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1 | Page GOVERNMENT OF KARANATAKA SUVARNA AROGYA SURAKSHA TRUST, (HEALTH&FAMILY WELFARE DEPARTMENT) TENDER DOCUMENT PROCUREMENT AND APPOINTMENT OF INTERNAL AUDITORS FOR SUVARNA AROGYA SURAKSHA TRUST Executive Director, Suvarna Arogya Suraksha Trust, Bangalore. 1 TENDER REFERENCE SAST/ACCT/Internal Audit/2018-19 2 Date of publishing Tender Document on e- Procurement platform 19.06.2018 - 11:00 AM 3 Last date for seeking clarifications 26.06.2018 - 05:00 PM 4 Last date for submission of bids 18.07.2018 - 05:00 PM 5 Technical bid opening date 20.07.2018 - 12:00 PM 6 Financial Bid opening date 23.07.2018 - 12:00 PM 7 Availability of Tender Documents http://www.eproc.karnataka.gov.in 8 Place of opening of Tenders Suvarna Arogya Suraksha Trust, ―A‖ Wing, TTMC Building, 4th Floor, K H Road, Shanthinagar, Bangalore-560027. Phone: 080-22536200 9 ADDRESS FOR COMMUNICATION: The Executive Director, Suvarna Arogya Suraksha Trust, ―A‖ Wing, TTMC Building, 4th Floor, K H Road, Shanthinagar, Bangalore-560027. Email: [email protected]

GOVERNMENT OF KARANATAKA SUVARNA …pdicai.org/docs/Suvarna-Arogya-Suraksha-Trust-Bangalore-Karnataka... · Jyothi Sanjeevini and RBSK. 4. Additional information on the assignment

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Page 1: GOVERNMENT OF KARANATAKA SUVARNA …pdicai.org/docs/Suvarna-Arogya-Suraksha-Trust-Bangalore-Karnataka... · Jyothi Sanjeevini and RBSK. 4. Additional information on the assignment

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GOVERNMENT OF KARANATAKA SUVARNA AROGYA SURAKSHA TRUST,

(HEALTH&FAMILY WELFARE DEPARTMENT)

TENDER DOCUMENT

PROCUREMENT AND APPOINTMENT OF INTERNAL AUDITORS FOR

SUVARNA AROGYA SURAKSHA TRUST

Executive Director,

Suvarna Arogya Suraksha Trust, Bangalore.

1 TENDER REFERENCE SAST/ACCT/Internal Audit/2018-19

2 Date of publishing Tender Document on e-

Procurement platform

19.06.2018 - 11:00 AM

3 Last date for seeking clarifications 26.06.2018 - 05:00 PM

4 Last date for submission of bids 18.07.2018 - 05:00 PM

5 Technical bid opening date 20.07.2018 - 12:00 PM

6 Financial Bid opening date 23.07.2018 - 12:00 PM

7 Availability of Tender Documents

http://www.eproc.karnataka.gov.in

8 Place of opening of Tenders Suvarna Arogya Suraksha Trust, ―A‖ Wing, TTMC Building, 4th Floor,

K H Road, Shanthinagar, Bangalore-560027. Phone: 080-22536200

9 ADDRESS FOR COMMUNICATION: The Executive Director, Suvarna Arogya Suraksha Trust,

―A‖ Wing, TTMC Building, 4th Floor, K H Road, Shanthinagar, Bangalore-560027.

Email: [email protected]

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Suvarna Arogya Suraksha Trust BMTC, TTMC, 4th Floor, Shanthi Nagar, K.H. Road, Bangalore 560 027

Phone: 080-22536200 Fax: 080-22536221 e-Mail:[email protected]

Ref: SAST/ACCT/Internal Audit/2018-19 Dated: 18.06.2018

To whom so ever it may concern,

Subject: procurement and appointment of Concurrent Internal auditor for Suvarna Arogya Suraksha Trust

Suvarna Arogya Suraksha Trust (SAST) an Autonomous Organization under Government of

Karnataka, is providing universal health coverage, through a new scheme called ― Arogya Karnataka‖, to all residents of Karnataka State by way of primary healthcare, normal secondary healthcare, complex secondary healthcare, tertiary heath care and emergency healthcare. RBSK for school children and Jyothi Sanjeevini schame for Govt. Employees. The

existing schemes listed below are subsumed in the Arogya Karnataka scheme: i. Yashaswini Scheme;

ii. Vajapayee Arogyashree Scheme:

iii. Rajiv Arogya Bhagya Scheme:

iv. Rashtriya Swasthya Bhima Yojana (RSBY) including RSBY for senior citizens;

v. Rashtriya Bala Swasthya Karyakrama (RBSK);

vi. Mukhyamanthri Santhwana Harish Scheme and

vii. Indira Suraksha Yojane

Treatment is being provided through Public Health Institutions and empanelled Network Hospitals, as per benefit package codes & rates listed by Government of Karnataka. The entire procedural transactions are made on e-platform ―right from the admission of the

beneficiary” to his/her ―discharge‖, the claims get processed online & and subsequently payment made through RTGS to the hospitals.

SAST is mandated to appoint Internal Auditor as per Trust Deed for auditing the

quarterly accounts of the SAST. Accordingly, with the present appointee’s term getting expired as on 30th of June 2018, it is proposed to float this e-tender through e-portal of the Government.

1. Tenders are invited for submission of technical and financial proposals from CA

firms for conducting the Internal audit in the form of Concurrent Audit to be conducted in the month “following the month under audit”, by stationing minimum two Auditors to Audit the expenditure of Suvarna Arogya Suraksha Trust for One year i.e., for the period of 1st April 2018 to 31st march 2019, payable

quarterly.

2. The purpose of this assignment is to obtain professional services for Concurrent Internal audit of SAST for one Year, i.e. 1st April 2018 to 31st march 2019.

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3. The Annual Budget allotted for SAST for the year 2018-19 of Rs. 878.62 crores for implementing Arogya Karnataka along with separate budget for implementing Jyothi Sanjeevini and RBSK.

4. Additional information on the assignment and the local conditions, may be sought by sending queries by e mail to the email id [email protected].

5. Executive Director, Suvarna arogya Suraksha Trust will be the Tender Inviting and Tender Accepting Authority.

6. Technical and Financial Bid approval Committee:

a. Executive Director, SAST : Chairman b. Director (operations), SAST : Member Secretary

c. Director ( Medical Management): Member d. Project Manager (IT): Member e. Director (Finance) : Member

7. Additional Chief Secretary to Health And Family Welfare Department Government of Karnataka will be the appellate Authority for all kinds of arbitration.

Submission of Proposals in General:

1. Professional services for Concurrent Internal audit of SAST for one Year, i.e, 1st april 2018 to 31st march 2019.

2. Proposals shall be submitted by CA firm supported with their certificate of registration

with ICA of India in two parts, viz., Technical and Financial and should follow the formats prescribed in the "Supplementary Information for the bidders".

3. "Technical" and "Financial" proposals must be submitted through e-portal (www.eproc.karnataka.gov.in) of the Department of E-Governance, Government of Karnataka indicating the professional service for which they apply in the following the formats/schedules given in the supplementary information. The "Technical proposal"

should include the description of the firm/organization, firm’s general experience in the field of assignment, qualification and competency of the personnel proposed for the assignment and the proposed work plan methodology and approach in response to the suggested terms of reference and it should not contain any information relating to financial proposal. The 'FINANCIAL PROPOSAL' must be submitted along with it

separately and should contain the lump-sum offer for the Consultancy Services, excluding taxes.

4. The proposal has to be accompanied with payment of EMD amounting to Rs.50,000/-

through e-portal. The successful bidder’s EMD shall get released only after 1st Quarter of their contract and on submission of Bank Guarantee of Rs.50,000/- in favour of SAST. And the other unsuccessful bidders’ EMD shall get refunded to them soon after the signing of the contract.

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5. Opening of proposals: The technical proposals will be opened online by the Executive Director, SAST or his authorized representative at the above address of the office of Executive Director, SAST at 12.00 PM on 20.07.2018 The Financial proposals will only

be opened 23.07.2018 after the pre-qualification of the tenderer’s based on their technical proposals and will be notified to such pre-qualified bidders.

6. Evaluation: A two stage procedure will be adopted in evaluating the proposals with the

technical evaluation being completed prior to any financial proposals being opened.

7. Technical proposals will be evaluated using the following criteria;

A. Key personnel in the audit team, their minimum qualifications, and anticipated inputs are indicated below:

i. Audit team should be led by a Partner who is a CA with a minimum of 5 years of post-qualification experience in the audit of PSUs with good exposure to social sector schemes, Govt. system of budgeting and accounting under Govt. sponsored schemes.

ii. Day to day management of the audit should be the responsibility of one Manager/Partner having more than 5 years of post-qualification experience as a practicing Chartered Accountant and at least 3 years experience in the audit of Govt. system or PSUs social sector schemes.

B. Firm should have its office in Karnataka from at least last five years

and shall have registered with ICAI (attach copy of certificate downloaded from ICAI website showing name of address head office and partners etc.);

C. Annual turnover of firm in last three years (2014-15, 2015-16 & 2016-17

financial years) shall be 10 lakhs; D. Audit experience of the firm: overall audit experience and of similar

sector projects funded by the Govt./External Agencies in particular and capacity in which was associated with such assignments, understanding of the ToR, methodology of work, familiarity with Govt. system of budgeting & funds release, exposure to Karnataka Financial Code, KTPP Act and similar rules, expertise in GST, IT and other Statutory deductions and filing.

E. Auditor and persons associated with SAST Audit shall mandatorily have Proficiency in Kannada language (both writing and reading)

F. CA and other Auditors and Firm should not have been blacklisted by any Statutory Body.

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Qualified Technical proposals will only be pre-qualified and considered for financial evaluation.

8. Financial Evaluation:

8.1 Only the Pre-qualified firms evaluated technically will be considered for financial evaluation.

8.2 The Financial quote shall be on a lump sum basis (exclusive of Taxes) for one

Year, i.e, , 1st april 2018 to 31st march 2019, in Indian rupees payable quarterly.

a) The Financial Proposals will be opened for Internal Audit services through e-procurement on 23.07.2018.

b) Trust will select the lowest financial quotation among those pre-qualified firms on verifications of original records.

c) Trust is not bound to select any of the firms submitting proposals and at any point

of time, SAST can reject it without assigning any reasons. d) The proposals submitted will be valid for 60 days from the date of submission,

without change of the personnel proposed for the assignment and the financial bid. Trust will make its best efforts to select the audit firm within this period.

e) The cost of preparing a proposal, negotiating a contract including visits to the

Trust office is not reimbursable.

f) Assuming that the contract is satisfactorily concluded, the assignment is to be taken forthwith from the date as communicated by Suvarna Arogya Suraksha

Trust.

g) If Tender schedule days happened to be holidays, then dates will be scheduled

to next working days.

Executive Director, Suvarna Arogya Suraksha Trust.

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9. TERMS OF REFERENCE FOR THE INTERNAL AUDITORS

SAST Proposes to appoint Internal Auditors

1. To audit the claims monthly in the form of Concurrent Audit to be conducted in

the month ―following the month under audit‖, by stationing minimum two

Auditors to Audit the said expenditure of Suvarna Arogya Suraksha Trust to be reported quarterly and the other administrative expenditure, on concurrent basis every month. The claims expenditure and the other Administrative expenditure have to be audited.

2. The following Accounting System and applicability of various provisions is for guidance;

Trust follows Cash Based double entry accounting system and maintains its accounts in Microsoft Navision NAV & Tally accounting software under the generally accepted accounting principles and Accounting Standards prescribed by the ICAI, to the extent they are relevant to the activities of the Trust. Since Trust is fully funded by the GOK for its activities, provisions of the Karnataka Financial Code, Manual of Contingent Expenditure, Budget Manual and Standing Orders or instructions amended from time to time, as applicable to the Departments of Government shall be applicable to the Trust as well.

In addition, provisions of Karnataka Transparency in Public Procurement Act, 1999 with Rules framed there under and Right to Information Act are also applicable to the Trust.

10. Internal Audit (Concurrent Audit) period is , 1st April 2018 to 31st march 2019.

a) The Internal Audit in the form of ―Concurrent Audit‖ shall be done in the month following the month under audit‖, by stationing minimum two Auditors to Audit the said expenditure of Suvarna Arogya Suraksha Trust framing to a quarterly report.

b) The quarterly report is a continuous and critical appraisal of the functioning of the Trust with a view to suggest improvements thereto and add value to and strengthen the overall governance mechanism including effectiveness of risk management and internal control systems prevalent in the organization. Internal audit is contemplated to assess the adequacy of the Trust’s financial management system including internal controls and provide feedback to the Trust management on whether the internal controls, both financial and operational, within the system are operating as intended, in order to ensure that corrective measures, wherever necessary, are taken in a timely manner.

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11. Scope of work

The overall objectives of the internal audit are to:

100% Concurrent Audit of the claims expenditure, on a monthly basis in

the month “following the month under audit “, by stationing minimum two Auditors to Audit the said expenditure of Suvarna Arogya Suraksha Trust;

100% concurrent audit of the monthly administrative expenditure on a monthly basis;

Ascertain whether the systems of internal checks and control operating are effective;

Ascertain the extent to which systems are in place to monitor efficient use of Trust funds/assets;

Ascertain that the financial rules and procedures as laid down in the Manuals/Trust Deed/applicable Govt. Orders/Rules/Regulations and generally accepted accounting principles are followed;

Ascertain the reliability and authenticity of the accounting records maintained and the financial reports/statements generated there from;

Ascertain Income tax filing and corrections if any so that IT outstanding demand doesn’t exist; and

Ascertain any statutory mandate.

12. Coverage under the Internal Audit

Internal audit would cover all the Trust activities and all sources and application of funds. Internal audit would be conducted on quarterly basis at the Trust office, Bangalore. Internal audit should be carried out in accordance with the Auditing Standards issued by the Institute of Chartered Accountants of India, to the extent relevant. The audit should include such tests and controls as the Internal Auditor considers necessary under the circumstances. Specific areas of coverage of the internal audit will include the following:

An assessment of the adequacy of the Trust financial management systems,

including internal controls on a continuous basis, and a specific report on this aspect would be provided quarterly. This would include aspects such as adequacy and effectiveness of accounting, financial and operational controls and any need for revision, level of compliance with the established policies, plans & procedures, reliability of accounting systems, data and financial reports, methods of remedying weak controls, verification of assets(including physical verification of assets) & liabilities, integrity, controls and effectiveness of the operation of the computerized system.

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Shall conduct audit of monthly Reconciliation with Bank statement, Cash book and Tally entry.

That Trust funds have been used with due regard to economy & efficiency and only for the purposes of the Trust as approved by appropriate authority.

That proper systems/controls are in place for timely & effective disposal of referrals/requests received for providing health care under SAST including their receipt, scrutiny and issue of pre authorization to the empanelled/network hospitals, by ensuring that the prospective beneficiary is an eligible beneficiary, proposed health care/treatment falls under the approved packages and proposed authorization in addition to benefits already availed, is within the maximum scale of benefit fixed under the scheme.

That claims of empanelled/network hospitals settled are in accordance with the approved packages and duly documented for all the procedures/tests forming part of the package and are processed & paid for in accordance with the prescribed procedures/guidelines and deviations, if any, have been approved by the competent authority/properly reported & dealt with.

That adequate records are maintained for the assets created/acquired by the Trust, including details of cost, identification and location of assets and that the management has a reasonable system of physical verification of assets which is commensurate with the size and nature of operations. Internal Auditors shall carry out physical verification of the assets, at beginning of financial year and comment on its maintenance & utilization.

That there exists proper controls and systems for sanction of advances, timely rendering of accounts and recoupment of unspent advance.

That there exists proper controls for ensuring adequate and timely compliance with all applicable statutory/legal requirements, particularly under Income Tax and Service Tax provisions.

That the expenditures charged to the Trust are eligible expenditures and have been correctly classified

That all the amounts realized/received towards EMD/SD / Bank Guarantee, refunds out of advance, stall rent, registration fee and realization under any other head including excess payments, if any, have been properly receipted, accounted for and remitted to Bank on time.

That all necessary supporting documents, contracts, records, and accounts have been kept in respect of all the Trust activities, and that clear linkages exist between the accounting records, books of account and Trust’s Financial Statements.

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That UC’s are verified and signed on monthly/quarterly/annually basis.

That visit at least one empanelled hospital per month as per instructions of ED to verify appropriate claim submission by hospital and settlement by trust.

That MPIC reports are Audited on monthly basis.

13. Areas to be covered under Internal audit

Submission of claim by the empanelled hospital for treatment given to the beneficiary.

Online Verification of the claim at SAST for settlement. Verification, approval and settlement of claims by the SAST towards

empanelled hospitals. Continuous review of terms of contract with any agency, adherence to

deliverables as per the stipulated timeline and verification of payments under the contract.

Verification of all other receipts, including scheme advance/working capital from the Govt. etc., their utilization and payments under all other heads.

Statutory compliance including deduction of tax at source and remittance, filing of periodical returns and related aspects.

Maintenance of records relating to assets acquired/received by the Trust, their upkeep, physical verification & reconciliation with books at regular intervals and segregation of unserviceable assets.

14. Concurrent Audit of “CLAIMS SETLEMENT” of empanelled hospitals and

other expenditure, reporting etc.,

1. Extent of the verification of the claims by Audit; 100% verification of individual claims exceeding Rs.30,000/- 30% verification of individual claims less than Rs.30,000/-

2. 100% verification of the other Administrative Expenditure.

Quarterly reporting:

The Internal Audit would be carried out on a monthly basis and will focus on the following:

Operation of the financial management system and internal controls

Transactional review of expenditures incurred by the Trust under different heads and particularly, settlement of claims of empanelled/network hospitals

Reporting would be done quarterly as detailed below.

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Internal auditor will provide a quarterly report to Trust management highlighting findings during the period under audit review, in the form of a Management Letter which will inter-alia include:

Comments and observations on the financial records, systems and

controls that were examined during the course of the audit Deficiencies and areas of weaknesses in the systems & controls and

recommendations for addressing the deficiencies and areas of weaknesses

Compliance with covenants in the Trust deed and comments if any, on

the internal and external matters affecting such compliance Matters that have come to attention during the review, which might

have a significant impact on the activities of the Trust Any special review procedures required of a compliance nature Any other matter that the Auditor considers pertinent.

Quarterly report in draft form should be submitted within 15 days from the end of the respective quarter, for review by the Review Committee constituted by the Trust. Final report shall be submitted within five days from the date of receipt of comments/views/compliance of the Review Committee, after duly considering the same.

15. Key personnel:

Key personnel in the audit team, their minimum qualifications, and anticipated inputs are indicated below:

Audit team should be led by a Partner who is a CA with a minimum of 10 years of post-qualification experience in the audit of PSUs with good exposure to social sector schemes, Govt. system of budgeting and accounting under Govt. sponsored schemes.

Day to day management of the audit should be the responsibility of one Manager/Partner having more than 10 years of post-qualification experience as a practicing Chartered Accountant and at least 5 years experience in the audit of Govt. system or PSUs social sector schemes.

In addition, the audit team should include sufficient number of trained staff

to be permanently stationed at SAST office on all working days for day to day basis under pre and concurrent mode of audit commensurate with the size and scope of the assignment.

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16. General:

Internal Auditor would be given access to all documents, correspondence, and any other information relating to the Trust and deemed necessary by the Internal Auditor. Internal Auditor should also become familiar with the relevant policies and guidelines of the Government and the World Bank funds under IDA Credit, with the GOK funds for implementing and health schemes through the Trust including related financial management & reporting requirements. Auditors should obtain satisfactorily documentary evidence to support their conclusions. To prevent conflict of interest, internal auditors or any of their associates (including associates of the firm’s partners) would not be eligible to be appointed to carry out any other assignment in the Trust.

17. Period:

18. Internal auditor would be initially appointed to conduct audit for the period , 1st

April 2018 to 31st march 2019.

19. Review Committee

Audit and Finance Committee of SAST will act as Review Committee.

The committee will review the draft internal audit report submitted by the Internal Auditor and communicate comments/views/compliance to the Internal Auditor besides initiating necessary remedial measures to address the deficiencies/discrepancies pointed out in the draft internal audit.

20. Checklist of areas to be covered

a) The auditor is required to cover the following as a part of the internal audit:

The internal audit activities should include payment audit as well as independent appraisals of the financial, operational and control activities of the scheme.

Funds have been used in accordance with the condition of the relevant financial norms and regulations with due attention to economy and efficiency, and only for the purpose for which it was provided.

Whether there is adequate segregation of duties and controls? Applicable accounting principles have been followed while incurring

expenditure. There is a proper financial & administrative delegation and expenditure

incurred/advances paid are properly authorized, as per the existing delegation. If need be, comment on the adequacy or otherwise of the delegation of powers at various levels.

Review systems followed for disbursement of advances, whether they are in accordance with the stipulated procedures/guidelines, whether there is a system for monitoring timely settlement of claims/advances and

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whether there is a system of adequate review & approval before the settlement of claims/advance and there is evidence of such review?

Goods, works and services including procurement of assets are in accordance with the accepted procurement procedures - compliance with KTPP Act, 1999 and rules framed there under and where funds of other external agencies have been utilized for such procurement, procurement procedures s stipulated by the funding agencies – and procurement manual, as applicable for the procurement under Health & Family Welfare Department.

Adequate and proper supporting documents viz. tender documents, purchase orders, invoices, vouchers, receipts, pay bills, TA bills, vouchers etc., are maintained in respect of all the procurement of goods & services, expenditure booked/incurred and properly linked to the transactions.

Whether Bank accounts are reconciled regularly and timely action taken to reconcile the differences/unlinked debits & credits and confirmation is being obtained from Bank/s on a regular basis.

b) Specific areas shall include but not limited to the following:

Cash and Bank balance

Urgent office expenditure and other contingencies shall be met out of a pre-determined imprest amount, which shall be recouped from time to time. Imprest limit shall be need based and it shall be ensured that:

Amount is drawn/recouped as per authorization/delegation; Cash on hand at any point of time shall tally with the Cash Book balance; All cash realizations/proceeds are remitted to the Bank account on the

next working day, without being mixed up with imprest cash and adequate controls exist for safe keeping of cash including insurance cover;

Only office contingency, training/workshop and other petty expenditure are met out of the imprest;

All other payments shall be made through account payee crossed cheques only;

Bank accounts are reconciled at monthly intervals and list of outstanding entries shall be prepared and followed up for timely clearance.

Vouchers

All the vouchers have to be scrutinized and verified to check whether proper sanction/approval is there for all the payments, payment has been properly authorized and expenditure is correctly booked in the accounts.

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Verification of Registers

Audit should verify and comment on the up to date maintenance of relevant registers and records in connection with the activities & expenditure of the Trust, including Fixed Assets Register

Physical verification of cash, assets and other items

Process of audit should also include surprise verification of cash at least two times during each spell of audit and confirmation to the effect that physical balance tallies with the cash book balance. Physical verification of assets shall be undertaken at regular intervals during the course of the audit followed by comparison of the physical balance with book balance and commenting upon variations, if any, as also segregation of unserviceable/damaged assets from sound assets.

Suggestions and recommendations

Internal audit should review existing systems internal control, their efficacy/effectiveness and come up with suggestions/recommendations for improvements in the system of internal controls, MIS and related aspects leading to more effective functioning and achievement of the Trust objects.

c) Audit report shall have the following contents:

Introductory paragraph – stating that the audit has been conducted for the

year in accordance with the accounting standards and list of documents verified/reviewed, while arriving at the audit findings

Scope Paragraph – areas of audit, terms of reference, time spent by the audit

team and the methodology adopted for conducting the audit

Findings – Under each head of Account and Bank Accounts, comments of the

Auditors along with Management replies/explanations/clarifications in relation to the audit observations

Issues and Suggestions – Auditor should identify specific issues/areas of

weaknesses, which need to be addressed and suggest steps & strategies to overcome them.

Recommendations - Overall opinion on the audit conducted shall be given

under this head. Lack/inadequacy of systems of internal control can be highlighted under this chapter along with recommendations and best practices followed, elsewhere.

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21. Checklist format relating to settlement of claims of empanelled hospitals

(a) Procedure for empanelment of hospitals:

List of empanelled hospitals with complete address

If the empanelment is for a specific period, is there a system of renewal of the empanelment

Is there a system of updating the list of empanelled hospitals, by seeking renewal from the hospitals already empanelled and seeking renewal from new hospitals, at prescribed intervals

Have standards been fixed/determined for empanelment of hospitals and procedure followed for evaluation of applications received for empanelment/renewal

(b) Eligibility of beneficiaries, approval for referrals and settlement of claims:

Is there a system of maintaining the eligible list of

beneficiary families and within the family, family

members who are eligible to avail the benefits?

Is there a system of updating of the beneficiary family

list periodically for additions & deletions, both with

regard to the families and the beneficiaries within the

family?

Ensure that all the pre authorizations to empanelled

hospitals are issued by SAST on the basis of initial

referral by the Govt. Hospitals & the referral is based

on (a) Observation; or (b) Lab reports or (c) Hospital’s

examination report and the procedure/s followed by

the empanelled hospitals for vetting the initial referral,

while seeking pre authorization?

Before issue of pre authorization, SAST has ensured

that:

(i) the disease identification and recommended

treatment is within the approved list of diseases

& treatment packages?

(ii) cumulatively not more than five

members(including the current pre

authorization) of the beneficiary family have

availed benefit; and

(iii) the quantum of authorizations have not exceeded

the maximum financial cap per family?

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What is the time taken by the empanelled hospital to seek Pre authorization, after examining the referred patient and the response time of the SAST for disposal of the pre authorization request?

(c) Settlement of claims of empanelled hospitals

What is the time taken by the empanelled hospital to

submit the bill after providing treatment to the patient

and response time of the SAST for disposal of the claim

of the hospital?

System followed by the SAST for verification of claims

of the empanelled hospitals and ensuring that:

(i) dates of admission and discharge of the patient,

are well within the period for which Pre

authorization is issued?

(ii) Pre authorization limit approved and actual

claim by the Hospital

(iii) Claim is supported by relevant bills, reports etc.,

(iv) Compliance with pre authorization conditions or

otherwise

(v) Bill is signed by the patient or his authorized

representative, as a token of having received

treatment for which claim is raised

System in place for monitoring receipt of claims from

the SAST and disposal of the same by the Trust

including timeline for payment to the hospitals

Whether reasons are recorded in writing for

disallowance/s by the Trust, if any, while settling the

claims recommended by the SAST?

Is there a system to capture beneficiary family wise

information on a concurrent basis, relating to pre

authorizations issued, actual availment and balance

limit available (both in regard to no. of beneficiaries

and financial limit for the family)

Executive Director,

Suvarna Arogya Suraksha Trust.

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Annexure - I

Letter of Transmittal

To,

Executive Director, Suvarna Arogya Suraksha Trust,

Bangalore. Madam / Sir, We, the undersigned, offer to provide the audit services for Suvarna Arogya

Suraksha Trust (SAST) in accordance with your Request for Proposal dated [insert date]. We

are hereby submitting our Proposal, having details about the firm and proposed audit fees.

We hereby declare that all the information and statements made in this Proposal are

true and accept that any misinterpretation contained in it may lead to our disqualification.

The Fees quoted by us is valid till six months from the date of submission of the

proposal. We confirm that this proposal will remain binding upon us and may be accepted

by you at any time before the expiry date.

Prices have been arrived independently without consultation, communication,

agreement or understanding (for the purpose of restricting competition) with any

competitive bidder.

We agree to bear all costs incurred by us in connection with the preparation and

submission of the proposal and to bear any further pre-contract costs.

We understand that Suvarna Arogya Suraksha Trust (SAST), Karnataka is not

bound to accept the lowest or any proposal or to give any reason for award, or for the

rejection of any proposal.

I confirm that I have authority of [insert Name of the C.A firm] to submit the

proposal and to negotiate on its behalf.

Yours faithfully,

( )

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Annexure - II

Format for technical proposal

Sl. No.

Particulars Supporting documents required to be submitted along with this Form

1. Name of the Firm

2. Addresses of the Firm

Head Office

Phone No:

Fax No:

Mobile No. of Head Office In-charge:

Date of establishment of the firm

Date since when is H.O at the existing Station

Branch Office 1,2,3……. (Particulars of

each branch to be given)

Phone No:

Fax No: Mobile No. of Head Office In-charge:

3. Firm Income Tax PAN No. Attach copy of PAN Card

4. Firm Service Tax / GST Registration

No.

Attach copy of registration

5. Firm’s Registration No. with ICAI Attach a copy of certificate downloaded

from ICAI Website showing the name of address of H.O., B.O. and Partners etc.,

6. Empanelment No. with C&AG Attach proof of empanelment with C&AG

for the year under Audit (2016-17)

confirming that the firm is eligible for major PSU audits.

7. No. of years of Firm Existence & Date

of establishment of Firm

Attach copy of Partnership Deed

8. Turnover of the Firm in last three years Attach copy of Balance Sheet and P & L

Account of the last three years or a C.A Certificate give Break-up of Audit Fee and

Other Fees received.

9. Audit Experience of the Firm:

1. Number of Assignment in commercial /Statutory Audit.

2. Number of Assignment of Externally Aided Projects/Social

Sector Project (excluding audit of

Charitable Org.) Institutions & NGOs In the Audit of government schemes.

Copy of the Offer Letter & the Fee Charged for each assignment.

(Relevant evidences to be given of the

turnover and fee)

10. Details of Partners:

Provide following details:

Number of Full Time Fellow Partners associated with the firm

Name of each partner Date of becoming ACA and FCA Date of joining the firm Membership No. Qualification Experience

Attested copy of Certificate of ICAI not before 01.01.2018

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Whether the partners is engaged

full time or part time with the firm Their Contact Mobile No., e-mail

and full Address (Attested copy of

Certificate/Letter of ICAI not before 01.01.2018)

11. CURRICULUM VITAE (CV) FOR PROPOSED

KEY PROFESSIONAL STAFF

Attested copies of proposed key Professional staff shall be submitted.

Note: The firm shall give an undertaking that the team members are proficient in the

State’s official language (both oral and written).

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ANNEXURE -III

FINANCIAL BID

(On the letter head of the consultancy firm)

Date: To,

The Executive Director, Suvarna Arogya Suraksha Trust,

BMTC, TTMC, 4th Floor, Shanthi Nagar, K.H. Road, Bangalore 560 027.

Sir,

Sub: Financial bid for internal audit of Suvarna Arogya Suraksha Trust

22. I/We ——————————— consultant/consultancy firm/organization submit the following financial lump sum bid for Concurrent Internal audit of Suvarna Arogya Suraksha Trust from , 1st April 2018 to 31st march 2019 and the validity of the bid shall be for a period of 60 days from the date of its opening.

Name of the assignment Amount

23. Audit Lump sum bid for Internal audit of Suvarna Arogya Suraksha Trust for the period , 1st April 2018 to 31st march 2019 (Exclusive of taxes)

T

Total

Rupees (in words)

Name of the authorized signatory: Capacity of the authorized signatory: Signature of the authorized signatory with Rubber stamp of the firm

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ANNEXURE -IV

DRAFT CONTRACT FOR INTERNAL AUDIT SERVICES

Subject: Internal Audit of Suvarna Arogya Suraksha Trust (Name of the audit firm) Set out below are the terms and conditions under which (Name of the audit firm) has agreed to carry out for Suvarna Arogya Suraksha Trust (SAST) the above

mentioned assignment specified in the attached Terms of Reference.

1. Internal audit in the form of Concurrent Audit to be conducted in the month “following the month under audit”, by stationing minimum two Auditors to Audit

the expenditure of Suvarna Arogya Suraksha Trust for the period 1st April 2018 to 31st march 2019, payable quarterly which is culminated into a contract between

your firm and Suvarna Arogya Suraksha Trust (SAST) and acceptable. 2. For administrative purposes, Director (Finance), SAST has been assigned to provide

[Name of the audit firm] with all relevant information needed to carry out the assignment. The services will be required in the Suvarna Arogya Suraksha Trust for conducting Internal audit of the Trust for the period , 1st April 2018 to 31st march 2019.

3. Services to be performed and reports to be submitted will be in accordance with the

Tender document.

4. This Contract, its meaning and interpretation and the relation between the parties shall be governed by the laws of Union of India

5. This Contract will become effective upon confirmation of this letter on behalf of

(Name of the audit firm) and will terminate on completion of Internal audit of the Trust accounts for the period 1st April 2018 to 31st march 2019 for such other date

as mutually agreed between the Suvarna Arogya Suraksha Trust and the (Name of the audit firm).

6. Payments for the services will not exceed the total amounting to `_________/- (in

words) excluding Taxes; by dividing it into Eleven Quarterly Installments and shall get payable on a Quarterly basis.

7. Suvarna Arogya Suraksha Trust will pay (Name of the audit firm), within 30 days

following submission by the Consultant of invoices in Triplicate to the Executive

Director of the Trust

8. [Name of the audit firm] shall indemnify and hold harmless the Suvarna Arogya Suraksha Trust against any and all claims, demands, and/or judgments of any nature brought against the (Client) arising out of the services by the [Name of the audit firm] under this Contract. The obligation under this paragraph shall survive

the termination of this Contract.

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9. Internal Auditor agrees that, during the term of this Contract and after its termination, the Internal Auditor and any entity affiliated with the Internal Auditor, shall be disqualified from providing goods, works or services (other than the Services and any

continuation thereof) for any project resulting from or closely related to the Services.

10. All final plans, drawings, specifications, designs, reports and other documents or software submitted by the [Name of the audit firm] in the performance of the Services shall become and remain the [property of the Client. Internal Auditor may retain a copy of such documents but shall not use them for purposes unrelated to this Contract without the prior written approval of the Client.

11. Internal Auditor undertakes to carry out the assignment in accordance with the highest standard of professional and ethical competence and integrity, having due

regard to the nature and purpose of the assignment, and to ensure that the staff assigned to perform the services under this Contract, will conduct themselves in a manner consistent herewith.

12. Internal Auditor will not assign this contract or sub contract or any portion of it.

13. The [Name of the audit firm] shall pay the taxes, duties fee, levies and other

impositions levied under the applicable law and the Client shall perform such duties, in regard to the deduction of such tax, as may be lawfully imposed.

14. The [Name of the audit firm] also agree that all knowledge and information not within the public domain which may be acquired during the carrying out of this

Contract, shall be, for all time and for all purpose, regarded as strictly confidential and held in confidence, and shall not be directly or indirectly disclosed to any person whatsoever, except with the written permission of Suvarna Arogya Suraksha Trust.

Place:

Date: Signature of Authorized Representative on behalf of the Consultant) (Signature & Name of the Client's Representative) Note: Contract terms will be as provided by SAST at the time of Award of Contract.