Health Medical & Family Welfare Department – Employees Health Scheme (EHS) – Constitution of Technical Committee to look into the cases where the cost of treatment exceeds Rs.2.00 lakhs – Orders Issued.
HEALTH MEDICAL & FAMILY WELFARE (M2) DEPARTMENT, G.O.Rt.No.79 Dated:21.01.2014.
Read the following:
1.G.O.Ms.No.174, HM & FW (M2) Dept., dt.01.11.2013
2.From the Chief Executive Officer, Aarogyasri Health Care Trust, Letter No.186/EHS/P&C/2014, dated.10.01.2014.
O R D E R:
2. In the letter 2nd read above, the Chief Executive Officer, Aarogyasri Health Care Trust has stated that in para 4.3 of the G.O.Ms.No.174, HM & FW (M2) Department, dated.01.11.2013 under ‘Financial Coverage’, the following is mentioned: |
b. The limit of Rs.2.00 lakhs will not apply in cases where predetermined package rates are above Rs.2.00 lakhs.
c. Chief Executive Officer, Aarogyasri Healthcare Trust will settle the claims which exceed Rs.2.00 lakhs, following the standard claims settlement process after obtaining the approval of the Technical committee constituted by the Government.
3. The Chief Executive Officer, Aarogyasri Health Care Trust has further stated that already 10,44,000 temporary health cards have been generated under the Scheme, in respect of the Employees / Pensioners and their family members who have already enrolled. As many as 396 beneficiaries have undergone surgeries so far. In order to meet any eventuality where the cost of treatment exceeds Rs.2.00 lakhs, it is necessary to constitute a Technical Committee in terms of para.4.3 (c) of G.O.Ms.No.174, HM & FW (M2) Dept.,
dated.01.11.2013
4. The Chief Executive Officer, Aarogyasri Health Care Trust has requested the Government that a ‘Technical Committee’ with the following composition may be constituted in terms of para.4.3 (c) of G.O.Ms.No.174, HM & FW (M2) Dept., dated.01.11.2013.
1. Director of Medical Education - Member
2. Commissioner, APVVP - Member
3. Executive Officer (P&C), AHCT - Member-Convener
he has also stated that the panel doctors of the Trust, who are specialists in the respective fields, will assist the Committee in the process of examining and making recommendations in the above process.
5. Government after careful examination hereby constitute a ‘Technical Committee’ with the following composition in terms of para.4.3 (c) of G.O.Ms.No.174, HM&FW (M2) Dept., dated.01.11.2013.
1. Additional Director of Medical Education - Member
2. Joint Commissioner, APVVP (Medical) - Member
3. Executive Officer (P&C), AHCT - Member-Convener
The panel doctors of the Trust, who are specialists in the respective fields, will assist the Committee in the process of examining and making recommendations in the above process.
6. The Committee shall take further action in matter.
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