strengthening of Employee Health Scheme for Providing Cashless medical treatment to the State Government Employees, Pensioners and their dependent family members-orders -Issued
HM&FW Department-Steering Committee meeting convened by the Chief Secretary, Government of Andhra Pradesh with various Employees Associations on 16.02.2022 at 11:00A.M. in Conference hall, 1st Floor, 5th Block, A.P. Secretariat. Velagapudi for strengthening of Employee Health Scheme for Providing Cashless medical treatment to the State Government Employees, Pensioners and their dependent family members – orders – Issued
HEALTH, MEIDCAL & FAMILY WELFARE (11) DEPARTMENT
G.O.Ms.No 203 Dated 08/08/2022
Read the following
1.GO.Ms.No.174, HM&W(M2) Department. Dated.01.11.2013.
2. G.O.Rt.No.83. HMS FW12) Department. Dated 25-02-2016
3. GO.M.No.54, HM&PW11) Department, Dated 06-05-2020.
4. G.O.Rt.No.3578, GA(SW) Department, Dated 30-10-2014.
5. From the CEO, Dr. YSR AHCT. Guntur, e-file No. YSRAS 25/2/2022 – EHS -YSRAS (Computer No.1647975).
6. G.O.Rt.No.192, HM & PW (1.1) Dept,, dated:21-03-2022.
ORDER
In the GO.1st rend above, orders were issued for notifying the Employees Health Scheme (EHS) and its implementation, wherein it was directed that a Steering Committee under the chairmanship of Chief Secretary to Government will review the implementation of the Scheme from time to time. The Steering Committee constituting members from employees and pensioners associations and from the Government In the ratio of 40:60 will meet as frequently as required, discuss, monitor and review the Scheme, benefit packages. grievances, quality of medical care including the modalities of an Employees Health Trust, Further, orders were issued fixing the contribution of Government and the employee / pensioner in the ratio of 60:40.
In the G.0.2nd read above, orders were issued for the monthly share of the Government and the Employees/ Pensioners towards EHS was revised from 60:40 to 50:50
In the G.O.3rd read above, orders were issued among other things enhancing the monthly contribution from the Employees towards EHS from Rs.90/- and Rs.120/- to Rs.225/- and Rs. 300/- respectively as per the Slabs and Pay grades as specified in the G.OMI.No.174 HM&FW (M2) Dept.. dated 1.11.2013. In the same way, the Government Contribution per employee was enhanced from Rs. 90/- and Rs.120- to Rs.225/- and Rs.300/- respectively.
In the GO4th read above, orders were issued for Constitution of Steering Committee under the Chairmanship of Chief Secretary to Government to review the implementation of the Employees Health Scheme(EHS) from time to time.
The Chief Secretary to Government and Chairman of Steering Committee to review the implementation of the EHS from time to time hat convened a meeting with various Employees associations on 16.02.2022 at 11:00 A.M. in Conference hall, ft Floor, 5th Block A.P. Secretariat. Velagapudi for strengthening of Employee Health Scheme.
In the Steering Committee Meeting, the Members of Employees Associations have raised several issues on the implementations of the Employees Health Scheme (EHS). The issues raised by the Associations have been examined by the CEO, Dr. YSR AHCT., Guntur and recommended to approve the following recommendations in the 1st phase for strengthening of Employee Health Scheme (EHS). The remaining issues will be examined in depth and a view can be taken subsequently vide reference 5th read above:
- The Medical Reimbursement (MR) scheme will be extended until 31.03.2022.
- The identified 565 procedures which are covered under Aarogyasri but excluded from EHS will be included in EHS.
- The payments for the claims under the EHS scheme will be brought under the Auto Debit Scheme of the Government for clearance in 21 days along with the bills of Aarogyasri.
- Strengthening of help desks at all Network hospitals to ensure that Aarogya mitras assist the EHS policies and development of EHS APP to streamline the functioning of EHS.
- The Aarogyasri Network Hospitals in other States shall also be empaneled for EHS as is the case with hospitals with A.P.
Government vide reference 6th read above. Issued orders extending the Medical Reimbursement Scheme under APIMA Rules, 1972 from 01-08-2021 to 31-07-2022 to the employees and pensioners in parallel with Employees Health Scheme (EHS), duly following the comprehensive guidelines Issued from time to time.
Government after careful examination of the matter hereby decided to strengthen the Employee Health Scheme and approved the following recommendations in the 1st phase to Provide Cashless medical treatment to the State Government Employees, Pensioners and their dependent family members
i. The identified 565 procedures which are covered under Aarogyasri but excluded from EHS will be included in Employee Health Scheme.
ii. The payments for the claims under the EHS scheme will be brought the Auto Debit Scheme of the Government for clearance in 21 days along with the bills of Aarogyasri.
iii. Strengthening of help desks at all Network hospitals to ensure that Aarogya mitras assist the EHS beneficiaries for getting cashless treatment at empaneled hospitals.
iv. The Aarogyasri Network Hospitals in other States shall also be empaneled for Employee Health Scheme as is the case with hospitals with A.P.
The Chief Executive Officer, Dr. YSR Aarogyairi Health Care Trust. Mangalagiri, Guntur District shall take necessary action accordingly.
This order issued with the concurrence of Finance(FMU-HM&FW Department vide U.O.No.FMUOFCIHMF1/327/FMU.HM&FW/2022. Dated:05-08-2022 (Computer, No. 1803564)