Professional Documents
Culture Documents
CS (Medical Attendance Rules) 1944: - Extent of Application
CS (Medical Attendance Rules) 1944: - Extent of Application
• Extent of Application
• These rules apply to all Govt. servants except covered under CGHS
& other than those in Railway service. However Railway
employees on deputation to various other offices under the
Central Govt. are governed by these rules.
• These rules also apply to:-
1. All central govt. servants who are on leave preparatory to
retirement.
2. Govt. pensioners on their re employment under the Central Govt.
3. Defense Accounts Department personnel
4. A probationer
5. Apprentice who are in the whole time service of Govt.
6. All state govt. servants on deputation with the central govt.
• These rules do not apply to-
• 1. Defence Service personnel
• 2. Govt. Servants who are on deputation abroad
• 3. Retired govt. Officials
• 4. Govt. Servants who are governed by CGHS while in
stations where this scheme is functioning.
• 5. Officers of All India Services and other persons who are
governed by the All India(MA) Rules, 1954
• 6. India based officers and staff serving in Missions abroad
who are governed by the Assisted Medical Attendance
Scheme.
• DEFINITIONS
• “Medical Attendance” means attendance at the
hospital(OPD)or at the residence of the Govt. Servant or at
the consulting room of the AMA whether at the hospital or
at his own residence.
• “Treatment” means the use of all medical and surgical
facilities available at the hospital.
Note: The exp. incurred in connection with treatment may be
treated at reimbursable. No reimbursement will be
admissible if treatment is obtained to improve general
physical fitness/stamina/for cosmetic purpose/improve
figure etc. The refund of the cost of preparations which are
not medicines but are primarily foods, tonics, toiled
preparations or disinfectant is not admissible under the
Rules.
Authorized Medical Attendant(AMA)
• Authorized Medical Attendant(AMA) means-Medical Officer whether or not
under the employ of the central Govt. appointed by (i) the Deptt. Of Health
of the Govt. of India (ii) any other Department of the GOI in relation to
persons under the employ of that Deptt.,(iii) the Chairman of the Central
Govt. Employees Welfare Co-ordination committee.
• Who can be AMA
There are three categories of Medical Officers who can be appointed as
AMA
(1)MOs under the employ of Central Govt.(2) MOs who are not employees
of the Central Govt.(3) MOs in the employ of the State Govt. or UTs
• Private regd. Medical Practitioner may also be appointed as AMA where
adequate number of Doctors in the employ of the Central Govt. or the State
Govt. is not available or because of the remoteness of the area in which the
patient lives.
• Choice of AMA- Employee should consult the AMA nearest to his residence.
However he may consult any other AMA provided he gives his option in
writing.
• No treatment outside normal duty station from private medical practitioners
appointed as AMAs. Treatment is to be taken from Govt. hospital
• Exception in case of emergency:
• In case of extreme emergency or unforeseen circumstances
when an official or the member of his family falls ill, he/she
may be allowed to take treatment from any other
empanelled AMA even if he is not an AMA nominated by his
deptt. Each case could be considered on merits by the
Controlling Officer who would be free to disallow a claim if
he is not satisfied about genuineness of the same after
giving the aggrieved official an opportunity to explain his
case.
• The AMA of a Govt. Servant is determined with ref. to the place at
which he falls ill, where it be his permanent residence or place of
casual stay or the place where he may be spending his leave.
• “Medical Attendance” includes attendance at the
hospital/dispensary or at the residence of the Govt. Servant or at
the consulting room of the AMA whether maintained at the
hospital or at his own residence by arrangement with him.
• No AMA should charge any fee for attendance upon, or
professional services rendered to any person at the hospital
premises during hospital hours.
• However if the professional services are rendered outside of the
hospital, whether appointed as AMA or rendering services as a
specialist, is entitled to charge his fees at the prescribed rates, if
otherwise permissible.
• No fee should be charged by MOs who are in receipt of NPA.
• No AMAs from RMP owning private nursing homes.
• Validity of panel- one year which is renewable.
• When a MO can be his own AMA- He can be treated as AMA
for himself and family only when there is only one AMA.
• Consultation/visiting fee of AMA
• 1. Medical P.G./Specialist- First consultation Rs. 100/- the
Rs. 60/- for subsequent consultation.
• 2. Medical Graduates(MBBS)- First consultation Rs. 70/- the
Rs. 40/- for subsequent consultation.
• No separate charges for day and night consultation.
• Fresh or subsequent consultation
• Every consultation after the first in r/o of the same
illness of the same patient should be treated as
“subsequent consultation”.
• Where a patient after being cured of a particular
illness develops a fresh illness & consults the same
doctor, that consultation should be regarded as a
fresh consultation.
• Where a patient consults the same doctor in regard
to the super-imposition of another disease during the
course of treatment of one disease, that consultation
should be regarded as a fresh consultation.
• Hospitals recognized by the State Govt./CGHS/CS(MA) Rules 1944
• Central Govt. Employees and the member of their families may be
permitted to avail of medical facilities in any of the Central Govt.,
State Govt. Hospitals and the hospital recognized by the State
Govt./CGHS /CS(MA) Rules as well as the hospitals funded by
Central/State Govt. Subject to the condition that they will be
reimbursed the medical Exp. at the rates fixed by the Govt. Under
the CGHS/CS(MA) rules.
• If the treatment for a particular disease/procedure is available in
the same city where the Govt. Servant is employed he may be
permitted to avail of medical services in any other city without
any TA/DA. In case treatment is not available in the city, he will be
eligible for TA for taking treatment in a different city.
Simplification of procedure for treatment at private hospital
empanelled under CGHS/CS(MA) Rules
• Procedure for treatment at private hospital empanelled under
CGHS/CS(MA) Rules has been simplified now. Beneficiaries are
allowed to undergo treatment at pvt. Hospitals empanelled under
CGHS/CS(MA) Rules for specific treatment as advised by Specialist
in a Central/State Govt. Hospital without any requirement of any
other referral letter.
• Serving Govt. Employees shall enclose the prescription in original
while submitting the medical claim to the concerned
Ministry/deptt. for reimbursement.
• Govt. Specialist shall not refer the beneficiaries to any particular
empanelled hospital by name but specify the treatment and
mention ’referred to any empanelled hospital’.
• Simultaneous treatment in two or more systems of
medicine:-
• Treatment for the same ailment should not be
taken simultaneously in more than one system of
medicine. However no objection to treatment being
received simultaneously in different systems of
medicine for different ailments. This should be
done with the knowledge of the attending doctor of
the other system concerned.
Medical Attendance
• A Govt. servant shall be entitled, free of charge to medical
attendance by the AMA. If any amount paid by him on account
of such medical attendance shall on production of a certificate
be reimbursed to him by the Central Govt.
Limits for reimbursement of consultation fees and cost of
medicines:-
• Reimbursement of consultation fees at the prescribed rates
should be restricted to the first four consultations/visits at the
rate of one consultation/visit a day. Cost of medicines
prescribed during these consultations only is reimbursable.
• The intention is that, first four consultations at the rate of one
consultation should be completed within a period of ten days
from the date of commencement of treatment in r/o one
single and continuous spell of illness in r/o a particular
disease.
• The limit of 10 days treatment may be increased to 20
days in case the treatment is had from an AMA in
Indian System of Medicines and in Homoeopathy. The
total number of consultation during 20 days would be
four.
• It has been provided that ‘medical attendance’
includes attendance at a hospital. Hence medical
attendance from the very beginning may also be
received at the OPD of a Govt. recognized hospital
without the prior approval of the AMA. ‘Prolonged
treatment’ should be received only at the OPD. The
MO at the OPD should be regarded as the AMA.
• All charges for such attendance at the OPD levied
should be reimbursed .
• ‘Medical Attendance’ is distinct from ‘medical
treatment’. For the purpose of ‘medical attendance’
there should be no repeated consultations which
include ‘repeat ‘prescriptions.
• NOTE: Govt. Have held that the fee paid for
consultation on the tenth day of the treatment is
admissible in case no further medication is
necessary i.e. no medicine is prescribed on that
consultation.
Travelling Allowance for Medical Attendance Journeys
• When the place at which a patient falls ill is more than five
miles by the shortest route from the consulting room of the
AMA
• (a) the patient shall be entitled to TA for the journey to and
from such consulting room
• (b) if the patient is too ill to travel, the AMA shall be entitled
to TA for the journey to and from the place where the
patient is.
• Application for T.A. Shall be accompanied by a certificate in
writing by the AMA stating that medical attendance was
necessary and the patient was too ill to travel.
Consultation with Specialist
• If the AMA is of opinion that the case of patient is of such a serious or
special nature as to require medical attendance by some person other
than himself he may-
• (a) send the patient to the nearest specialist or other Medical Officer by
whom in his opinion medical attendance is required for the patient; or
• (b) if the patient is too ill to travel, summon such specialist or other MO to
attend upon the patient.
• A civil Surgeon is not entitled to charge any fees for professional services
rendered to a Govt. servant on the advice of AMA.
• A patient should not be referred to a private specialist or clinic and under
any circumstances to a specialist -Govt. or private- outside the state.
Specialist consultation outside the district:-
• Permission can be given subject to the condition that where the AMA is
not the DMO , the patient should be examined by the DMO before such
permission is accorded.
Medical Treatment
• A Govt. servant shall be entitled free of charge to treatment-
• (a) in such Govt. hospital at or near the place where he falls
ill; or
• (b) if there is no such hospital, to a hospital other than a
Govt. hospital at or near the place as can in the opinion of
AMA provide the necessary and suitable treatment.
• Where a Govt. servant is entitled free of charge to
treatment, any amount paid by him be reimbursed to him by
the central govt.
• Controlling officer has the right to reject any claim if he is not
satisfied with its genuineness . While doing so he shall
communicate to the claimant the reasons in brief for
rejecting the claim and the claimant may submit an appeal
within a period of forty five days.
• Cases of ‘medical treatment’ requiring hospitalization will
normally be referred to a Govt./recognized hospital by the
AMA for admission.
• If hospitalization is not required but treatment is expected
to be prolonged requiring more than four consultations,
patient should be referred to the OPD of Govt./recognized
hospital.
• If in spite of specific advice of the AMA or the MO, a patient
does not seek admission in the hospital, the AMA or MO
concerned should record a note to that effect while signing a
certificate necessary to be produced by the Govt. Servant for
the purpose of claiming refund from Govt. In such case no
refund would be admissible.
• Regarding tests/investigations/Procedures at pvt.
Hospitals empanelled under CGHS/CS(MA) Rules:-
• Beneficiaries availing tests/investigations at
empanelled pvt. Hospitals on the recommendation
of AMA, the medical prescription issued by AMA
shall be treated for a single use within a period of
30 days from the date of prescription. The medical
prescription would require revalidation after expiry
of validity period. Prescription/advice issued by
AMA for any procedure is valid for three months.
In –patient treatment in hospital without consulting AMA
permissible:-
A Govt. servant may be allowed to receive treatment as an
in-patient without consulting his AMA in a hospital where he
is ordinarily entitled to receive treatment under the rules.
Hospitalization not allowed in Nursing Home/Clinics of
AMAs even in emergent cases.
Payment/Reimbursement of medical exp. from two sources
viz. from the Insurance Co. and the CGHS:-
1. Reimbursement allowed from both the sources subject to
the condition that the reimbursement should not exceed the
total exp.
2. First claim from Insurance Co. and second from CGHS as
per approved package rates. Original vouchers will be
submitted to Insurance Co. And photocopies of vouchers
duly certified by Insurance Co. will be submitted to CGHS.
• Entitlement of ward in case of hospitalization:-
• Basic pay Ward Entitlement