Government of India
Ministry of Communications & IT
Department of Posts
Dak Bhavan, Sansad Marg
New Delhi – 110116
No. 6-1/2006-Medical
Dated – 27th October, 2010
To,
All recognized Unions/Associations of Department of Posts
Sub: – CS (MA) Rules, 1944 – Reimbursement of expenditure involved in emergent cases for the treatment taken at private nursing home/clinic – Delegation of powers – reg.
Sir,
I am directed to forward herewith a copy of Ministry of Health and Family Welfare, New Delhi O.M. No. S-14025/46/92-MS dated 4-2-1993 on the above subject for your information/guidelines and necessary action.
(Mahendra Kumar)
Assistant Director General (Medical)
No. S-14025/46/92-MS
Government of India
Ministry of Health and Family Welfare
Nirman Bhawan, New Delhi – 110011
Dated the 4th February, 1993
Office Memorandum
Subject – CS (MA) Rules, 1944 – Reimbursement of expenditure involved on emergent cases for the treatment taken at private nursing home/clinic – Delegation of powers – Regarding.
The undersigned is directed to say that under the CS (MA) Rules, 1944, vide Miscellaneous Important Decisions No. 5 under Section VII of the compilation of the CS (MA) Rules and further modified vide O.Ms. No. S-14012/9/75-MC (MS) dated 23.2.77, 7.5.79 and 18.6.82, powers have been delegated to the Heads of Departments to allow reimbursement of the medical claims in respect of the treatment obtained under emergency at private hospitals, as distinct from private nursing home/private clinic, subject to item-wise ceilings as per the rates prescribed in the Annexure to the O.Ms. referred to above without any financial limit on the total amount to be reimbursed.
2. However, although the broad guidelines provided in para 1 (iv) of the O.M. dated 18.6.82 referred to above are only indicative and not exhaustive, a large number of cases are being referred to this Ministry/Dte. G.H.S. for seeking relaxation of the rules stating that the hospital is not run on ‘No profit and No Loss Basis’, which otherwise could have been settled by the concerned Department under the delegated powers.
3. It has now been decided by the Government that in order to eliminate the confusion regarding distinction between the private hospital and a private nursing home Clinic, the delegated powers referred to above are applicable to all private medical institutions without making any distinction between a private hospital and a private nursing home/clinic.
4. the medical claims for specialized treatment for heart diseases, kidney transplantation, etc. may be settled as per the schedule of rates approved for the treatment of C.G.H.S beneficiaries from time to time at private recognized hospitals under that Scheme or the actual charges, whichever is less, and all other cases may be settled as per the item wise ceilings prescribed in the Annexure to the O.Ms. referred to above. No. references should be made to this Ministry/Dte. G.H.S. in the matter for further relaxation of the Rules and may be settled by the concerned Ministry/Department.
5. In this connection it may be reiterated that as already stated in para (iii) of the O.M. dated 18.6.82 referred to above, reimbursement of expenses incurred on treatment obtained in the private clinics/nursing homes of the Authorised Medical Attendants would not be admissible under the above provisions and also in relaxation of the CS(MA) Rules even in emergent cases.
6. All pending cases may be decided accordingly, However, the cases which are already settled or decided, may not be re-opened.
7. This issues with the concurrence of the Department of Pension and Pensioners’ Welfare vide their U.O. No. 272/92 P& PW (K) dated 19.10.1992 and the Ministry of Finance Deptt. Of Expenditure) vide their U.O. No. 1441/E.V/92 dated 17.11.1992.
8. In so far as persons serving in the Indian Audit and Accounts Deptts. are concerned, this issues with the concurrence of the office of the comptroller and Auditor General of India vide their U.O. No. 27-Audit-I/72-90, dated 25.1.1993.
Sd/-
(Braham Dev)
Under Secretary to the Govt. of India
source-http://nfpe.blogspot.com/2010/12/government-of-india-ministry-of.html
roopinder singh says
Sir i am working in kendriya vidayalaya as a principal . my son get pain in gallbladder and stop toilet dueto the stone . kidney can be damage . government hospital is about 9 km . so we admitted him into private hospital which is near to home . and doctor do operation immediately in emergency . plz help how it will be reimbursed emergency case.
roopinder singh says
Sir i am working in kendriya vidayalaya as a principal . my son get pain in gallbladder and stop toilet dueto the stone . government hospital is about 9 km . so we admitted him into private hospital which is near to home . and doctor do operation immediately in emergency . plz help how it will be reimbursed emergency case.
dinesh Kumar Sharma says
My son is autistic child and thearpies and speech therapy on daily basi. And this costing me RS 30000 PM are these expenses are reimbursable and what are the ceiling if any
Purushottam Maroti Pathrabe says
I am working in Central Excise & Customs. My daughter was under treatment to Authorized Medical Attendant (i.e.AMA) she was suffering from very high fever. As doctor has advised the tests were undertaken at Consulting Pathologist. Thus platelets counts were low and there were symptoms of typhoid. Hence, doctor has advised to admit an private hospital as an emergency case for further and she was admitted in the private hospital due to emergency and this hospital is nearest to my home about 1/2km.
We can claim for medical bills under CS MA/CGHS Rules. Can I get reimbursement bill or otherwise? Is there any limit on claims (for indoor and outdoor treatments both) ? Please guide me.
Harshad Vazar says
My wife was admitted in the private hospital due to emergency and doctor suggested for cesarean . after then my wife delivered a baby.
i am working in central government department as a class 1 officer.
i am working in non CGHS area.
kindly please suggest how to reimbursed my medical bill.
om prakash says
sir please sent me list of medicines which are not reimbursable under CSMA rule or government servant
Vishnu Sekhar says
Sir,
I’m a teacher in kvs. My wife did not have a normal delivery at a private Hospital. How can I claim the reimbursement of the expenses.
Thanking you.
Yours faithfully,
VISHNU SEKHAR (TGT, English)
deepak srivastava says
my wife was pregnant in the m/o September and due date was in October first weak but due to leaking & breach I had to admit her in a pvt clinic where she delivered a baby of 8 months.I want to know how my bill will be processed.my office responding negative.please suggest me along with relevant circulars etc.
Nitin Kumar Jain says
My daughter is suffering with Cerebral Palsy. Due to this, she is unable to walk properly. Doctors have suggested her the injection “Botulinum Toxin” in her legs and left hand. They are advising Physiotherapy also. I am working in Kendriya Vidyalaya Sangathan in PUNE.
We can claim for medical bills under CSMA. Can I get reimbursement of injection Botulinum Toxin and Physiotherapy? Is there any limit on claims (for indoor and outdoor treatments both) ? Please guide me.
BSM SIMHADRI says
Dear Sirs,
I am working in CVRDE, (DRDO) Avadi, Chennai-500 054 as a Technical Officer and residing at Ambattur, Chennai-500 053.
My wife is suffering from Type 2 diabetics and my son(M20) is suffering from Type1 diabetics .
Please advise the procedure for re-imbursement of medicines which includes regular administration of insulin injection as per CS(MA) rules.
P. Nibedita says
I am working in a central govt. organisation. My husband is self-employed person and is a tax-payer himself. But, my mother-in-law who is staying with me is ill and needs medical attention and treatment. I want to know, whether I can include her name as a dependent member of my family and claim medical benefits for her ? She is in receipt of no income/pension, whatsoever.
Kindly respond urgently.
Pramod Srivastava says
My wife is suffering from Rheumatoid Arthrities and getting treatment from Rheumotologist Dr. Anish Aggarwal havind his hospital covered under CGHC. Dr. Anish is also a visiting consultant in Combined Medical Institute a multifunctional hospital. Every month my wife I used to go with my wife for consultation. The cost of medicines is about 2500/- p.m. apart from consultation charges. Will I get reimbursement?
satish bagul says
ltc encashment