Main Article - Nov, 2005
CENTRAL SERVICES (MEDICAL ATTENDANCE) RULES, 1944
Ch. Srinivasa Rao, Under Secretary, CSIR, New Delhi
Introduction
The title Central Services (Medical Attendance) Rules, 1944 itself suggests that these rules have been introduced during pre-independence era as a welfare measure in respect of employees working in Government of India and its Departments. Typically, there have not been much change in the basic tenets of these rules. The present generation may, at times, find some sort of absurdity in its expression, explanation, provisions, restrictions, etc. Yet there have been many amendments in recent years. While presenting this compilation, sincere efforts were put in to avoid inherent monotony that normally exists in Govt. rules.
Applicability
The Central Services (Medical Attendance) Rules, 1944 are applicable to all Government servants, and their families, civilians paid from the Defence Services Estimates; industrial and work-charged staff who are not covered by Employees State Insurance Scheme and employees of the Ordnance and Ordnance Equipment Factories who are put up beyond a distance of 8 Km. radius from the factory premises through an option.
Government Hospitals
Central Govt. employees and the members of their families are permitted to avail of medical facilities in any of the Central/State Govt. hospitals and the hospitals recognized by the State Govt./ CGHS Rules/CS (MA) Rules, 1944, hospitals fully funded by Central/State Govts. subject to the condition that they reimburse the medical expenditure to their employees at the rates fixed by the Govt. or the actual expenditure incurred, whichever is less.
Maternity and Child Welfare Centres with In-patient arrangements which are recognized by State Govts. for medical attendance of their employees are also regarded as Govt. Hospitals. Similarly, Cantonment Hospitals, Railway Hospitals, Pay clinics recognized by State Govts., hospitals maintained by Local Bodies, PSUs, Port Trust, including their Medical Officers are also recognized for treatment of Govt. employees and their families.
A Govt. Hospital includes a departmental Dispensary whether full-time or part-time established and run by a Department of a Govt., a hospital maintained by a Local Authority and any other hospital with which arrangements have been made by the Govt. for treatment.
Treatment in two systems of medicine
Simultaneous treatment in more than one system of medicine such as Allopathic, Ayurveda, Homoeopathic, Unani, etc. provided that it is done with the knowledge of the doctor of the other system.
Ch. Srinivasa Rao, Under Secretary, CSIR, New Delhi
Introduction
The title Central Services (Medical Attendance) Rules, 1944 itself suggests that these rules have been introduced during pre-independence era as a welfare measure in respect of employees working in Government of India and its Departments. Typically, there have not been much change in the basic tenets of these rules. The present generation may, at times, find some sort of absurdity in its expression, explanation, provisions, restrictions, etc. Yet there have been many amendments in recent years. While presenting this compilation, sincere efforts were put in to avoid inherent monotony that normally exists in Govt. rules.
Applicability
The Central Services (Medical Attendance) Rules, 1944 are applicable to all Government servants, and their families, civilians paid from the Defence Services Estimates; industrial and work-charged staff who are not covered by Employees State Insurance Scheme and employees of the Ordnance and Ordnance Equipment Factories who are put up beyond a distance of 8 Km. radius from the factory premises through an option.
Government Hospitals
Central Govt. employees and the members of their families are permitted to avail of medical facilities in any of the Central/State Govt. hospitals and the hospitals recognized by the State Govt./ CGHS Rules/CS (MA) Rules, 1944, hospitals fully funded by Central/State Govts. subject to the condition that they reimburse the medical expenditure to their employees at the rates fixed by the Govt. or the actual expenditure incurred, whichever is less.
Maternity and Child Welfare Centres with In-patient arrangements which are recognized by State Govts. for medical attendance of their employees are also regarded as Govt. Hospitals. Similarly, Cantonment Hospitals, Railway Hospitals, Pay clinics recognized by State Govts., hospitals maintained by Local Bodies, PSUs, Port Trust, including their Medical Officers are also recognized for treatment of Govt. employees and their families.
A Govt. Hospital includes a departmental Dispensary whether full-time or part-time established and run by a Department of a Govt., a hospital maintained by a Local Authority and any other hospital with which arrangements have been made by the Govt. for treatment.
Treatment in two systems of medicine
Simultaneous treatment in more than one system of medicine such as Allopathic, Ayurveda, Homoeopathic, Unani, etc. provided that it is done with the knowledge of the doctor of the other system.
Authorized Medical Attendant
A Medical Officer. appointed by the GoI, Department of Health or any other department of the GoI; a Medical Officer whether or not under the employ of the Central Govt. or the Chairman of the Central Govt. Employees’ Welfare Co-ordination Committee in relation to the Central Govt. employees at that station is considered to be an Authorized Medical Attendant (AMA) under these rules.
In the absence of any such person, a Govt. servant who belongs to a Central Service Group A or whose pay is not less than Rs.2,500/- p.m. (pre-revised); the Principal Medical Officer of the district; a Govt. servant not belonging to a Central Service, Gr. A whose pay is less than Rs.2,500/- but more than Rs.1,200/- (pre-revised) p.m.; an Assistant Surgeon, Grade I (Medical Graduate) or other Medical Officer appointed by the Govt. to attend its Officers in the station; or in respect of any other Govt. servant, an Asst. Surgeon, Gr.II (Medical Licentiate); or where such person is not available, an Asst. Surgeon, Gr.I (Medical Graduate), similarly appointed can be treated as AMA.
The AMA of a Govt. servant is determined with reference to the place at which he falls ill as Officers of appropriate rank may or may not be available at all the places.
A Govt. employee can consult any AMA of his choice. However, he will not be eligible to draw TA/DA for consultation. For diseases pertaining to women and children, a Govt. servant may opt for a second AMA.
In case of extreme emergency, a Govt. servant is allowed to take treatment from any other empanelled AMA even if such an AMA is not nominated by his own department. Any AMA who is on leave and Honorary Medical Officers outside hospital precincts cannot be treated as AMAs.
A Medical Officer under the employ of a Department and declared as AMA for its staff and their families stationed at a particular place can be treated as AMA for himself and his family members only in such stations where there is only one AMA.
The panel of AMAs would be valid for a period of one year. If any AMA indulges in any malpractice or non-observance of rules, his name can be struck off from the panel.
Appointment of private AMA
In terms of Supplementary Rule 2 (10), even a private Registered Medical Practitioner (RMP) can be appointed as AMA in respect of a class or classes of Central Govt. employees where adequate number of Doctors in the employ of the Central/State Govt. is not available, or because of remoteness of the area in which the patient lives. Such an AMA is required to follow CS (MA) Rules strictly. An RMP who is owning a Nursing Home should not be appointed as AMA. No private Dentist is permitted to be appointed as AMA.
Arrangements for the medical treatment of Central Govt. servants and members of their families in certain States/stations within India are made.
Medical Officers who are in receipt of Non-Practising Allowance should not charge any fee for the service rendered to the Central Govt. servants and members of their families either before or during or after hospital hours.
A Medical Officer. appointed by the GoI, Department of Health or any other department of the GoI; a Medical Officer whether or not under the employ of the Central Govt. or the Chairman of the Central Govt. Employees’ Welfare Co-ordination Committee in relation to the Central Govt. employees at that station is considered to be an Authorized Medical Attendant (AMA) under these rules.
In the absence of any such person, a Govt. servant who belongs to a Central Service Group A or whose pay is not less than Rs.2,500/- p.m. (pre-revised); the Principal Medical Officer of the district; a Govt. servant not belonging to a Central Service, Gr. A whose pay is less than Rs.2,500/- but more than Rs.1,200/- (pre-revised) p.m.; an Assistant Surgeon, Grade I (Medical Graduate) or other Medical Officer appointed by the Govt. to attend its Officers in the station; or in respect of any other Govt. servant, an Asst. Surgeon, Gr.II (Medical Licentiate); or where such person is not available, an Asst. Surgeon, Gr.I (Medical Graduate), similarly appointed can be treated as AMA.
The AMA of a Govt. servant is determined with reference to the place at which he falls ill as Officers of appropriate rank may or may not be available at all the places.
A Govt. employee can consult any AMA of his choice. However, he will not be eligible to draw TA/DA for consultation. For diseases pertaining to women and children, a Govt. servant may opt for a second AMA.
In case of extreme emergency, a Govt. servant is allowed to take treatment from any other empanelled AMA even if such an AMA is not nominated by his own department. Any AMA who is on leave and Honorary Medical Officers outside hospital precincts cannot be treated as AMAs.
A Medical Officer under the employ of a Department and declared as AMA for its staff and their families stationed at a particular place can be treated as AMA for himself and his family members only in such stations where there is only one AMA.
The panel of AMAs would be valid for a period of one year. If any AMA indulges in any malpractice or non-observance of rules, his name can be struck off from the panel.
Appointment of private AMA
In terms of Supplementary Rule 2 (10), even a private Registered Medical Practitioner (RMP) can be appointed as AMA in respect of a class or classes of Central Govt. employees where adequate number of Doctors in the employ of the Central/State Govt. is not available, or because of remoteness of the area in which the patient lives. Such an AMA is required to follow CS (MA) Rules strictly. An RMP who is owning a Nursing Home should not be appointed as AMA. No private Dentist is permitted to be appointed as AMA.
Arrangements for the medical treatment of Central Govt. servants and members of their families in certain States/stations within India are made.
Medical Officers who are in receipt of Non-Practising Allowance should not charge any fee for the service rendered to the Central Govt. servants and members of their families either before or during or after hospital hours.
Reimbursement of expenses incurred on account of consultation with a Specialist who is not in Govt. service is not admissible. Refund of the cost of preparations which are not medicines but are primarily foods, tonics, toilet preparations or disinfectants is not admissible.
Pathological and other tests for the purpose of diagnosis should be carried out only at the Govt. hospital. The Govt. servant should produce a certificate from the AMA that such examinations were considered necessary by him. Treatment at consulting room should be limited to the administration of injections only.
Expenses incurred in connection with physiotherapeutic and occupational therapeutic treatment is reimbursable to the extent these facilities are available in Govt. recognised hospitals provided that the treatment is given to recoup certain physical weakness/defect.
Sales tax paid by the Govt. servants while purchasing special medicines is refundable while packing and postage charges are not refundable.
Medical Attendance
Medical attendance is distinct from medical treatment. Medical attendance does not require repeated consultations/ prescriptions. It includes attendance at the hospital/dispensary or at the residence of the Govt. servant or at the consulting room of the AMA whether maintained at the hospital or at the residence of AMA.
Reimbursement of consultation fees at the prescribed rates should be restricted to the first four consultations/visits at the rate of one consultation in a calendar day which should be completed within a period of 10 days from the date of commencement of treatment.
Cost of admissible medicines prescribed during these consultations is reimbursable on production of original prescriptions/cash memos.
There should be a reasonable gap between the closing of the first spell of illness from the disease and recurrence of the same disease for a second time to justify a fresh claim.
Prolonged treatment should be received only at the OPDs of a Govt./recognized hospital.
Status of a Govt. servant will be determined on the basis of the actual pay being drawn at the time of falling ill. In the case of re-employed pensioners, the pension should be taken into consideration along with pay for the purpose of determining the grade.
A Govt. servant shall be entitled to medical attendance by the AMA free of charge. Any amount paid on account of such medical attendance shall be reimbursed to him on production of a certificate in writing by the AMA.
The Controlling Officer may reject any claim, if he is not satisfied with its genuineness. He may communicate the reasons for rejection and afford an opportunity to the claimant of being heard within 45 days of the date of receipt of the order.
Consultation/visiting/injection fee
Wherever the respective State Govts./ Union Territories have prescribed the rates for consultation, visiting and injection fee, these rates as detailed hereunder are to be paid.
Pathological and other tests for the purpose of diagnosis should be carried out only at the Govt. hospital. The Govt. servant should produce a certificate from the AMA that such examinations were considered necessary by him. Treatment at consulting room should be limited to the administration of injections only.
Expenses incurred in connection with physiotherapeutic and occupational therapeutic treatment is reimbursable to the extent these facilities are available in Govt. recognised hospitals provided that the treatment is given to recoup certain physical weakness/defect.
Sales tax paid by the Govt. servants while purchasing special medicines is refundable while packing and postage charges are not refundable.
Medical Attendance
Medical attendance is distinct from medical treatment. Medical attendance does not require repeated consultations/ prescriptions. It includes attendance at the hospital/dispensary or at the residence of the Govt. servant or at the consulting room of the AMA whether maintained at the hospital or at the residence of AMA.
Reimbursement of consultation fees at the prescribed rates should be restricted to the first four consultations/visits at the rate of one consultation in a calendar day which should be completed within a period of 10 days from the date of commencement of treatment.
Cost of admissible medicines prescribed during these consultations is reimbursable on production of original prescriptions/cash memos.
There should be a reasonable gap between the closing of the first spell of illness from the disease and recurrence of the same disease for a second time to justify a fresh claim.
Prolonged treatment should be received only at the OPDs of a Govt./recognized hospital.
Status of a Govt. servant will be determined on the basis of the actual pay being drawn at the time of falling ill. In the case of re-employed pensioners, the pension should be taken into consideration along with pay for the purpose of determining the grade.
A Govt. servant shall be entitled to medical attendance by the AMA free of charge. Any amount paid on account of such medical attendance shall be reimbursed to him on production of a certificate in writing by the AMA.
The Controlling Officer may reject any claim, if he is not satisfied with its genuineness. He may communicate the reasons for rejection and afford an opportunity to the claimant of being heard within 45 days of the date of receipt of the order.
Consultation/visiting/injection fee
Wherever the respective State Govts./ Union Territories have prescribed the rates for consultation, visiting and injection fee, these rates as detailed hereunder are to be paid.
CONSULTATION/VISITING/INJECTION FEE PAYABLE TO A.M.A.
I.Wherever the respective State Govts./UTs have prescribed the rates for consultation, visiting and injection fee, these rates shall be paid as given hereunder:
I.Wherever the respective State Govts./UTs have prescribed the rates for consultation, visiting and injection fee, these rates shall be paid as given hereunder:
1.Medical Officers under the employ of the Govt. appointed as AMAsAs per the schedule of rates approved by the concerned State Govt./ UT Administration2.Private Medical Practitioners appointed as AMAs As per the schedule of rates approved by the concerned State Govt./UT Administration in respect of Asst. Surgeon Gr.I/II or equivalent
II.Where the Govt. have not prescribed any fees for their Medical Officers in accordance with their qualifications who are appointed as AMAs shall be paid as given hereunder:
1.Consultation fee:
Medical Post-Graduates/
SpecialistsMedical Licentiates and Medical
Graduates (MBBS or equivalent)
First consultation
Subsequent consultationRs.50/-
Rs.30/-Rs.35/-
Rs.20/-
II.Where the Govt. have not prescribed any fees for their Medical Officers in accordance with their qualifications who are appointed as AMAs shall be paid as given hereunder:
1.Consultation fee:
Medical Post-Graduates/
SpecialistsMedical Licentiates and Medical
Graduates (MBBS or equivalent)
First consultation
Subsequent consultationRs.50/-
Rs.30/-Rs.35/-
Rs.20/-
2.Visiting fees:
Day
Night
Rs.50/-
Rs.60/-
Rs.40/-
Rs.50/-3.Injection fees:
Intra-muscular/
Subcutaneous
Intravenous
Rs.10/-
Rs.20/-
Rs.10/-
Rs.20/-
NB:
Day
Night
Rs.50/-
Rs.60/-
Rs.40/-
Rs.50/-3.Injection fees:
Intra-muscular/
Subcutaneous
Intravenous
Rs.10/-
Rs.20/-
Rs.10/-
Rs.20/-
NB:
1.Where CGHS facilities exist, the rates of such consulting fee, etc. would be at par with the CGHS rates of the station concerned.
2.These rules are also applicable to persons covered under Special Rules to Kolkata.
Administering injections forms part of treatment and such treatment should normally be received at the hospital. Up to 15 injections can be taken at the consulting room/residence of the AMA/patient. Beyond 15 injections, the patient should be referred to the OPD.
Consultation with Specialist
If a Govt. servant or his family requires Specialist service which could only be provided in the adjoining city, he/she may consult such a Specialist in a Govt./ recognized hospital. If the AMA is of the opinion that the case of a patient is of such a serious or special nature as to require medical attendance by some person other than himself, he may refer the patient to a Specialist or other Medical Officer or if the patient is too ill to travel, summon such Specialist/Medical Officer to attend upon the patient.
A fixed medical allowance of Rs.100/- per employee can be paid to staff working in the interior where AMA is not available within a radius of 5 km., even if available, such person is not willing to be appointed as AMA.
Super-imposition of another disease
Where a patient consults the same Doctor in regard to another disease during the course of treatment of one disease, such consultation should be regarded as “fresh consultation” and paid at full rate.
If one or more minor treatment procedures form part of a major treatment procedure, package charges would be made against the major procedures. Only half of actual charges quoted for the minor procedures would be added to the package charges of the first major procedure.
Special Nursing
Special nursing as certified to be essential for the recovery or for the prevention of serious deterioration in the condition of the patient by the Medical Officer concerned and the Medical Superintendent of the hospital in prescribed proforma, limited to the amount which is in excess of 25% of the pay of the Govt. servant concerned is reimburseable. Reimbursement for Attendant charges are admissible only in cases where it is certified by the hospital authorities that the it forms part of treatment and that the Attendant was not engaged in lieu of "Special Nursing".
Effective from 15-9-1995, maximum admissible rates for Nursing/Attendant per a shift of 12 hours are (a) Special Nurse: Rs.150/-; and (b) Ayah/Attendant: Rs.75/-.
Reimbursement of charges
Clinical tests at private institutions: Reimbursement of the charges paid to private practitioners/institutions for undertaking skiagrams, electric therapy, bacteriological, pathological examinations, etc. owing to non-availability of the facility at a Govt. hospital, on the advice of the AMA is permissible with the prior consent of the Director of Health Services/Chief Administrative Medical Officer.
Cost of blood and transfusion charges: Cost of Blood and transfusion charges paid to a Govt. institution or any other local organization recognized by the State Govt. of blood are refundable, provided that it is certified by the treating Doctor (AMA) that the supply of blood was not available in the hospital, and that the price paid was reasonable.
Testing of eye-sight: Govt. servants may get their eyesight tested for glasses at a Govt./recognized hospital once in three years on the recommendation of the AMA Fee paid to the Specialist for such services will be reimbursed according to the scheduled rates prescribed in the concerned State. Expenses towards correction of squint (eye) are reimbursable. There is no provision for reimbursement of cost of spectacles. The members of families are not entitled to the facility for testing of eye sight for glasses.
Medical treatment:A Govt. servant and members of family are entitled to treatment in such Govt. hospital at or near the place where the patient fell ill. If there is no such hospital other than Govt. hospital at or near the place which provides treatment free of charge. Permission can be granted to the CG employees to obtain medical services from any of the private hospitals recognized under CGHS.
Hospitalization:Cases of medical treatment requiring hospitalization will normally be referred to a Govt./recognized hospital by the AMA for admission. If hospitalization is not considered necessary but treatment is expected to be prolonged, a patient should be referred to the OPD of a Govt./recognized hospital. Charges levied, if any, are reimbursable.
The average stay in a hospital as an in-patient should be reckoned as two weeks. Any hospital stay beyond three weeks is treated as prolonged stay.
Prolonged treatment is defined as “a case of single and continuous spell of illness which requires either more than 4 consultations/ visits within a period of 10 days from the date of commencement of treatment or more than a course of 15 injections.”
In-patient treatment:A Govt. servant can receive treatment in a hospital where he is ordinarily entitled to receive treatment under the rules as an in-patient for himself and members of his family without consulting his AMA. While claiming reimbursement, a certificate should be produced from the Medical Superintendent of the hospital that the facilities provided were the minimum and were essential for the patient’s treatment. If a Central Govt. servant or family member suffering from an infectious disease receive in-patient treatment in a Govt. Infectious Diseases Hospital situated at a place where the Govt. servant is entitled to receive medical attendance and treatment.
Even in emergency, hospitalization in Nursing Home/Clinic of AMA is not admissible. However, treatment at the Consulting room of AMA is permissible.
The status of medical reimbursement on certain eventualities in the course of service of a Govt. servant is detailed hereunder:
STATUS OF MEDICAL REIMBURSEMENT ON CERTAIN EVENTUALITIES
S.No.Status/EventEntitlement
1.Dies nonEntitled
2.These rules are also applicable to persons covered under Special Rules to Kolkata.
Administering injections forms part of treatment and such treatment should normally be received at the hospital. Up to 15 injections can be taken at the consulting room/residence of the AMA/patient. Beyond 15 injections, the patient should be referred to the OPD.
Consultation with Specialist
If a Govt. servant or his family requires Specialist service which could only be provided in the adjoining city, he/she may consult such a Specialist in a Govt./ recognized hospital. If the AMA is of the opinion that the case of a patient is of such a serious or special nature as to require medical attendance by some person other than himself, he may refer the patient to a Specialist or other Medical Officer or if the patient is too ill to travel, summon such Specialist/Medical Officer to attend upon the patient.
A fixed medical allowance of Rs.100/- per employee can be paid to staff working in the interior where AMA is not available within a radius of 5 km., even if available, such person is not willing to be appointed as AMA.
Super-imposition of another disease
Where a patient consults the same Doctor in regard to another disease during the course of treatment of one disease, such consultation should be regarded as “fresh consultation” and paid at full rate.
If one or more minor treatment procedures form part of a major treatment procedure, package charges would be made against the major procedures. Only half of actual charges quoted for the minor procedures would be added to the package charges of the first major procedure.
Special Nursing
Special nursing as certified to be essential for the recovery or for the prevention of serious deterioration in the condition of the patient by the Medical Officer concerned and the Medical Superintendent of the hospital in prescribed proforma, limited to the amount which is in excess of 25% of the pay of the Govt. servant concerned is reimburseable. Reimbursement for Attendant charges are admissible only in cases where it is certified by the hospital authorities that the it forms part of treatment and that the Attendant was not engaged in lieu of "Special Nursing".
Effective from 15-9-1995, maximum admissible rates for Nursing/Attendant per a shift of 12 hours are (a) Special Nurse: Rs.150/-; and (b) Ayah/Attendant: Rs.75/-.
Reimbursement of charges
Clinical tests at private institutions: Reimbursement of the charges paid to private practitioners/institutions for undertaking skiagrams, electric therapy, bacteriological, pathological examinations, etc. owing to non-availability of the facility at a Govt. hospital, on the advice of the AMA is permissible with the prior consent of the Director of Health Services/Chief Administrative Medical Officer.
Cost of blood and transfusion charges: Cost of Blood and transfusion charges paid to a Govt. institution or any other local organization recognized by the State Govt. of blood are refundable, provided that it is certified by the treating Doctor (AMA) that the supply of blood was not available in the hospital, and that the price paid was reasonable.
Testing of eye-sight: Govt. servants may get their eyesight tested for glasses at a Govt./recognized hospital once in three years on the recommendation of the AMA Fee paid to the Specialist for such services will be reimbursed according to the scheduled rates prescribed in the concerned State. Expenses towards correction of squint (eye) are reimbursable. There is no provision for reimbursement of cost of spectacles. The members of families are not entitled to the facility for testing of eye sight for glasses.
Medical treatment:A Govt. servant and members of family are entitled to treatment in such Govt. hospital at or near the place where the patient fell ill. If there is no such hospital other than Govt. hospital at or near the place which provides treatment free of charge. Permission can be granted to the CG employees to obtain medical services from any of the private hospitals recognized under CGHS.
Hospitalization:Cases of medical treatment requiring hospitalization will normally be referred to a Govt./recognized hospital by the AMA for admission. If hospitalization is not considered necessary but treatment is expected to be prolonged, a patient should be referred to the OPD of a Govt./recognized hospital. Charges levied, if any, are reimbursable.
The average stay in a hospital as an in-patient should be reckoned as two weeks. Any hospital stay beyond three weeks is treated as prolonged stay.
Prolonged treatment is defined as “a case of single and continuous spell of illness which requires either more than 4 consultations/ visits within a period of 10 days from the date of commencement of treatment or more than a course of 15 injections.”
In-patient treatment:A Govt. servant can receive treatment in a hospital where he is ordinarily entitled to receive treatment under the rules as an in-patient for himself and members of his family without consulting his AMA. While claiming reimbursement, a certificate should be produced from the Medical Superintendent of the hospital that the facilities provided were the minimum and were essential for the patient’s treatment. If a Central Govt. servant or family member suffering from an infectious disease receive in-patient treatment in a Govt. Infectious Diseases Hospital situated at a place where the Govt. servant is entitled to receive medical attendance and treatment.
Even in emergency, hospitalization in Nursing Home/Clinic of AMA is not admissible. However, treatment at the Consulting room of AMA is permissible.
The status of medical reimbursement on certain eventualities in the course of service of a Govt. servant is detailed hereunder:
STATUS OF MEDICAL REIMBURSEMENT ON CERTAIN EVENTUALITIES
S.No.Status/EventEntitlement
1.Dies nonEntitled
2.Suspension-do-
3.Study leave-do-
4.Foreign serviceEntitled from foreign employer
5.Deputation abroadEntitled from foreign employer
6.Special leave abroadEntitled depending upon the purpose
7.Voluntary/training/ embodiment in the Territorial Army/Military service during emergencyEntitled
NB:While a Govt. servant is abroad, leaving behind his family in India, his family can continue to avail medical facilities under these rules, subject to certain conditions.
NB:While a Govt. servant is abroad, leaving behind his family in India, his family can continue to avail medical facilities under these rules, subject to certain conditions.
Accommodation: Allotment of accommodation in a hospital depends upon the pay being drawn by the Govt. servant at the time of falling ill by himself or by his family members. If suitable accommodation as per the status of the Govt. servant is not available, accommodation of a higher class may be allotted, provided it is certified by the Medical Superintendent of the Hospital that accommodation of the appropriate class was not available at the time of admission and that the admission of the patient into the hospital could not be delayed.
If appropriate class of accommodation is not available, before seeking higher class of accommodation, efforts should be put in to seek admission in one more similar hospital, if available, at the same station. A certificate non-availability of suitable accommodation at such ‘other” hospital should be obtained.
ENTITLEMENT OF ACCOMMODATION
Basic pay up to Rs. 7,500/-General wardRs. 500/- per day (max.)*
If appropriate class of accommodation is not available, before seeking higher class of accommodation, efforts should be put in to seek admission in one more similar hospital, if available, at the same station. A certificate non-availability of suitable accommodation at such ‘other” hospital should be obtained.
ENTITLEMENT OF ACCOMMODATION
Basic pay up to Rs. 7,500/-General wardRs. 500/- per day (max.)*
Basic pay from Rs.7,501/- to Rs.10,500/-Semi-private wardRs. 1,000/- per day*
Basic pay Rs.10,501/- and abovePrivate wardRs. 1,500/- per day * Day care (6-8 hours admission) (Same for all categories)---Rs. 500/- per day *
* The package rate given above is for treatment in Semi-private ward. For Private Ward, there will be an "increase" of 15% and for General Ward there will be a "decrease" of 10%. For investigations and treatment procedures for which admission is not required, the rates will be same for all categories.
Pay for the purpose of determining the eligibility includes Non-Practising Allowance and Stagnation Increment drawn, if any by the Govt. servant in the pre-revised scale of pay (Fourth Pay Commission)
Electric lighting charges and fan charges form part of accommodation charges are reimbursable. Cottage booking/admission fee, dhobi/air-conditioning/heater charges are not reimbursable.
Diet charges: Diet charges paid to hospital, TB Sanatoria, etc. during the course of their indoor treatment are reimburseable in full, if the pay of the Govt. servant concerned is not more than (i) Rs.2,000/- (pre-revised) p.m. in case of patients suffering from TB and Mental diseases. In respect of those who are drawing not more than Rs.1,350/- p.m. (pre-revised), the diet charges are reimbursable in all diseases.
Where the hospital charges a flat rate which includes diet, accommodation, ordinary nursing, medical and surgical services, and also in respect of Military or recognized factory hospitals, 20% of the flat charges will be reckoned as diet charges; where it includes diet, accommodation and ordinary nursing only, 50% of the charge will be reckoned as diet charges.
Treatment for Immunization: In case of communicable diseases, charges incurred for Immunizing and Prophylactic purposes are refundable to Central Govt. servants in respect of treatment for themselves or members of their families, provided: (i) OPDs of Govt./recognized hospital/dispensary, etc. have no arrangements for providing such treatment free of charge; and (ii) reimbursement of cost of prophylactic and immunizing agents and consultation fee is admissible.
Cost of vaccination for Hepatitis B is reimbursable.
Absence of prescribed rates
The claims for reimbursement of charges of treatment/examination, etc. for which no corresponding rates are not available in the nearest Govt. hospitals for regulating such claims may be reimbursed by (a) restricting such claims to the rate of Govt. hospitals in the concerned State, and (b) where such rates/facilities are not available in the concerned State, full reimbursement of such charges may be made on the certification of the Director of Health Services of the concerned State.
Treatment at AIIMS, New Delhi: CGHS beneficiaries possessing a valid card can avail treatment facilities in the All India Institute of Medical Sciences, Delhi without any prior permission. Drugs prescribed, if any, during the treatment at OPD should be obtained from concerned CGHS Dispensary on the basis of prescription. The reimbursement will be as per the entitlement and the prescribed rates of AIIMS.
Treatment outside District/State
Central Govt. servants and members of their families may receive treatment for all diseases (other than TB, Cancer, Polio and Mental diseases) for which treatment is provided in a Govt./recognized hospital outside the District/State, provided: (i) necessary facilities for treatment are not available in a Govt./recognized hospital where the person fell ill; and (ii) the treatment outside the District/State is recommended by the AMA and countersigned by the Chief Medical Officer (CMO) of the District. If it is to be undertaken outside the State, countersigning by the CMO of the State is required.
Treatment at residence
If the AMA is of the opinion that owing to the absence or remoteness of a suitable hospital or to the severity of the illness, a Govt. servant may receive treatment at his residence. He shall be entitled to receive the cost of treatment as per rules. Claims for reimbursement have to be preferred within three months. Heads of Departments are delegated with powers to condone the delay, if any, in submission of claims.
Foreign service
Govt. servant shall be allowed to go on foreign service only if the foreign employer undertakes to provide him the privileges not inferior to those which he would have enjoyed under the rules had he been in the service of Govt. of India.
Other Medical facilities
Charges which were not included in medical attendance/treatment under these rules shall be determined by the AMA and paid by the patient. Anti-rabic treatment is reimbursable. Expenses incurred for treatment for venereal diseases and delirium tremens, sterility, sterilization, medical termination of pregnancy, etc. are admissible.
Treatment by a private Dentist or Oculist is not admissible.
General debility or secondary anaemia is also covered by these rules.
The details of reimbursable and non-reimbursable diagnostic and other procedures are given in Annexure-I.
Coronary diseases
The rates of Coronary Bypass Surgery for in respect of all recognized private hospitals have been regulated on package deal basis. No limit has been prescribed on number of bypass surgeries.
A list of private hospitals recognized for Coronary Bypass Surgery has been given hereunder:
RECOGNIZED PRIVATE HOSPITALS FOR CORONARY BYPASS SURGERY
Name of the Hospital
Pay for the purpose of determining the eligibility includes Non-Practising Allowance and Stagnation Increment drawn, if any by the Govt. servant in the pre-revised scale of pay (Fourth Pay Commission)
Electric lighting charges and fan charges form part of accommodation charges are reimbursable. Cottage booking/admission fee, dhobi/air-conditioning/heater charges are not reimbursable.
Diet charges: Diet charges paid to hospital, TB Sanatoria, etc. during the course of their indoor treatment are reimburseable in full, if the pay of the Govt. servant concerned is not more than (i) Rs.2,000/- (pre-revised) p.m. in case of patients suffering from TB and Mental diseases. In respect of those who are drawing not more than Rs.1,350/- p.m. (pre-revised), the diet charges are reimbursable in all diseases.
Where the hospital charges a flat rate which includes diet, accommodation, ordinary nursing, medical and surgical services, and also in respect of Military or recognized factory hospitals, 20% of the flat charges will be reckoned as diet charges; where it includes diet, accommodation and ordinary nursing only, 50% of the charge will be reckoned as diet charges.
Treatment for Immunization: In case of communicable diseases, charges incurred for Immunizing and Prophylactic purposes are refundable to Central Govt. servants in respect of treatment for themselves or members of their families, provided: (i) OPDs of Govt./recognized hospital/dispensary, etc. have no arrangements for providing such treatment free of charge; and (ii) reimbursement of cost of prophylactic and immunizing agents and consultation fee is admissible.
Cost of vaccination for Hepatitis B is reimbursable.
Absence of prescribed rates
The claims for reimbursement of charges of treatment/examination, etc. for which no corresponding rates are not available in the nearest Govt. hospitals for regulating such claims may be reimbursed by (a) restricting such claims to the rate of Govt. hospitals in the concerned State, and (b) where such rates/facilities are not available in the concerned State, full reimbursement of such charges may be made on the certification of the Director of Health Services of the concerned State.
Treatment at AIIMS, New Delhi: CGHS beneficiaries possessing a valid card can avail treatment facilities in the All India Institute of Medical Sciences, Delhi without any prior permission. Drugs prescribed, if any, during the treatment at OPD should be obtained from concerned CGHS Dispensary on the basis of prescription. The reimbursement will be as per the entitlement and the prescribed rates of AIIMS.
Treatment outside District/State
Central Govt. servants and members of their families may receive treatment for all diseases (other than TB, Cancer, Polio and Mental diseases) for which treatment is provided in a Govt./recognized hospital outside the District/State, provided: (i) necessary facilities for treatment are not available in a Govt./recognized hospital where the person fell ill; and (ii) the treatment outside the District/State is recommended by the AMA and countersigned by the Chief Medical Officer (CMO) of the District. If it is to be undertaken outside the State, countersigning by the CMO of the State is required.
Treatment at residence
If the AMA is of the opinion that owing to the absence or remoteness of a suitable hospital or to the severity of the illness, a Govt. servant may receive treatment at his residence. He shall be entitled to receive the cost of treatment as per rules. Claims for reimbursement have to be preferred within three months. Heads of Departments are delegated with powers to condone the delay, if any, in submission of claims.
Foreign service
Govt. servant shall be allowed to go on foreign service only if the foreign employer undertakes to provide him the privileges not inferior to those which he would have enjoyed under the rules had he been in the service of Govt. of India.
Other Medical facilities
Charges which were not included in medical attendance/treatment under these rules shall be determined by the AMA and paid by the patient. Anti-rabic treatment is reimbursable. Expenses incurred for treatment for venereal diseases and delirium tremens, sterility, sterilization, medical termination of pregnancy, etc. are admissible.
Treatment by a private Dentist or Oculist is not admissible.
General debility or secondary anaemia is also covered by these rules.
The details of reimbursable and non-reimbursable diagnostic and other procedures are given in Annexure-I.
Coronary diseases
The rates of Coronary Bypass Surgery for in respect of all recognized private hospitals have been regulated on package deal basis. No limit has been prescribed on number of bypass surgeries.
A list of private hospitals recognized for Coronary Bypass Surgery has been given hereunder:
RECOGNIZED PRIVATE HOSPITALS FOR CORONARY BYPASS SURGERY
Name of the Hospital
Delhi
1. Batra Hospital & Medical Research Centre
2. National Heart Institute
3. Escorts Heart Institute & Research Centre
2. National Heart Institute
3. Escorts Heart Institute & Research Centre
Hyderabad
1. Apollo Hospital
2. Medwin Hospital
2. Medwin Hospital
Chennai
1. Apollo Hospital
2. Madras Medical Mission (Institute of Cardio-vascular Diseases)
3. Trinity Acute Care Hospital
2. Madras Medical Mission (Institute of Cardio-vascular Diseases)
3. Trinity Acute Care Hospital
Pune:
1. Ruby Hall Clinic (Poona Medical Foundation)
Kolkata
1. Woodland Nursing Home
2. B.M. Birla Heart Research Centre
2. B.M. Birla Heart Research Centre
Bangalore
1. Manipal Hospital
2. Wockhardt Medical & Research Centre
2. Wockhardt Medical & Research Centre
Mumbai
1. Bombay Hospital
2. Nanavati Hospital
2. Nanavati Hospital
Package rate: Package rate means a lump sum cost of in-patient treatment or Diagnostic procedure which includes all charges, admission, accommodation, ICU/ ICCU, monitoring, operation theatre, anesthesia, cost of disposables, surgical charges, surgeon's fee, related routine investigations, physiotherapy charges and medicines used during hospitalization, etc.
Package rate does not include diet, telephone/TV charges, cosmetics, toiletry, tonics and medicines advertised in mass media. The hospital/ centre cannot charge more than the package rate from the beneficiary.
Package rate for CABG and Coronary Angiography includes room rent from the date of admission to the date of discharge, service charges, nursing/medical care, surgeon’s and anaesthetist’s fee, operation theatre charge, etc. but does not include diet, cosmetics, toiletry, telephone charges, etc. Expenses over and above the prescribed rates, if any, have to be borne by the beneficiaries.
The cost ceiling for coronary stents, knee implants, etc. has been given in Annexure-II.
Under package rate, duration of stay in a hospital for different treatments is given hereunder:
Specialized procedure: 12 Days
Other procedures : 7-8 Days
Laproscopic surgery: 3 Days
Day care/minor procedure (OPD): 1 Day
If the beneficiary stays in the hospital for recovery for more than the above period, the additional reimbursement shall be limited to room rent as per entitlement, cost of the prescribed medicines and investigations, doctors' visits (2 times a day) during additional stay.
Dental treatment
Dental treatment is not covered under these rules. However, if the diagnosis of the physiological or other disability from which a Govt. servant is suffering indicates that teeth are the actual source of problem, dental treatment of a major kind such as treatment of jaw bone disease, removal of all the teeth, removal of odontomes and impacted wisdom tooth, gum boils, etc. is reimbursable.
Expenses incurred by Central Govt. employees in connection with the following types of dental treatment obtained at Govt. recognized hospitals are reimbursable: (a) extraction (b) scaling and gum treatment (including Pyorrhoea and Gingivitis) (c) filling of teeth (d) root canal treatment. Reimbursement of expenditure for complete Denture with a ceiling of Rs.2000/- (Denture of one Jaw would be Rs.1000/-) is admissible on one time basis
Artificial appliances
Reimbursement of the cost of various artificial appliances including the cost of Heart Pace Maker and replacement of the pulse generator, cost of replacement of diseased heart valves, artificial electronic larynx, hearing aid is admissible. In such cases, the administrative authority shall make payment direct to the supplying agency.
Cost of boot (shoe) in case of patients is reimbursable only after three years for a maximum limit of 3 times. Repairs and adjustments where necessitated under the advice of the Medical Specialist should be got done at the recognized centres. It has to be ensured that the cost of repairs/adjustment of appliances is less than the cost of replacement. Replacement of hearing aid is permitted after 5 years on the basis of a condemnation certificate from a technical expert and on approval of an ENT Specialist.
Reimbursement of cost of artificial appliances is allowed only when these are certified as essential by a Specialist in the hospital.
Grant of advances
Application for advance should be supported by a Certificate that the patient is being treated indicating the duration of such treatment and the anticipated cost . Advance limited to Rs.10,000/-, or such other amount as the Medical Officer-in-charge of the patient may recommend whichever is less would be admissible when a Govt. servant or a member of his family is being treated (a) as an in-patient in a hospital (b) as an out-patient in the case of TB/Cancer.
A second advance can also be granted at the discretion of the Head of Office not exceed Rs.10,000/- including the first advance. Advance can also be granted for purchase/replacement of artificial appliances.
If an advance is requested by the Govt. servant or on his/her behalf of spouse/legal heir, it will be paid direct to the hospital concerned on receipt of an estimate from the treating Physician/Medical Superintendent of the hospital. Settlement of advance will be through subsequent claim for reimbursement as admissible under CS (MA) Rules, and balance, if any, recovered from the pay/leave salary of the Govt. servant in not more than four equal monthly installments. In case of prolonged treatment, reimbursement of medical expenses may continue to be allowed to Govt. servants to the extent admissible, and the advance in such cases need not be adjusted within one month as in the above case, if it is certified by the Medical Officer-in-charge.
Heads of Office are empowered to grant advances to Central Govt. servants to enable them to initially meet the expenditure on medical attendance and treatment for themselves and their family members. Advances are admissible to all Govt. servants irrespective of their pay, subject to fulfilment of certain conditions. Temporary Govt. servants can be granted medical advance on providing necessary surety from a permanent Govt. employee.
The limits prescribed for grant of advance for medical treatment are given hereunder:
GRANT OF ADVANCES AND LIMITATIONS
S.No.Nature of treatmentLimitations
Package rate does not include diet, telephone/TV charges, cosmetics, toiletry, tonics and medicines advertised in mass media. The hospital/ centre cannot charge more than the package rate from the beneficiary.
Package rate for CABG and Coronary Angiography includes room rent from the date of admission to the date of discharge, service charges, nursing/medical care, surgeon’s and anaesthetist’s fee, operation theatre charge, etc. but does not include diet, cosmetics, toiletry, telephone charges, etc. Expenses over and above the prescribed rates, if any, have to be borne by the beneficiaries.
The cost ceiling for coronary stents, knee implants, etc. has been given in Annexure-II.
Under package rate, duration of stay in a hospital for different treatments is given hereunder:
Specialized procedure: 12 Days
Other procedures : 7-8 Days
Laproscopic surgery: 3 Days
Day care/minor procedure (OPD): 1 Day
If the beneficiary stays in the hospital for recovery for more than the above period, the additional reimbursement shall be limited to room rent as per entitlement, cost of the prescribed medicines and investigations, doctors' visits (2 times a day) during additional stay.
Dental treatment
Dental treatment is not covered under these rules. However, if the diagnosis of the physiological or other disability from which a Govt. servant is suffering indicates that teeth are the actual source of problem, dental treatment of a major kind such as treatment of jaw bone disease, removal of all the teeth, removal of odontomes and impacted wisdom tooth, gum boils, etc. is reimbursable.
Expenses incurred by Central Govt. employees in connection with the following types of dental treatment obtained at Govt. recognized hospitals are reimbursable: (a) extraction (b) scaling and gum treatment (including Pyorrhoea and Gingivitis) (c) filling of teeth (d) root canal treatment. Reimbursement of expenditure for complete Denture with a ceiling of Rs.2000/- (Denture of one Jaw would be Rs.1000/-) is admissible on one time basis
Artificial appliances
Reimbursement of the cost of various artificial appliances including the cost of Heart Pace Maker and replacement of the pulse generator, cost of replacement of diseased heart valves, artificial electronic larynx, hearing aid is admissible. In such cases, the administrative authority shall make payment direct to the supplying agency.
Cost of boot (shoe) in case of patients is reimbursable only after three years for a maximum limit of 3 times. Repairs and adjustments where necessitated under the advice of the Medical Specialist should be got done at the recognized centres. It has to be ensured that the cost of repairs/adjustment of appliances is less than the cost of replacement. Replacement of hearing aid is permitted after 5 years on the basis of a condemnation certificate from a technical expert and on approval of an ENT Specialist.
Reimbursement of cost of artificial appliances is allowed only when these are certified as essential by a Specialist in the hospital.
Grant of advances
Application for advance should be supported by a Certificate that the patient is being treated indicating the duration of such treatment and the anticipated cost . Advance limited to Rs.10,000/-, or such other amount as the Medical Officer-in-charge of the patient may recommend whichever is less would be admissible when a Govt. servant or a member of his family is being treated (a) as an in-patient in a hospital (b) as an out-patient in the case of TB/Cancer.
A second advance can also be granted at the discretion of the Head of Office not exceed Rs.10,000/- including the first advance. Advance can also be granted for purchase/replacement of artificial appliances.
If an advance is requested by the Govt. servant or on his/her behalf of spouse/legal heir, it will be paid direct to the hospital concerned on receipt of an estimate from the treating Physician/Medical Superintendent of the hospital. Settlement of advance will be through subsequent claim for reimbursement as admissible under CS (MA) Rules, and balance, if any, recovered from the pay/leave salary of the Govt. servant in not more than four equal monthly installments. In case of prolonged treatment, reimbursement of medical expenses may continue to be allowed to Govt. servants to the extent admissible, and the advance in such cases need not be adjusted within one month as in the above case, if it is certified by the Medical Officer-in-charge.
Heads of Office are empowered to grant advances to Central Govt. servants to enable them to initially meet the expenditure on medical attendance and treatment for themselves and their family members. Advances are admissible to all Govt. servants irrespective of their pay, subject to fulfilment of certain conditions. Temporary Govt. servants can be granted medical advance on providing necessary surety from a permanent Govt. employee.
The limits prescribed for grant of advance for medical treatment are given hereunder:
GRANT OF ADVANCES AND LIMITATIONS
S.No.Nature of treatmentLimitations
1.For indoor treatment in a hospital and out-patient treatment for diseases like Cancer, etc. where the duration of treatment is 3 months or less Rs.10,000/- or the amount recommended by the Physician whichever is less.
2.In case of TB where the duration of treatment is more than 3 monthsLimited to 80% of the estimated
cost or Rs.36,000/- whichever is less
cost or Rs.36,000/- whichever is less
3.Major illness of Bypass surgery/Kidney/ Cancer including Acute Myeloid Leukemia/ chronic Active Hepatitis, Subset of Hepatitis-BLimited to 90% of the package deal wherever exists or according to the estimate submitted by the Govt./ recognized private hospital.
Treatment of special diseases
A Central Govt. servant or a member of his family may receive treatment for special diseases such as Cancer, Diabetes, Mental diseases, Poliomyelitis, Cerebral Palsy and Spastics, Tubercular diseases. Leprosy, Thalassaemia Major, at a hospital where specialized treatment for a particular disease is available on the recommendation of Medical Superintendent of the recognized hospital to whom the patient is referred for treatment.
In cases where a patient who has undergone treatment in a recognized hospital for a particular disease is advised by the Medical Superintendent of the hospital to continue certain treatment or check ups after discharge from the hospital, such patient may be allowed to consult and receive medical treatment directly from a Govt./recognized hospital without consulting the AMA.
Concessions for families
The family of a Govt. servant is entitled to receive medical attendance and treatment at the hospital at which the Govt. servant himself is entitled. The term "family" for the purpose of these rules shall mean a Govt. servant's wife/husband, parents (excluding step-parents) sisters, widowed sisters, widowed daughters, brothers (excluding major brothers), children (including legally adopted children), stepchildren, divorced/ separated daughters and step-mother wholly dependent upon the Govt. servant.
Income limits for dependency: A member of the family is treated as dependant only if his/her income from all sources such as recurring monthly income from houses, land-holdings, etc. including pension and pension equivalent of DCRG benefit but excluding relief on pension (sanctioned after December 1995) is less than Rs.1,500/- per month. However, lump sum non-recurring income such as CPF benefits, Govt. of India Prize Bonds, Gratuity, Commuted Gratuity, Insurance benefits, etc. should not be regarded as income for this purpose.
If wife and husband are Central Govt. servants, they may be allowed to avail the medical concessions along with eligible dependents according to his/her status by furnishing their respective administrative authorities, a joint declaration (in duplicate) as to who will prefer the claim for reimbursement of medical expenses. A copy of each shall be recorded in their personal files in their respective Offices. Such declaration shall remain in force till it is revised by them.
The families of a Central Govt. servant are eligible for medical facilities even when the Govt. servants are under voluntary training/embodiment in the Territorial Army/Military service during emergency, proceeding ex-India on deputation or leave including study leave and deputation-cum-special leave under the various schemes.
Details of dependency and corresponding rule position are given in Annexure-III.
Facilities to CGHS beneficiaries
On the recommendation of Specialist of CGHS/Govt. Hospital/CMO-In-Charge of CGHS Dispensary, the beneficiary is free to avail specialized treatment/diagnostic tests at any CGHS recognised hospitals/centres as per prescribed rates.
For non-emergency cases, CGHS beneficiaries are entitled to medical reimbursement for treatment in recognised hospitals, subject to written permission from the competent authority. On production of permission, the recognized hospitals/ diagnostic centres shall provide credit facilities to CGHS beneficiaries including pensioners, family pensioners and their dependents.
In case of emergency, the recognized private hospital cannot refuse admission or even demand advance from the beneficiary. They shall provide credit facilities to the concerned patient on production of valid CGHS card. Reimbursement in respect of serving CGHS beneficiaries will be made by the respective Departments.
Medical facilities to CSIR Pensioners
CSIR Dispensaries of all the National Labs./Instts. (other than Delhi) have to be treated at par with the CGHS Dispensaries to get the same facilities as available to Govt./CSIR pensioners residing at Delhi.
They will be given "one-time option" at the time of their retirement for medical coverage either under CGHS or under the CS (MA) Rules, 1944. On opting for CGHS facilities, they have to get themselves registered in the nearest CGHS City for availing facilities. In such cases, the claims for reimbursement would be processed by the Addl. Director, CGHS of the concerned city. In cases of those employees who were given extension of service or re-employed, they can pay normal contribution in order to avail CGHS facilities as in the case of serving officials. The extended period of service will be deducted from the total number of 10 years while calculating the amount. For those opting CS (MA) Rules, 1944, the scrutiny of the claims would have to be done by the parent Office as in the case of serving employees.
Issue of Life Cards
It is compulsory for all the Pensioners to enroll themselves for availing medical facility by making lump sum one-time contribution. Pensioners on having deposited the lump sum one-time subscription equivalent to 10 years’ for availing medical facility have to be issued a permanent Medical Identity Card which would be 13 x 8 cm in size and light blue in colour containing the details as per specimen provided by CSIR.
This facility has also been extended to those who retired before 17-10-1991, if they are willing to pay subscription for the remaining period equal to 10 years.
CSIR pensioners who enroll themselves with the dispensaries at Labs./Instts. shall now be eligible for medical treatment and reimbursement as applicable to the Govt. pensioners covered under CGHS Scheme.
If Pensioners or their dependent family members are referred to Govt./recognised hospital for consultation/Specialist treatment from Out-Patient Department, the medicines so prescribed have to be procured by the Dispensary on urgent basis and supplied.
No reimbursement shall be admissible to the pensioners for OPD treatment at the Govt./Recognised hospitals and the medicines prescribed by the Specialists of such hospitals are to be procured and supplied by the Dispensaries. Medical reimbursement with regard to indoor treatment shall be admissible provided the patient is referred for Specialist treatment by the Medical Officer-in-Charge of the CSIR Dispensaries.
The pensioners and their families who reside at places where no CSIR Lab. Dispensary facilities are not available shall be eligible for the medical facilities provided by a Govt./recognised hospital or in lieu of OPD treatment, they are eligible to draw Rs.100/- p.m.
The rate of contribution similar to CGHS is given hereunder:
RATE OF CONTRIBUTION W.E.F. 1-4-2004
Basic pay plus Dearness Pay or Basic Pension plus Dearness Pension
Monthly subscriptionUpto Rs.3000Rs. 15.00Rs.3001 to Rs.6000Rs. 40.00Rs.6001 to Rs.10000Rs. 70.00Rs.10000 to Rs.15000Rs.100.00Rs.15001 and aboveRs.150.00
The Pensioners shall have an option to get their CGHS Pensioner card made by either making CGHS contribution on an annual basis (12 months) or by paying for 10 years (120 months) for getting a Permanent/ Whole Life Card. Pensioners who join the CGHS w.e.f. 1-4-2004 or a subsequent date would get their Ward entitlement based on their last Basic pay plus DP i.e. they would continue to get the same Ward entitlement as they had while in service.
Reimbursement by Insurance Companies
If CGHS Pensioners and those who are governed by CS (MA) Rules holding CGHS/Medical Identity Card are also possessing a Mediclaim Policy, they would be allowed to claim reimbursement of medical expenses both from Insurance Companies as well as the CGHS.
Medical claim against the original vouchers/bills would be raised by the pensioner first on the Insurance Co. which would issue a Certificate to the Director, CGHS of the amount reimbursed to the pensioner holding the Mediclaim policy. The concerned Insurance Co. would retain the original bills in such cases. The CGHS cardholder would then prefer medical claim to the concerned Addl. Director of CGHS along with photocopies of the vouchers/bills duly certified in ink and stamped on the reverse of the bills. The CGHS/CSIR Lab., as the case may be, would reimburse to the pensioner only the balance of the admissible amount (amount admissible (-) amount paid by Insurance Company). The total amount reimbursed by the two organizations does not exceed the total expenditure incurred by the pensioner.
Indian and Homoeopathic Systems of Medicine
The policy of the Government was that Allopathic scientific medicine should continue to be the basis for the development of the National Health Services in the country. This policy has recently been modified to admit Indian and Homoeopathic Systems of Medicines (ISM).
The details of AMAs under Indian and Homoeopathic Systems of Medicine and Consultation fee payable to them are given hereunder:
AUTHORISED MEDICAL ATTENDANTS FOR INDIAN MEDICINE SYSTEMS
1. Gr. A Govt. servant whose pay is not less than Rs.2,500/- (pre-revised) p.m.
Gr. A Officers belonging to Ayurveda, Unani, Siddha
and Homoeopathic Medical Services of the State or
Central Govt. or any other qualified Medical Officer
appointed by the Govt. to attend its Officers in the
District.
A Central Govt. servant or a member of his family may receive treatment for special diseases such as Cancer, Diabetes, Mental diseases, Poliomyelitis, Cerebral Palsy and Spastics, Tubercular diseases. Leprosy, Thalassaemia Major, at a hospital where specialized treatment for a particular disease is available on the recommendation of Medical Superintendent of the recognized hospital to whom the patient is referred for treatment.
In cases where a patient who has undergone treatment in a recognized hospital for a particular disease is advised by the Medical Superintendent of the hospital to continue certain treatment or check ups after discharge from the hospital, such patient may be allowed to consult and receive medical treatment directly from a Govt./recognized hospital without consulting the AMA.
Concessions for families
The family of a Govt. servant is entitled to receive medical attendance and treatment at the hospital at which the Govt. servant himself is entitled. The term "family" for the purpose of these rules shall mean a Govt. servant's wife/husband, parents (excluding step-parents) sisters, widowed sisters, widowed daughters, brothers (excluding major brothers), children (including legally adopted children), stepchildren, divorced/ separated daughters and step-mother wholly dependent upon the Govt. servant.
Income limits for dependency: A member of the family is treated as dependant only if his/her income from all sources such as recurring monthly income from houses, land-holdings, etc. including pension and pension equivalent of DCRG benefit but excluding relief on pension (sanctioned after December 1995) is less than Rs.1,500/- per month. However, lump sum non-recurring income such as CPF benefits, Govt. of India Prize Bonds, Gratuity, Commuted Gratuity, Insurance benefits, etc. should not be regarded as income for this purpose.
If wife and husband are Central Govt. servants, they may be allowed to avail the medical concessions along with eligible dependents according to his/her status by furnishing their respective administrative authorities, a joint declaration (in duplicate) as to who will prefer the claim for reimbursement of medical expenses. A copy of each shall be recorded in their personal files in their respective Offices. Such declaration shall remain in force till it is revised by them.
The families of a Central Govt. servant are eligible for medical facilities even when the Govt. servants are under voluntary training/embodiment in the Territorial Army/Military service during emergency, proceeding ex-India on deputation or leave including study leave and deputation-cum-special leave under the various schemes.
Details of dependency and corresponding rule position are given in Annexure-III.
Facilities to CGHS beneficiaries
On the recommendation of Specialist of CGHS/Govt. Hospital/CMO-In-Charge of CGHS Dispensary, the beneficiary is free to avail specialized treatment/diagnostic tests at any CGHS recognised hospitals/centres as per prescribed rates.
For non-emergency cases, CGHS beneficiaries are entitled to medical reimbursement for treatment in recognised hospitals, subject to written permission from the competent authority. On production of permission, the recognized hospitals/ diagnostic centres shall provide credit facilities to CGHS beneficiaries including pensioners, family pensioners and their dependents.
In case of emergency, the recognized private hospital cannot refuse admission or even demand advance from the beneficiary. They shall provide credit facilities to the concerned patient on production of valid CGHS card. Reimbursement in respect of serving CGHS beneficiaries will be made by the respective Departments.
Medical facilities to CSIR Pensioners
CSIR Dispensaries of all the National Labs./Instts. (other than Delhi) have to be treated at par with the CGHS Dispensaries to get the same facilities as available to Govt./CSIR pensioners residing at Delhi.
They will be given "one-time option" at the time of their retirement for medical coverage either under CGHS or under the CS (MA) Rules, 1944. On opting for CGHS facilities, they have to get themselves registered in the nearest CGHS City for availing facilities. In such cases, the claims for reimbursement would be processed by the Addl. Director, CGHS of the concerned city. In cases of those employees who were given extension of service or re-employed, they can pay normal contribution in order to avail CGHS facilities as in the case of serving officials. The extended period of service will be deducted from the total number of 10 years while calculating the amount. For those opting CS (MA) Rules, 1944, the scrutiny of the claims would have to be done by the parent Office as in the case of serving employees.
Issue of Life Cards
It is compulsory for all the Pensioners to enroll themselves for availing medical facility by making lump sum one-time contribution. Pensioners on having deposited the lump sum one-time subscription equivalent to 10 years’ for availing medical facility have to be issued a permanent Medical Identity Card which would be 13 x 8 cm in size and light blue in colour containing the details as per specimen provided by CSIR.
This facility has also been extended to those who retired before 17-10-1991, if they are willing to pay subscription for the remaining period equal to 10 years.
CSIR pensioners who enroll themselves with the dispensaries at Labs./Instts. shall now be eligible for medical treatment and reimbursement as applicable to the Govt. pensioners covered under CGHS Scheme.
If Pensioners or their dependent family members are referred to Govt./recognised hospital for consultation/Specialist treatment from Out-Patient Department, the medicines so prescribed have to be procured by the Dispensary on urgent basis and supplied.
No reimbursement shall be admissible to the pensioners for OPD treatment at the Govt./Recognised hospitals and the medicines prescribed by the Specialists of such hospitals are to be procured and supplied by the Dispensaries. Medical reimbursement with regard to indoor treatment shall be admissible provided the patient is referred for Specialist treatment by the Medical Officer-in-Charge of the CSIR Dispensaries.
The pensioners and their families who reside at places where no CSIR Lab. Dispensary facilities are not available shall be eligible for the medical facilities provided by a Govt./recognised hospital or in lieu of OPD treatment, they are eligible to draw Rs.100/- p.m.
The rate of contribution similar to CGHS is given hereunder:
RATE OF CONTRIBUTION W.E.F. 1-4-2004
Basic pay plus Dearness Pay or Basic Pension plus Dearness Pension
Monthly subscriptionUpto Rs.3000Rs. 15.00Rs.3001 to Rs.6000Rs. 40.00Rs.6001 to Rs.10000Rs. 70.00Rs.10000 to Rs.15000Rs.100.00Rs.15001 and aboveRs.150.00
The Pensioners shall have an option to get their CGHS Pensioner card made by either making CGHS contribution on an annual basis (12 months) or by paying for 10 years (120 months) for getting a Permanent/ Whole Life Card. Pensioners who join the CGHS w.e.f. 1-4-2004 or a subsequent date would get their Ward entitlement based on their last Basic pay plus DP i.e. they would continue to get the same Ward entitlement as they had while in service.
Reimbursement by Insurance Companies
If CGHS Pensioners and those who are governed by CS (MA) Rules holding CGHS/Medical Identity Card are also possessing a Mediclaim Policy, they would be allowed to claim reimbursement of medical expenses both from Insurance Companies as well as the CGHS.
Medical claim against the original vouchers/bills would be raised by the pensioner first on the Insurance Co. which would issue a Certificate to the Director, CGHS of the amount reimbursed to the pensioner holding the Mediclaim policy. The concerned Insurance Co. would retain the original bills in such cases. The CGHS cardholder would then prefer medical claim to the concerned Addl. Director of CGHS along with photocopies of the vouchers/bills duly certified in ink and stamped on the reverse of the bills. The CGHS/CSIR Lab., as the case may be, would reimburse to the pensioner only the balance of the admissible amount (amount admissible (-) amount paid by Insurance Company). The total amount reimbursed by the two organizations does not exceed the total expenditure incurred by the pensioner.
Indian and Homoeopathic Systems of Medicine
The policy of the Government was that Allopathic scientific medicine should continue to be the basis for the development of the National Health Services in the country. This policy has recently been modified to admit Indian and Homoeopathic Systems of Medicines (ISM).
The details of AMAs under Indian and Homoeopathic Systems of Medicine and Consultation fee payable to them are given hereunder:
AUTHORISED MEDICAL ATTENDANTS FOR INDIAN MEDICINE SYSTEMS
1. Gr. A Govt. servant whose pay is not less than Rs.2,500/- (pre-revised) p.m.
Gr. A Officers belonging to Ayurveda, Unani, Siddha
and Homoeopathic Medical Services of the State or
Central Govt. or any other qualified Medical Officer
appointed by the Govt. to attend its Officers in the
District.
2.Gr. A Officers whose pay is less than Rs.2,500/- (pre-revised but more than Rs.1,200/-(pre-revised) p.m.
A Group B Gazetted Officer of the above
3.In respect of any other Govt. servant
The Physicians in-charge of Govt., /Govt.-aided,
Municipal, Panchayat dispensaries of Govt., Govt.-aided, Municipal and Panchayati dispensaries of Indian Medicine and/or any other qualified Medical Officer similarly appointed
A Group B Gazetted Officer of the above
3.In respect of any other Govt. servant
The Physicians in-charge of Govt., /Govt.-aided,
Municipal, Panchayat dispensaries of Govt., Govt.-aided, Municipal and Panchayati dispensaries of Indian Medicine and/or any other qualified Medical Officer similarly appointed
4.In respect of any or all the above categories of Govt. servants:
A Registered Medical Practitioner holding degree or diploma in Indian Medicine of not less than 4 years' duration from a University/Statutory Board/ Council/ Faculty of Indian Medicine Central Council Act, 1970/
Homoepathy Central Council Act, 1973 and having at least 5 years' professional experience in the system of medicine. It would be desirable to select practitioners having a recognized Post-graduate
CONSULTANCY FEE PAYABLE TO AUTHORISED MEDICAL ATTENDANTS FOR INDIAN MEDICINE SYSTEMS
S.No.Nature of FeesMedical Post-Graduates
Graduates/Specialists of ISM&HMedical Graduates, Medical
Licentiates/Medical Graduates
of ISM&H
1.Consultation fee:
First consultation
Second
Consultation
Rs.30/-
Rs.16/-
Rs.24/-
Rs.13/-2.Visiting fees:
Day
Night
Rs.40/-
Rs.48/-
Rs.32/-
Rs.40/-
Private Registered Medical Practitioners
appointed as AMAs
Post-Graduate Graduate
Rs.3/- Rs.2/-
Rs.2/- Rs.1.50
Treatment outside India
A Govt. servant shall be eligible to obtain medical treatment and to claim reimbursement of the cost of any medical treatment obtained inside or outside India are given hereunder:
NATURE OF TREATMENT PERMITTED TO BE TAKEN ABROAD
S.No.Nature of treatment
1.Complex/high risk Cardio Vascular Surgery cases for treatment
at Centres with Extensive experience
2.Bone-marrow transplantation
3.Complex Medical and Oncological disorders such as Leukemia
and Neoplastic conditions
4.Complex high risk cases in Micro-vascular and Neurosurgery for
treatment at Centres with extensive experience
5.Treatment of extremely complex ailments Other than those
mentioned above which in the opinion of Standing Committee can
only be treated abroad and fall in the high risk category
A Govt. servant desirous of availing of medical treatment outside India for himself or for a member of his family for treatment as specified in the rules may make an application through the Department/Ministry to which the Govt. servant is attached to the Standing Committee in prescribed form. The Committee may recommend one Attendant to accompany the Govt. servant or a member of his family and the expenditure shall be reimbursable. The scale of expenditure and the eligibility for treatment shall be identical to the scale of expenditure and the eligibility of an Official of the Indian Foreign Service of the corresponding grade in the Ministry of External Affairs under any Assisted Medical Attendance Scheme.
Treatment of TB.
Non-Gazetted/Gazetted staff drawing pay less than Rs.2,500/- (pre-revised) p.m. stationed in and passing through Kolkata and members of their families are entitled to receive medical attendance for TB diseases from private doctors of their choice at their residence/residence of the doctor/consulting room.
Casual workers with temporary status
Medical facilities as available in the CSIR Dispensaries can be availed by the Casual/Dailywage workers who are conferred with temporary status, subject to the condition that no reimbursement of medical expenses would be admissible to them. However, their family members are not entitled to such facility.
Travelling Allowance
When the place at which a patient falls ill is more than 5 miles (8 Km.) by the shortest route from the consulting room of the AMA, the patient shall be entitled to TA for the journey to and from such consulting room. If the patient is too ill to travel, the AMA, Specialist AMA, shall be entitled to TA for the journey to and from the place the patient. However, Compounder/Lab. Assistant are not eligible for TA. Claims for TA shall be accompanied by a certificate by the AMA.
CGHS beneficiaries are not entitled for grant of conveyance charges when they are referred to Specialists/Hospitals within the city. Since CSIR Dispensaries are equated with CGHS, no conveyance charges shall be payable to CSIR employees or their family members including pensioners on their refererral for treatment as an Out-patient in recognized hospitals in the same city, even if the distance involved is more than 8 km.
Financial assistance
As per rules, the medical expenses in respect of the treatment taken in the private recognised hospitals for major illness like kidney transplant, coronary bye-pass surgery, heart transplant, chemotherapy, brain surgery, etc. are restricted to the ceilings fixed by the GoI. As the cost of treatment actually charged by the hospitals is very high in comparison with the ceilings fixed under the rules, the additional expenditure will be met from Welfare Fund of CSIR on case to case basis.
References
1.GoI MoH (DoH) O.M.No.S-11016/1/92-CGHS(P) dt. 29-10-1992
2.Swamysnews, Oct. 1993, 529
3.CSIR Lr. No. 17/1/91-E.II dt. 8-11-1994
4.GI MH&FW (DOH) OM No.S.14025/ 31/93-M.S. dt.16-2-1995; CSIR Endt. No. 31(5)/ 94-G dt. 31-1-1995
5.GI MH&FW OM No. 1-4/94-R&H/ CGHS(P) dt. 15-9-1995; Swamysnews, Nov. 1995, 850-1
6. CSIR Lr. No. 12(1)/95-E.II dt. 12-12-1995
7. CSIR Lr. No. 2(28)91-E.II dt. 11-6-1998
8. GI MoH& FW OM No.S-14025/4/96-MS dt.5-6-98; Swamysnews, Oct. 1998, 35-6
9. GI MH&FW Notfn.No.S.14025/31/ 97-MS dt. 7-7-1998; Swamysnews, Oct. 1998, 36
10. GI DoH OM No. Z.28013/8/98-MS dt. 26-5-2000; Swamysnews, July 2000, 54
11. GI DoH OM No. S.14025/18/2000-MS dt.29-5-2000; Swamysnews, July 2000, 54-55
12. CSIR Lr.No.14(38)/98-E.II dt. 14-12-2001
13. GI DH&FW OM No.11006/2000-JD (R&H) CGHS (P) dt. 11-6-2001; Swamysnews, Aug. 2001, 31-2
14. GI MH&FW OM No.24-2/96/ R&H/ CGHS/Pt.I/CGHS(P) dt. 26-6-2001; Swamysnews, Jan. 2002, 20
15. GI MH&FW OM Rec. No.24/2001/JD(M)/ CGHS/DELHI/CGHS(P) dt.7-9-2001 and No.24/2000-2001/CGHS/ JD(M)/1096-97 dt. 25-10-2001; Swamysnews, Jan. 2002 20-55 & 56-7
16. GI MH&FW OM No. S-11030/6/2001-CGHS (P) dt.5-11-2001; Swamysnews, Jan. 2002, 57
17. GoI MF FW OM No. S.14025/10/2001-MS dt. 31-12-2002; Swamysnews, Feb.2002, 62-3
18. GoI DoH O.M.No.S.14025/9/2002-MS dt. 13-8-2002; Swamysnews, Oct. 2002, 11
19. GoI MH&FW O.M. No. S-11011/4/2003-CGHS(P) dt. 8-1-2004; Swamysnews, April 2004, 11 and GoI MH O.M. No.S-11011/4/2003-CGHS(P) dt. 27-2-2004; Swamysnews, July 2004, 12-3]
20. GoI MH O.M.No.9005/2003/R&H/CGHS/CGHS(P) dt.8-3-2004; Swamysnews, July 2004, 13-4
21. CSIR Lr. No. 35-04(31)/02-PW&PG dt. 29-7-2004
22. GI MH&FW O.M.No.S-11011/6/98-CGHS (P) dt.20-9-2004; Swamysnews, Nov. 2004, 23-5
23. Swamy’s Compilation of the “Medical Attendance Rules” (2005), Swamy Publishers (P) Ltd., Chennai
24. CSIR Lr. No. 14(46)/MT/2000-E.II dt. 16-8-2005
A Registered Medical Practitioner holding degree or diploma in Indian Medicine of not less than 4 years' duration from a University/Statutory Board/ Council/ Faculty of Indian Medicine Central Council Act, 1970/
Homoepathy Central Council Act, 1973 and having at least 5 years' professional experience in the system of medicine. It would be desirable to select practitioners having a recognized Post-graduate
CONSULTANCY FEE PAYABLE TO AUTHORISED MEDICAL ATTENDANTS FOR INDIAN MEDICINE SYSTEMS
S.No.Nature of FeesMedical Post-Graduates
Graduates/Specialists of ISM&HMedical Graduates, Medical
Licentiates/Medical Graduates
of ISM&H
1.Consultation fee:
First consultation
Second
Consultation
Rs.30/-
Rs.16/-
Rs.24/-
Rs.13/-2.Visiting fees:
Day
Night
Rs.40/-
Rs.48/-
Rs.32/-
Rs.40/-
Private Registered Medical Practitioners
appointed as AMAs
Post-Graduate Graduate
Rs.3/- Rs.2/-
Rs.2/- Rs.1.50
Treatment outside India
A Govt. servant shall be eligible to obtain medical treatment and to claim reimbursement of the cost of any medical treatment obtained inside or outside India are given hereunder:
NATURE OF TREATMENT PERMITTED TO BE TAKEN ABROAD
S.No.Nature of treatment
1.Complex/high risk Cardio Vascular Surgery cases for treatment
at Centres with Extensive experience
2.Bone-marrow transplantation
3.Complex Medical and Oncological disorders such as Leukemia
and Neoplastic conditions
4.Complex high risk cases in Micro-vascular and Neurosurgery for
treatment at Centres with extensive experience
5.Treatment of extremely complex ailments Other than those
mentioned above which in the opinion of Standing Committee can
only be treated abroad and fall in the high risk category
A Govt. servant desirous of availing of medical treatment outside India for himself or for a member of his family for treatment as specified in the rules may make an application through the Department/Ministry to which the Govt. servant is attached to the Standing Committee in prescribed form. The Committee may recommend one Attendant to accompany the Govt. servant or a member of his family and the expenditure shall be reimbursable. The scale of expenditure and the eligibility for treatment shall be identical to the scale of expenditure and the eligibility of an Official of the Indian Foreign Service of the corresponding grade in the Ministry of External Affairs under any Assisted Medical Attendance Scheme.
Treatment of TB.
Non-Gazetted/Gazetted staff drawing pay less than Rs.2,500/- (pre-revised) p.m. stationed in and passing through Kolkata and members of their families are entitled to receive medical attendance for TB diseases from private doctors of their choice at their residence/residence of the doctor/consulting room.
Casual workers with temporary status
Medical facilities as available in the CSIR Dispensaries can be availed by the Casual/Dailywage workers who are conferred with temporary status, subject to the condition that no reimbursement of medical expenses would be admissible to them. However, their family members are not entitled to such facility.
Travelling Allowance
When the place at which a patient falls ill is more than 5 miles (8 Km.) by the shortest route from the consulting room of the AMA, the patient shall be entitled to TA for the journey to and from such consulting room. If the patient is too ill to travel, the AMA, Specialist AMA, shall be entitled to TA for the journey to and from the place the patient. However, Compounder/Lab. Assistant are not eligible for TA. Claims for TA shall be accompanied by a certificate by the AMA.
CGHS beneficiaries are not entitled for grant of conveyance charges when they are referred to Specialists/Hospitals within the city. Since CSIR Dispensaries are equated with CGHS, no conveyance charges shall be payable to CSIR employees or their family members including pensioners on their refererral for treatment as an Out-patient in recognized hospitals in the same city, even if the distance involved is more than 8 km.
Financial assistance
As per rules, the medical expenses in respect of the treatment taken in the private recognised hospitals for major illness like kidney transplant, coronary bye-pass surgery, heart transplant, chemotherapy, brain surgery, etc. are restricted to the ceilings fixed by the GoI. As the cost of treatment actually charged by the hospitals is very high in comparison with the ceilings fixed under the rules, the additional expenditure will be met from Welfare Fund of CSIR on case to case basis.
References
1.GoI MoH (DoH) O.M.No.S-11016/1/92-CGHS(P) dt. 29-10-1992
2.Swamysnews, Oct. 1993, 529
3.CSIR Lr. No. 17/1/91-E.II dt. 8-11-1994
4.GI MH&FW (DOH) OM No.S.14025/ 31/93-M.S. dt.16-2-1995; CSIR Endt. No. 31(5)/ 94-G dt. 31-1-1995
5.GI MH&FW OM No. 1-4/94-R&H/ CGHS(P) dt. 15-9-1995; Swamysnews, Nov. 1995, 850-1
6. CSIR Lr. No. 12(1)/95-E.II dt. 12-12-1995
7. CSIR Lr. No. 2(28)91-E.II dt. 11-6-1998
8. GI MoH& FW OM No.S-14025/4/96-MS dt.5-6-98; Swamysnews, Oct. 1998, 35-6
9. GI MH&FW Notfn.No.S.14025/31/ 97-MS dt. 7-7-1998; Swamysnews, Oct. 1998, 36
10. GI DoH OM No. Z.28013/8/98-MS dt. 26-5-2000; Swamysnews, July 2000, 54
11. GI DoH OM No. S.14025/18/2000-MS dt.29-5-2000; Swamysnews, July 2000, 54-55
12. CSIR Lr.No.14(38)/98-E.II dt. 14-12-2001
13. GI DH&FW OM No.11006/2000-JD (R&H) CGHS (P) dt. 11-6-2001; Swamysnews, Aug. 2001, 31-2
14. GI MH&FW OM No.24-2/96/ R&H/ CGHS/Pt.I/CGHS(P) dt. 26-6-2001; Swamysnews, Jan. 2002, 20
15. GI MH&FW OM Rec. No.24/2001/JD(M)/ CGHS/DELHI/CGHS(P) dt.7-9-2001 and No.24/2000-2001/CGHS/ JD(M)/1096-97 dt. 25-10-2001; Swamysnews, Jan. 2002 20-55 & 56-7
16. GI MH&FW OM No. S-11030/6/2001-CGHS (P) dt.5-11-2001; Swamysnews, Jan. 2002, 57
17. GoI MF FW OM No. S.14025/10/2001-MS dt. 31-12-2002; Swamysnews, Feb.2002, 62-3
18. GoI DoH O.M.No.S.14025/9/2002-MS dt. 13-8-2002; Swamysnews, Oct. 2002, 11
19. GoI MH&FW O.M. No. S-11011/4/2003-CGHS(P) dt. 8-1-2004; Swamysnews, April 2004, 11 and GoI MH O.M. No.S-11011/4/2003-CGHS(P) dt. 27-2-2004; Swamysnews, July 2004, 12-3]
20. GoI MH O.M.No.9005/2003/R&H/CGHS/CGHS(P) dt.8-3-2004; Swamysnews, July 2004, 13-4
21. CSIR Lr. No. 35-04(31)/02-PW&PG dt. 29-7-2004
22. GI MH&FW O.M.No.S-11011/6/98-CGHS (P) dt.20-9-2004; Swamysnews, Nov. 2004, 23-5
23. Swamy’s Compilation of the “Medical Attendance Rules” (2005), Swamy Publishers (P) Ltd., Chennai
24. CSIR Lr. No. 14(46)/MT/2000-E.II dt. 16-8-2005
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