues with the concurrence of Finance Department vide their U.O. No. 42028/418/2017-FMU-HM&FW, DT.01/12/2017.

(BY ORDER AND IN THE NAME OF THE GOVERNOR OF ANDHRA PRADESH)

DINESH KUMAR

CHIEF SECRETARY TO GOVERNMENT