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07 February, 2014

G.O.Ms.No. 26, Dated.05.02.2014 :: Free Consultation Out Patient Facility for EHS Patients amendment to G.O.Ms.No.174, HM & FW (M2) Dept., dated.01.11.2013

G.O.Ms.No. 26, Dated.05.02.2014 :: Free Consultation Out Patient Facility for EHS Patients amendment  to G.O.Ms.No.174, HM & FW (M2) Dept., dated.01.11.2013

References:
1..G.O.Ms.No.174, HM & FW (M2)  Dept.,. dt.01.11.2013
2.G.O.Ms.No.176, HM & FW (M2)Dept.,.dt.01.11.2013
3.From the C.E.O., AHCT, Lr.No.6428/EHS/P&C/2013, dated.11.12.2013.

O R D E R :
1.       In the G.O. first read above, orders were issued notifying the ‘Employees Health  Scheme’  with the  objective  of  providing  cashless  treatment  to  the employees and pensioners of the State Government and their dependent family members, which will ipso facto replace the existing  medical reimbursement system under APIMA Rules, 1972, with additional benefits such as post - operative  care  and  treatment of  chronic  diseases  which  do  not  require hospitalization and treatment in empanelled hospitals. In the G.O.2nd  read above, the Final Therapy Prices for the various packages under the Scheme, were adopted and notified.
2. In his 3rd read above, the Chief Executive Officer, Aarogyasri Healthcare Trust, which is the implementing agency, has stated that the package prices adopted and notified in the G.O. 2nd read above include cashless service from the point of OP Registration of a patient till the expiry of 10 days after discharge as Inpatient with a 30 day warranty  after discharge and therefore the prices are inclusive of pre-evaluation cost of OP cases which need to be screened before an IP case is identified.  He has expressed the view that this aspect has to be specifically indicated in the G.O.,  first read above under “Hospital Payments’ so as  to  avoid  ambiguity  and  scope  for  misinterpretation.    He  has,  therefore, suggested that a clause be inserted in the above G.O., clearly defining the package so as to include pre-evaluation cost.
3. Government after careful examination of the matter,  hereby issue the following amendment to G.O.Ms.No.174, HM & FW (M2) Dept., dated.01.11.2013:

AMENDMENT

In para5.2, of the G.O., under the heading‘Hospital Payments’ the following shall be inserted as ‘d’:
d) “The package will also include pre-evaluation of patients, including consultation and investigations even in the cases which do not finally end up with admission for IP treatment.  The network hospital shall not raise any claim for such pre-evaluation”.
4.The Chief Executive Officer, Aarogyasri Health Care Trust shall take necessary action.
5.This order issues with the concurrence of the Finance(Expr.M&H-I) Department vide their U.O.No.34359/471/A1/Expr.M&H-I/13, dated.04.01.2014.

Download G.O.Ms.No. 26, Dated.05.02.2014

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