14
.' ." Government of Himachal Pradesh- .. Health & Family Weifare Department .. .J No. HFW~B '(F) 1-112"008 -Shirula, the NOTIfICATION \ . Whereas . the .. '.'. matter .regarding . granting . recognition/empanelment to private hospiWs/h~al'th .institutions/diagnostic labs and ·reinibtirs.~ment to' State Government employees s. their d~pend~~~s. and 'Pensioners) .' within and outsidethe S~te :w~undei'c6~id~r~tiort' of the G~vemmeni. . . Now, . therefore, -.· in supersession of. this ~~partm~nt's, Notification' No .: HFW-B·· '~A)8-'1I~Od3{i!N) . dated: 14.7.2006,. Notificatiort No. HFW-B' : (A). .:. 8~ln003'(IiN~iy) . d~ied. i·f.' '0' and all other earlier . ..' .' . . inStructioris/office ~emorandatnotitica~i9i1S1gmdelines 'in tile matter concerned, the .Gov~mor of Hjn:t~~h~(P~adesh is ·plea~ed· to: fracle' a .new policy for 'granting . recognition/empanelment -to private ... :li~·~pit.alsl .healthiinstitutiuhs/diagncstio labs . \~ithin·'~d outside':the ''Stat~'both iri :J)~i~~t~ '~nd g~ve~e~t sectors for treatment '.,and.reimbursement .of the "~xp~l~~es t~: the~oventirtellt: e'm~Ioyeeslthdi dependent" and pensioners as p~r' Annexure-A, 'Henceforth the recognltioo.vempauelmeut to' ~ . .. I . '. . . . ' . .. ) ., private hospitals/health Institutions/diagndsticIabs .·for treatment and reimbursement tb H.P,' gove~nen:i" e~~loye~~' .and t~;e~' :d.~pende!1ts and pe~i'oners: shalf:' be' , . governed by this' Policy," . . The .private hospitals/health .institutions/diagnostic' labs recognized/ empanetieq,af pres~nt .. shall continue ~t.o: be: ernpanelled uu their present .' . period of empanelment ends or tm fh~y are granted or refused empanehnent under -. this Policy whichever is later:' I ". " It '·is·further . clarified that the .claims of reimbursement' .!l..•.. o, .. . becoming due i>ii9:t: to.the date. ofilotifi~ation of this Policy shaUbe decid~ as per -. '. ' . '.the existing lnst~ctio~~' and' the' claims becoming du~' aft~~'thi~ notillca1ion \~ill be . de.~icied asper·.ibis· Policy.. . ,. . , .'.~'" B}I Order' Principal Secretary (.Health) to the Government of Himachal Pradesh ~IIvJ . ' "'l::rf '.. RI l..;; /'. '- ..

` ])x)$ ''$'!' $W ! ) ' ' $'$' ' - Government of Himachal Pradesh, …]`ZXk`fe$ If )5 CAR(=xx "A/$-&")1A49+@; 3$ ' [Xk\[5 ,/)2)-++1') Ifk`]`ZXk`fik If) CAR(=$ 5 #/$' '.'3tce++.$%D`It`p&

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Page 1: ` ])x)$ ''$'!' $W ! ) ' ' $'$' ' - Government of Himachal Pradesh, …]`ZXk`fe$ If )5 CAR(=xx "A/$-&")1A49+@; 3$ ' [Xk\[5 ,/)2)-++1') Ifk`]`ZXk`fik If) CAR(=$ 5 #/$' '.'3tce++.$%D`It`p&

.'." Government of Himachal Pradesh-

.. Health & Family Weifare Department ..

.J

No. HFW~B '(F) 1-112"008 -Shirula, the

NOTIfICATION

\

. Whereas . the .. '. '. matter .regarding . granting

. recognition/empanelment to private hospiWs/h~al'th .institutions/diagnostic labs and

·reinibtirs.~ment to' State Government employees s .their d~pend~~~s. and 'Pensioners) .'

within and outsidethe S~te :w~undei'c6~id~r~tiort' of the G~vemmeni. .

. Now, . therefore, -.· in supersession of. this ~~partm~nt's,

Notification' No .: HFW-B·· '~A)8-'1I~Od3{i!N) .dated: 14.7.2006,. Notificatiort No.

HFW-B' : (A). .:.8~ln003'(IiN~iy) . d~ied. i·f.' '0' and all other earlier. ..' .' .

. inStructioris/office ~emorandatnotitica~i9i1S1gmdelines 'in tile matter concerned, the

.Gov~mor of Hjn:t~~h~(P~adesh is ·plea~ed· to: fracle' a .new policy for 'granting .

recognition/empanelment -to private ...:li~·~pit.alsl .healthiinstitutiuhs/diagncstio labs .

\~ithin·'~d outside':the ''Stat~'both iri :J)~i~~t~'~nd g~ve~e~t sectors for treatment

'.,and. reimbursement .of the"~xp~l~~est~: the~oventirtellt: e'm~Ioyeeslthdi dependent"

and pensioners as p~r' Annexure-A, 'Henceforth the recognltioo.vempauelmeut to'~ . .. I . '. . . . ' .

.. )

., private hospitals/health Institutions/diagndsticIabs .·for treatment and reimbursement

tb H.P,' gove~nen:i" e~~loye~~' .and t~;e~' :d.~pende!1ts and pe~i'oners: shalf:' be' ,. governed by this' Policy," .

.The .private hospitals/health .institutions/diagnostic' labs

recognized/ empanetieq,af pres~nt ..shall continue ~t.o:be: ernpanelled uu their present .'

. period of empanelment ends or tm fh~y are granted or refused empanehnent under

-. this Policy whichever is later:'I ". " •

It '·is·further . clarified that the .claims of reimbursement'.!l..•..o, ..

. becoming due i>ii9:t: to.the date. ofilotifi~ation of this Policy shaUbe decid~ as per -. '. '

. '.the existing lnst~ctio~~' and' the' claims becoming du~'aft~~'thi~ notillca1ion \~ill be

. de.~iciedasper·.ibis· Policy.. . , . . ,

.'.~'"

B}I Order'

Principal Secretary (.Health) to the

Government of Himachal Pradesh~IIvJ. '

"'l::rf '..RI• l..;; /'.'- ..

Page 2: ` ])x)$ ''$'!' $W ! ) ' ' $'$' ' - Government of Himachal Pradesh, …]`ZXk`fe$ If )5 CAR(=xx "A/$-&")1A49+@; 3$ ' [Xk\[5 ,/)2)-++1') Ifk`]`ZXk`fik If) CAR(=$ 5 #/$' '.'3tce++.$%D`It`p&

----~2-----',I ",.

-' I.

Endst.No,. As 8QOV¢. Dated, Shimla-Z, the .June 21, 2008 '

Copy forwarded to: ,

I.An Adminlstrative Secretaries, HP: '.2.All Heads of Departments in HP . ,

. 3.Registrar,Generai; Hon'ble Hi'gb Court ofHP,Shimia-l.

4.Under Secretary to GovernorSecretariat, HP,Shimla-2. ", 5.Secretary, ~.Vidhan Sabha, Shimla-4.

6.Resident Commissioner, Govt, of.Himachal Pradesh, SikandraRoad, Himachal,, Pradesh Bhawan, N~~peihf.· .' ,,',", '_ " . , , ',', ,

7.Accountant Gen~raJ.(A&E),HP~Sh1m1a':it . '

8.Accountant Genetal(Account) HP:Shiinla-4~" , '9.The Registrar, HP, Administrative Trubunla,HP,ShimIa.:.2. '

, 1O~All Divisional Commissionersin HP.

11..Ail the Deputy C61'rimissioners in HimachalPradesh :. :

, 12.AU the Chief Medical Officers in Himachal Pradesh. " ,

~'~13. the Superintendent of Police in Himachal 'Pradesh. , ,'., .14.. :, I the Distt.& Sessions Judges in -Himachal Pradesh. ,.', ,',

, ~ ':The, Director of 'Health: Services.Hle.Shimla-P for taking -further action in the

matter asper policy guidelines. . . ' .

16.The Director, Medical Education 'And Research.Hl' ,Shimla-9.

-:17.All the Managing Directors" Chairman' s/of Corporation/Boards in HP .

. I 8.TheRegistr~,HP .University.Shimla-V Agriculture University Solan/Horticulture

.University, Palampur, HimachalPradesh. ' " , '

19~The Director.Treasury /jG Account, HP,Shi,mla.

, , '20.All the·Distt. Treasury Officers hi: ill. , ,2~ Special Secretary (Finance' Department/Regulaiionsjfll' .Shimla-Z ' ,

',' 'w.r.t. ms"U.O. No. Fin . .A(3) -112007-loos'e dated 9.6.2008 ':for information.-

24.The'Under Secretarr(SAA) to the Government ofHP.'

25',The President, NGO Federation, HP,Shimla-2.' " ,

26.The President, Pensioners Association, the Ridge, Shimla-L .'

27;The"Controiler, Printing 'and Stationery, HP. Shiinla-4. for publication in .the :

Rajpatraffixtra-Ordinary). . ~. . . .

Addl, S~~ealtb) to the,

. Government of HiinachaI Pradesh'

Page 3: ` ])x)$ ''$'!' $W ! ) ' ' $'$' ' - Government of Himachal Pradesh, …]`ZXk`fe$ If )5 CAR(=xx "A/$-&")1A49+@; 3$ ' [Xk\[5 ,/)2)-++1') Ifk`]`ZXk`fik If) CAR(=$ 5 #/$' '.'3tce++.$%D`It`p&

~J

Annexure. A

.J .!

Government of Himachal PradeshDepartment ofHealth and Family Welfar~ .

New Policy to empanel hospitals! diagnostic' labs and to settlereimbursement claims

1.' Introductory

1.1. The Director Health Se~ice~(DHS).shall be the nodal agencyand

the' designated .. authority .for the . purpose of recognition, .

em:pail.elznent~renewal, rei~1;lursement 'c'lairris and' darifi~ation

regarding these issues.

1:2.The state government, through the designated authority (Le.DHS),.. '. . ,. ~ '"

. shall adopt the .Iist of empanelled institutions under the Central

Gov~n~~t '.Health' Scheme . (CGHS). for . 'its employees, their ..

. .dependents .and· pensioners as' per the procedure definedIn this

Policy•...' .,.

1.3. The DHS shallempanelthehealth Institutiona/ diagnosticlabs that·

are on.CGHSList· as per.the.procedure definedinthi~ policy. -.1'· .

1.4~The DHS shall empanel those Institutionsy diagnostic labs:thatare

not on.C;GHS List .both' withln'aildoutside the state as per the.

procedure <:fefIDedin this policy ..'.' . . .

2. .Empanelmentr General . .

.. 2.-LThena:tio~a1 lever government institutiorts/ diagnostic labs

established -under the ·Ministry of Health 'and Family Welfare,'. . t ". . . . .

Govemrnent vofTndta and . other .government hospitals/health

institutions/ ~i.agnostic _labs located. outside the state' shall be

empanelled.automatically as d~taiIed in :3 below.

2.2.·The DHS' shill ~xamine the' CGHs list. of, empanelled private

. Institution'? .and shall either adopt it in-toto or if he chooses to

restrict it, then this restriction should be justified with reasons. The

1

Page 4: ` ])x)$ ''$'!' $W ! ) ' ' $'$' ' - Government of Himachal Pradesh, …]`ZXk`fe$ If )5 CAR(=xx "A/$-&")1A49+@; 3$ ' [Xk\[5 ,/)2)-++1') Ifk`]`ZXk`fik If) CAR(=$ 5 #/$' '.'3tce++.$%D`It`p&

~.

.. ,

. .

procedure for empanelment or these institutions is 'given below in .. . . .' '. -

point 4.

2.3. In cases-where the institutionz' diagnostic lab is riot on CGHS list,

the .Directo~·· Health Seryk~·ssha11 e~pan~i. private in~~tutiO~. .

. after the inspection as per procedure given below.in point 5.

.3. Automatic Emp~elm~nt·.of National Levei Govemritent ·.Institbti.ons

.and Diagnostic Labs: The government medicaf/dental colleges, hea:tth·

institutio~/ d~agno~ti~ Iabs .es~~bii$h~dby-fhe Ministry of Healthl

Government- of .India; Staie ..:G~verprnents·. ~<;l other g6ve~eitt·

bodies/agencies .shall be· deemed to be ..empcti,eliedoautoma~ca1ly

unde~ thisPolicy. However, .the .inoIs shall notify the °first list. of all .

$uch' institutid~/ diagnostic ·l~bs· within" 'one .month from ~the

notificaficn. of this Policy arid.·5hai.ic~ntinue· to up-date .the list

r~gUl~Iy and skn.p~bli$hthe list at Ieast on~e'in a year;

4.. Pr.oc~duret~ empanel private i1'l~tiiutjons/Iabs thatare on.CGIIS list:

In. case of priv~te :i~tituti()~jl~bS alreadyon the empanelled list. of -

CGHSithe[)HS·will.opublicize:·~t~tion· of 'the' State Government," ..

~'within15 days from.·the.~otific~ti~i~· of-this PoiiCy, ..to·e~pan~l an such,"

.inst1tuti~,ns/labs 'Witho~t Inspection.: Oil the··b~sis ·ofthe .~~quests.· ..

re~eived, the' 'OHS .~~l 'enter jn~~' an' A~eement. with the willlng. .. ' '.

·institutions .. The:· ~ti~tions' ~~ ·~tripanclled· 'shall be notilied by' the

.DHS. The list of the empanelledInstitutions sh~ll be updated bythe .. : . .' . '. ~ .'

. .

DHS on regular basis, .

5. Procedure fa empanel prlvateinsti:httions/ labs located both .within ., . . . '.'

. arid outside the State which are not 011 CGHS Iist: In case the Director

Health Services gets the request from a private institution/Tab Iocated

: within or' outside the state {especially those in cliandigarh, Punjab,

Haryana, PathankotlJammuarea of Jammu. and Kashmir and

2,

Page 5: ` ])x)$ ''$'!' $W ! ) ' ' $'$' ' - Government of Himachal Pradesh, …]`ZXk`fe$ If )5 CAR(=xx "A/$-&")1A49+@; 3$ ' [Xk\[5 ,/)2)-++1') Ifk`]`ZXk`fik If) CAR(=$ 5 #/$' '.'3tce++.$%D`It`p&

L

,

'Uttrakhand) which has, not been empanelled by the CGHS, for

, empanelment the DHS shall co~stitUtean inspection team for the

: purposeafterreceipt of the specified fee for this purpose. '

,6. Inspection for Empanelmente The Director' H~alth Services (DBS).

shall adopt 'following, procedure for inspection of health

, institutions/ diagnostic labs: '. ' ..

6.1; Inspection ,Team for ,higher level health Institutiens located

within md outside-the State: For the institutions that offer indoor

,facilities and/or special procedures that are either not available in

the government sector within the state or are available onlyinthe ,: '.'

", medical-colleges 'of the state, the'insp~tion will be done by 'a State'

'Lev'eiTeamconstituted by the DHS'for the purpose. The Team will

consist ofexpe~ o~th~ co~cerned cllsdpline dep~nding'upon the'

, ,facilitieS~beingOffered by the, app1i~ant institution/lab. The DHS

will, take the ~es, of expert memberfs). of theinspection team

from, the Director, ',Medical . Education and 'Research' or the ". . . ". .' .

Principals ..of IGMC, ShimJa/Dr ,RPGMC; Tanda/Covernment

,Dentai' College, Shimla, or iirequired from any other institutionof• '. • • • I •

reputeas the case may-be. In addition at least one faculty member, '

from the State Government's Medical/Dental, College, preferably

,i related to' the treatIne~tf pl'oced~resl'tests being ~ffen~d by, the'

private institution, will also be 'a:member of the .team, '

6.2. 'District Level Team for,' Inspection of health, ,institutions/ ,. '. . '. . '. .

diagnostic labs located within the State: There will' be a-standing. '.' ~ .

team under the chairmanship of the .Chief Medical Officer (CMO), ,

ofthe distr~ct that will be notified by the DHS within15 days after, ' '

the publication of this Policy. The team will inspE7ctthe private.' '.,

iristitutions / diagnostic labs located in a district and Willing to get, ,

3

Page 6: ` ])x)$ ''$'!' $W ! ) ' ' $'$' ' - Government of Himachal Pradesh, …]`ZXk`fe$ If )5 CAR(=xx "A/$-&")1A49+@; 3$ ' [Xk\[5 ,/)2)-++1') Ifk`]`ZXk`fik If) CAR(=$ 5 #/$' '.'3tce++.$%D`It`p&

.' :

empanelled with the state government for treatment/procedures!

diagnostic' tests which, are available in' the District or' Regional! , '

Zon~l Hospital (if ~'Re~onal/Zonal Hospital is located in that. '. .' . . . .. . .' . -' ....

, district). In case of procedure ,ap.d/ or treatment! diagnostic test

being,' offered ' is 'not available in the' government hospital! lab.' . " . .

located in -the district (DiStrict,.Zonai 'or, Regional as the case-may

be), the private instituticn/Jab will have to,apply to the DHs and,

the' inspection will:be, d~~e,by'theS~ateievel Tea~. fu,~ther tases: th~ private Institutiona/Iabscan directly ap~ly to' the. CMO who

will getth~ inspection done'arid'sendthe report to the DHS fm'

further action. ," "'.

6.3. TIme Limit for .Inspectionr Once the .application is made,' to the,

','D~ , for:' insp~ti~n by ,an.'~tituti;on" aU' formalities Including

, inspection, submission'of i~~~Ctioi.l'reportl decisi~n'on the :report ' '

"',(whether: in':~,titution ist~' be empcinell~d or not) s~ 'be '

completed. Wiflun specilie(t:ti~e, ~t;" ~or"this purpose, all '

appli~ationS' received till s.tl1o~,a rn~nth '~hall oe .disposed off

,wHIilil that month. In c~Se'fu~:~pplicatio~ is 't~ceivedafter' 5~of '

the p:lonth."same' ~hall be decided 'h-t the"next, month, if, it' is riot

possible to be disposed off within that month. The District Level. .. ..

T~ shall inspect and submit report: ofInspection as. per. the '

Checklist wfthdeai' recommendation to the DHS Within a' period " '

, ,'of 20 days' from th~'date of. rec~ipt 0.£ application 'fr~~ the private, "

Institutiorr,

,: '6.4.'Checklist for' Inspection: A, detailed: Checklist will be prepared

,for 'insPectiOtl?y 'the Director li"ealth SerVic~s, ~hich ~i be

exhaustive 'arid clear. 'fhis wili1e~d to transparency and objectivity. '. . '. . ~. . ..

',in the process of empanelment. ThecheckIist will be prepared

4'

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\ .

.-

L-..

within '.a,period at 15 .days fromthe date of notification of this

Policy. The checklistwill then be sent to the government for~ . .

approval and final decision Ol~:the checklist will' be taken within

seven days 'after it is received by the state government., '

6.5. Inspection Fee: ~e DHS shall collect ~e inspection fee' from the. . . ..,

private, health institutions willing' to get empanelled as per the

, following rates: 'fee of rupees 15,000' shall ,'~ charged f~r an'

,inspection if it' is to bem~de, by the state Level Team for an

, institution/lab locatedwitlrln th~'state; fee of rupees 5~OOOshallbe

charged for aninspection to,bedon~ 'by the District Levei Team. In

case of .mstitutions l~cated in th~ following' states/UTs, ,fee of ,

, rupees, 25,000 ,'shall be charged: Punjab, Haryana, Chah~garhi"

Uttranchal, Jammu. In case, of institutio~' located in Delhi

inspection fee' of rupees 30,OQ.OstuUlbechaiged 'and for institutions' "

located at other places in ilie'~b~~trYa tee 'of rupees 35,OOO.shaIlbe •. . .... . . ..... . . . .

, 'charged."

,6,.6., Frequency ,of .htspection:'·Th~ h~p~c:tion' shall', be 'cmied ' out,'

" '. before empanelment' and after ~very tw~, years. ' In, addition; the. . . . '.

',' DHS can decide to,in~pect the .institution whenever required. The

expenses of the inspection shall 'be .borne by the private health

institution/ diagnostic lab. '

7.' Pm-iod of Einpanel~ent: TIle, institutionsj' diagnostic labs' both on. . . " .

CGHS list and the others that' will be.empanelled by the DHS after,,.' . , .'

5

.inspection will be empanelled for the periodof two years.. In case an. ':. '. .. .

-Instltutiorr/ diagnostic lab is removed from the CGHS,list' the same

'shcill also, st~ndre~oved from the list of ~mpanel1ed institutions for,

the state; In case the ,PHS gets,.a corriplalnt with regard to any

institution/diagnostic lab he shall get the matter inquired' into. Incase

Page 8: ` ])x)$ ''$'!' $W ! ) ' ' $'$' ' - Government of Himachal Pradesh, …]`ZXk`fe$ If )5 CAR(=xx "A/$-&")1A49+@; 3$ ' [Xk\[5 ,/)2)-++1') Ifk`]`ZXk`fik If) CAR(=$ 5 #/$' '.'3tce++.$%D`It`p&

the complaint is .found correct and he feels that the

institution/ diagnostic lab needs to be removed from the list of

Empanelled -List he shall give du~.·opportunity of being heard to the

concemedinstitutionydiagnostic lab.and then decide the matter... . . . .

8, Procedure :regarding the private health institutions/ diagnostic labs

that' a~ealready. empanelledi Incas~of 'priva~e 'health institutions/'·

diagnostic l~bs .located b~th· ·~·fum ·and. outside the. state' 'that .are

already ..e~panelled the ~mp~n~lment shall continue' till' the period

specified ~ the existing Agreement, The~~ will not be anyrenewal of,

.pr~sentagreement·an.d··new. Agreement will be signed underthe new

..policy.' .. :

9.: Reimbursement

9.1. Both out-p~tient and Indoor treahnentj diagnostic tests. ~aken in. .' .

~ospita1s/healt11 insti~~6ns/diagnostic labs loc~ted withi.n and

outside the state will be .reirnbursable subject to rate restrictions as

described below. . . ' .. , .

. 9.2. The ·.·expensesin~ed for' treatment in' all -.government

'institutions/ diagnostic labs'. located within .the state will be .fully. ' . . . . .

reimbursable ...

9.3. The expenses Incurredfor treatment in all' empanelled government

institutions/ diagnostic labs 'loca'~ed within and o~tsid~:' the state

(as 'mentioned in .point 3 above) will be fully reimbursable.·

9.4. In case ~eamtent is' taken ill a private empanelled institution

..located within thestate and' the procedure/fest is available in the. '. .

government. hospital located in. that 'district (district/ zorialj

regional hospital), tile reint amou'nt Mall-be resffidea to

the. rates-at Rogi-Kalj' ~

6

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...

9.5. In case treatment is taken in a

. Ioeate

9. ~'The .ra ' -of reimbursement .for treatment taken in an empanelled

.inSfihxtl6i1·!ocatedous . . be: restricted-to th: .rates'

of the R!<S' of IGMG, Shiffila/ .C;9~ernmentDe~~· coiiege,. Shi~~.'. . '. ...' . . .' . . . . .' . . ...', -: ,.' ,'. ... " .' . .' ..' . .' . .. ~. .' ,.

.or .Dr RPGMC Tandaas the' case 'may be depending upon' the· .

..··ila~e:ofpro2ed~e. hi ca~~ the trea~ent/ procedure ~s'avai1able~ •

these governmenrinstitutions. . .'"

9.8. mcasethere: is ,.~o .POl MER Cha,ndiga~h/A~IMS .Ratc~e .

. reimbursement sh~ be xestricted to theCGHS rates or actual

~hicheve~ is·lower.·

9.9~lncase treatment is taken in 'a nE19l~~m~iIii:nea:liiiilliiiil

'. ernergency,;t'(!imb~sementshall be re~trkt~d:tO:-~ratefi) IGM I':··'. . . .. . , .' . . . ' .

S~iGOVe.~.nlj').eIi.t' .Dental .' 'College; Shimla.. In' case the

procedure / treatment is· ' . not . available in.' the"~

Shimlaj'Government Dental C(~lle6e,Shirnla tht::~-,:ra:t~e~o~~!WbU~

ChandigcI!h/ IrvlS, Delmp-:CH:S or actual whichever vis least'

7

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. ,.,

'/ ..

t ....

..•.-.

shall apply. 11:1· case there are no such -rates .the CGHS· rates or·

· actual whichever-is lessshall apply, .... ..'. . .' . '.. \ . : .

. 9.10, In. cases where there areno CGHS :Rates,· the procedure 'being ..

..'~4opted. ~der ·~e . CGHS', will be applicable' to, the :stat~ of. . , .

· Himachal. ,.

10. Referral: "

'viO,!.There wiU not'be any.··~~ed 'f9rreferral in case. treatment' is ..taken .

. i11 an empanelled n1stittiti()n.·, . •.. ;:.' .. ,., .. .. . '

mergency the, treatment .can be. taken in .:a. no --...... •.••••••-..;;-,....--- •••••••..1' , __

~~@9i~~m_. However, the question of

~ir..ergency.· .\\Ti~l': be .. decided. by .th .. ~ ..D;' .con rnea.::::~d

sement shall be re·stiide ~' ,eer'tfiis Polie .

.10.3.T,::..;.;....-....;=--.:;~;;;,;,;;;:;;;;;.;;...:.:.~e allowed only in c~s'es where' the pa~ent· .

.out 9f state QYthe Medical Officer of the .--~--~~~--~·G.;,":ernment:lfospitai illthe state.'

'~bW :~~~~~mm~~.:Ma~~~,~~

~.th~-G=.~ov~~-·nun~·~en~t~~H~o~s~=r~~~~

treatment IS .taken, in emergency in an Institution ' that is.' 'net

empanelled or diagnostic tests are undertaken in a lab' which.Is not" .' .

empanelled within .arid/ or; outside . the state, the. question whether

··the!e ~as ari ·e~erg~ncy .or ,not;:b~~g a' 'question of fact, will be .

decided by 'the ~;D~ concerned. ·There ,~ll be no. need .to seek

permission of the Covernment .or De aF~t of Health and Family :. ' ,~ . .'

Welfare in such cases. The decisi~nof the A. D: whether there .was an

e~erge~cy or not shall be final. ;,r

8

- t

. r'

Page 11: ` ])x)$ ''$'!' $W ! ) ' ' $'$' ' - Government of Himachal Pradesh, …]`ZXk`fe$ If )5 CAR(=xx "A/$-&")1A49+@; 3$ ' [Xk\[5 ,/)2)-++1') Ifk`]`ZXk`fik If) CAR(=$ 5 #/$' '.'3tce++.$%D`It`p&

, ..-

(~):.1 ~:.

. .".. .... "

,i

1'2: Treatril ,nt.i 'cases of Cancer, Re~al FailurejKidn~y Transplanj: In ..

· .case of treatment.Ior Cancer;Ren.alFail~re/Kidney Transplant,. the

patient(e111play~es( ?epe~dent/perisioI1er)'}Vill be allowed toundergo

treatment" . in .any. super specialty hospital/ instifuti~h . whether

. empartelled.ar, not.subject·.to the cond~tion that the' ·~eimb~rseinent

amount.will be res&ided toCGHS r~t~ a~ a~aI whichev~r is less .. ' .

I :,The bills' ~iH~,b~.YE:rifiedby theMedi~aI'Officer .....

or Authorized' Sign~torybf 'the:elh~~elled- '~r .non-empanelled health .'

..i~tiht tion/Jab -.It WiUbe:'the.t'esp·~~~lb~i~ ot t~eODd co;nc~rrted to

. restrict. :thereimburse~ent'·.ainourit:' t.othe'a~9tnl~ .~dinissible.u~qer':1: ....

this policy. '., .4. , ••

. 14.·C1arifi~afions:Th~ DHS~hallissu·e'tL.<llifi~atio1}5; if'requirecI, .on 'its , :'.

'. 'awn b~ ifr~qu~~t~dbya~y HbDj.O~o'/Head~iQHice~·· . . .

15~Appeal: App~aIs·rela;ed. t6:~~fusid:'~9·etnp~ef.by~th~District·Level :.

'.' Team the-appeal shaJ{lieto·thg·DfIs.~ikcaSeof refusar~ythe State

·Lev.~l Tea~ tile a~peal shall Iiet6.'ihe:S~'c~etar}(H~~th).lncase .0£ a .

:.dispute related to rei~6u~~ement·~la!rrir.the'firstappeal' ~hall~lietathe: ..

". ·Adrh~s~ativ~' ..6epartinenL, 'The :~s~cond'appeaL:ShaU'1ieto' the:', :.' .~ecretarY' (Heaith) in 2~se the ern~l'oye~/ pensi~~er is 'not ~atisfie~'withj '.,

. .the decision t~ken by ,the. A.D. under this. Policy .. or a cl~'riflcation) , , '..

. ', - issued 'b~'the DHS..;f1~e·appealcah,be~referred9~ pi~in paper with' .- :.' . '.' ..' '. . . '. . ..

. 'the: detailsof the. case. .....' '. . ",

-.' 16.'On-going Process: .There should be a dedicated Cell in the office.of the ,

DHS··io.studY'the·CGHSlist:anci:the.:Circula~S.issU~s·underthat.·OHS·. .' '. '. : '. .' " ~".' ... ..... . '. '. .' ". .... ':,' ".. .

should' choose thenew.institutions that may. beempanelled and 'then .-" . . : -' '. .~ . . .'. .' .

·~et in touch with them far seeking. !he~ consent far empanelment with

...•'.•tIle ·stat~ goverrun~f onregularbrisis as. per requirement. The DHS'

·'shauld circulate thelist of eln~an.elled ins~itution~ periodically toall .

.. ........J .. . :.

. . .. .,.. . ,

.'~.'

.... .

9

,,

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,

.'

I

the' state government offices; Th~ li.s~of empanelled institutions and -,.

the CGHS / RKS rates should be published at least ·once is a y~ar inthe• '.' •••• • .1. •• ' • • • •

.month of January. Similarly .the Di:IS should 'keep. p-ackc?f the-CGHS .

.rates and keep: on crrquating thes~' to ~11c,onc~rned,-r:he· Cell should be ,:., , .

. propetly 'staffed with: following personnel: Superintendent Grade n

.. ' (1)/Senior .Assist~nt .(2)' arid :Oerk. (1): The' persons -pbst~d in the Cell ..

, will f~llo~· up '~n the .~ppli~atipns;·h1sp~ctions, e~panelmemt. critd .

.secure ,appropriat~·.:imormati~h,and:.reports fro~· other authOri~e~

,age~cies: to .in~pect'(e~g~·CMOs).·an~j$suing~iarifica'~~~ etc. B~sides/··

the CeU'wil{ undertake 'the work·~i~ubii~~ng/up·datii1gl circulating, ... .-. ,. . .. , .. ' . . '., ", ..: .' . '.-. ' :...

..the lists of .empanelment. 'and' rates of the: RKSs/ PGIM'ER/ AIIMS,'.

Denti!CGHS. , ....

·17; Iitt~rmati~n S~~tem:,Ther~, sful1 :b~·~·Unk.onthe w~b site of State ~r. . . . '..': .'.. .' : . . . . . . . "'., . .' . . .

Himathal(www.hitnachaLnic.irt) and also on the State Government's .

Health"Departme~fs' web site t~: th~ website .oi eGBS. Also, in .. ,

.addition toth~tilie listSo.f~,mp~el1ed ~1s~hrtionsartd rat~s approved

,:., :underCGHS;:lists of il1Sti~ti6~"~mpanelled, by the,state.~~~e~ertt. .

1.(both. in government an'd private sector, both ~~thih·anci·' Otlt' side ·fhe·

.:.:.--~' ....'state) should be available on thestate ·~ove~ehes~\Vebsite,and,~lso

., on' the web~ite:~fSt~te.Healthand Family Welfare'Depart~~nti~.·PDF.

, . ' . for~iit.Theselists 'should beJ~vised' ~~d updated as ~nd'when~ny,

. ·'c;hange happens,. The-' website-' should also display 'that·thelists .'r·· .. , .. ::: ' : .. . .-

.,.. available online-are the latest and; have appl:icability with effect from.

, ..the date: of up-dation ..

This policy Sh,allcome into effect with immediate'1ect.. • .' ..

Additional sek (Health) to theGovernment of Himachal Pradesh.

......

10

Page 13: ` ])x)$ ''$'!' $W ! ) ' ' $'$' ' - Government of Himachal Pradesh, …]`ZXk`fe$ If )5 CAR(=xx "A/$-&")1A49+@; 3$ ' [Xk\[5 ,/)2)-++1') Ifk`]`ZXk`fik If) CAR(=$ 5 #/$' '.'3tce++.$%D`It`p&

.-Government o'f Himachal Pradesh

Department of Medical Edu.and Rese~rch

~ •...EfW-B(~)8-112003(I1N) Shirnla-Z, the T3'h Febr'Uaiy •.fEP_ .

NOTIFICATION

J lU~sjoft,-of this department nctlfication No.HFW -B(A)8.112003(IIN) dated

•..•••••••..,•.••••~ 'Governor, ~xpac~al Pradesh is pleased to insert the following proviso to para 9.6 of the

said notification No. HFW-B(F)t:-112008 dated ~1.6.2008:·- '. ~ .

. 9: ..=;':-===.....:==reimbursement shalt ~ restricted to COHS'tate •.,..- .-' .. .

By Order

Ah.R.Rizvi

Principal Secretary (Health) to the

Governemnt of Himachal Pradesh

l:ndst.No.As above. dated: 13.2.2013

Copy forwarded tci:-I. All /'\dministrati ve Secretariesl Addl.Secretaries/Joint Secretaries/ Deputy

Secretaries/Under Secretaries to the Government of HP.

2.The Secretary to the do vernor of Himachal Pradesh.Shimla-Z.

3.The Secretary.Hf', VidhanSabha.Shimla-d .

4.All Heads of Department in Himachal Pradesh.

5.AU Divisional Commissioner in HP.

6.The Registrar. Hon'ble High Court ofI:IP.Shimla-l.

7.All the District & SessionsJudges in Himachal Pradesh.

~!.AiJ ,he' M.Ds of Boards/Corporations' in Himachal Pradesh.

'-'.The Registrar.Hl" Krishi Vishva Vidhalya Palarnpur/Dr.Yg.Parrnar-

C:~v"rsity.of Horticulture & Forestry Farming Solan.Hl' University

.Snimla-S,

IO.AII the Deputy Commissioners. HP. ,

II.AII the Chief Medical Officers in HP ..

!2.AII Treasury Officers /Sub- Treasury Officers/Asstt, Treasury Officers

in rtP. '

j 3.AII the Su oerintendent of Police in Himachal Pradesh.

I ~.Resldenll Commissioner. Govt, Of Himachal Pradesh Sikandra

Road.Himachal Pradesh Bhawan.New Delhi.

, 15.Private Secretary to the Chief Minister.Hf'.

l ti.Accountant General(A ,& G).HP.Shimla-4.

/Contd ..2/-

----2------17.DeputY Secretary (Finance -Regulation) HP.Secreumat.Shimla-2 with

reference to U.O.No.FinOB(l5)-3/97-loose dated 25.7.2012 for information.

'IS.Deputy Secretarytl'ension Cell).HP.Secretariat.Shimla-2.

19:Lhe Director of Health Servcies;HP.Shimla-9 is requested to take

necessary cction as per para-2 of this notification immediately under intimation to this department.

:W:The President HP NOOs Federation. the Planning Bhawan, Chhota

Shimla-2. '

21. TIle General' Secretary. HP NGOs Federation. the Planning Bhawan

Chhota Shimla-2.

22. The. President Joint Consultative for Pensioners. Alice Mount(LT)near

Page 14: ` ])x)$ ''$'!' $W ! ) ' ' $'$' ' - Government of Himachal Pradesh, …]`ZXk`fe$ If )5 CAR(=xx "A/$-&")1A49+@; 3$ ' [Xk\[5 ,/)2)-++1') Ifk`]`ZXk`fik If) CAR(=$ 5 #/$' '.'3tce++.$%D`It`p&

"Government of Himachal Pradesh

Department of Medical Edu.and Research

No. HFW-B(A)8-112003(1IN) Shimla-Z, the

NOTIFICAITN

In continuation of this department notification No.HFW-B(F)I-II2008 dated

21.6.200 • the Governor, Himachal Pradesh is pleased to insert the following provisio to para 9.6 of

the said notification :-

9.. A ij,ided that for treatment taken in empanelled CGHS institutions in the

NCR (National Capital Region), the reimbursement shall be restricted to CGHS

rates.

By Order

Secretary (Health) to the

Governemnt of Himachal Pradesh

dated: 16.8.20 12Endst.No.As above.

Copy forwarded tor-

I. All Administrative Secretaries! Addl.SecretarieslJoint Secretaries/ Deputy

2. SecretarieslUnder Secretaries to the Government of HP.

3. The Secretary to the Governor of Himachal Pradesh,Shimla-2.

4. The Secretary,HP, Vidhan Sabha,Shimla-4 .

5. All Heads of Department in Himachal Pradesh.

6. All Divisional Commissioner in HP.

7. The Registrar, Hon'ble High Court of HP,ShimJa-1,

8. All the District & Sessions Judges in Himachal Pradesh.

9. All the M.Ds of BoardslCorporations in Himachal Pradesh.

10. The Registrar,HP Krishi Vishva Vidhalya Palampur/Dr.Y.S.Parmar

II. University of Horticulture & Forestry Fanning Solan,HP University

12. .Shimla-S •.

13. All the Deputy Commissioner, HP.

14. All the Chief Medical Officers in HP.

IS. AU Treasuries Officers /Sub- Treasuries Officers! Asstt. Treasuries Officers

16. in HP.

17. All the Superintendent of Police in Himachal Pradesh.

18. Resident Commissioner. Govt. of Himachal Pradesh Sikandra

19. Road.Himachal Pradesh Bhawan,New Deihl.

20. Private Secretary to tho Chief Minister,HP.

21. Accountant General(A & C).HP,Shimla-4.

22. Deputy Secretary (Finance -Regulation) HP,Secretariat,Shimla-2 with

reference to U.O.No.FinOB(l5)-3197-loose dated 2S.7.2012 for

information.

Deputy Secretary(Pension Cell),HP,Secretariat,Shimla-2.

The Director of Health Servcies,HP,Shimla-9 is requested to take

necessary action as per para-2 of the notification immediately under

department.

The President HP NGOs Federation, the Planning Bhawan. Chhota

Shimla-2.

The General Secretary, HP NGOs Federation, the Planning Bhawan

Chhota Shimla-Z,The . President Joint Consultative for Pensioners, Alice Mount(L.T)near

Ridge, Shimla .

The General Secretary, Pensioners Welfare Association Alice

Mount(L. nnear Ridge. Shimla .

The Under Secretary (SAA) to the Government of HP.

The Controller, Printing & Sationery,HP,Shimla-4 . It is requested kindly

to publish this notification in the HP Rajpatra(Extrs-Ordinary) and send

copy this notification in the HP Rajpatrs (Extra-Ordinary) and send copy to

this department.

Guard file.

23.

24.intimation to this

2S.

26.

27.

28.

29.

30.

31.

Special Secretary(Health) to the

Government of Himachal Pradesh