HEALTH CARD LATEST GOS 2

GOVERNMENT OF ANDHRA PRADESH
ABSTRACT
Health, Medical and Family Welfare – Employees Health Scheme – Notification and
adoption of ‘Final Therapy Prices’ - Orders – Issued.
HEALTH, MEDICAL AND FAMILY WELFARE (M2) DEPARTMENT
G.O.Ms.No. 176 Dated: 01-11-2013.
Read the following:
1. G.O.Ms.No.227 HM&FW (K2) Dept dated 09-06-2006.
2. G.O.Ms.No.184 HM&FW(M2) Dept dated 14-08-2012.
3. Govt Memo. No. 21233 /M2/2012-3 HM&FW (M2) Dept dated
06/02/2013.
4. Representation dated 30-03-2013 received from AP Speciality Hospitals
Association (ASHA).
5. Representation dated:03-04-2013 received from AP Private Hospitals &
Nursing Homes Association (APNA).
6. From the Chief Executive Officer, Aarogyasri Healthcare Trust,
Hyderabad letter No.2349 /P&C/F.49/2013 dated 26-04-2013.
7. Govt Letter No.21233/M2/2012-4 HM&FW(M2) Dept dt.29-04-2013.
8. From the Chief Executive Officer, Aarogyasri Healthcare Trust,
Hyderabad letter No.AST/2349 /P&C/F.49/2013 dated 29-04-2013.
9. G.O.Ms.No.87 HM&FW (M2) Dept dated 27-06-2013.
10. From the Chief Executive Officer,Aarogyasri Healthcare Trust
Letter No.AST/ 4768 /P&C/F.49/ 2013, dated: 06-09-2013.
11. Government Memo.No.16977/M2/2010, Dated: 30/10/2013.
12. From the Chief Executive Officer, Aarogyasri Healthcare Trust, Letter
No.AST/ 4768 /P&C/F.49/ 2013, dated: 30-10-2013.
13. G.O.Ms.No.174, HM&FW (M2) Dept. Dated: 01/11/2013.
14. G.O.Ms.No.175, HM&FW (M2) Dept. Dated:01/11/2013.
-:oOo:-
ORDER:
Rajiv Aarogyasri Scheme (RAS) is being implemented by Government from
01.04.2007 to financially assist 233 lakh poor families to avail medical treatment for
identified diseases covering 938 In-patient (IP) therapies and 125 follow-up therapies
vide G.O. first read above. Government have also decided to implement a similar
cashless scheme (Employees Health Scheme) for Government pensioners and
employees with coverage envisaged in APIMA rules, 1972 vide G.O. 2nd read above.
Aarogyasri Healthcare Trust, after deliberations and in consultation with specialists, has
identified additional IP therapies for inclusion in employees health scheme, in addition
to Aarogyasri packages.
2. AP Speciality Hospitals Association (ASHA) and A P Private Hospitals & Nursing
Homes Association (APNA) representing the private hospitals empanelled under Rajiv
Aarogyasri Scheme, submitted representations to Government, seeking revision of the
package rates for Rajiv Aarogyasri Scheme and also clarifications on certain other
issues. In Memo. No. 21233 /M2/2012-3 HM&FW (M2) Dept dated 06-02-2013,
Government have constituted a committee headed by Principal Finance Secretary and
consisting of Principal Secretary to Government, Health Medical & Family Welfare
Department, Commissioner, A.P.
Contd. P.2.,
-2-
Vaidhya Vidhana Parishad, Director of Medical Education, as members, Chief Executive
Officer, Aarogyasri Health Care Trust as member-convenor, and two representatives
each from ASHA and APNA as members for examining the grievances of ASHA and
APNA. The Committee, after detailed discussions and deliberations submitted its
recommendations to the Government.
3. Government issued orders in the G.O. 9th read above, by notifying the ‘Input
Code Book’, ‘Standard Schedule of Rates for 2012-13’, and the ‘Final Therapy Prices ’,
for being adopted by the Aarogyasri Health Care Trust for determining the package
rates for treatment of patients in empanelled hospitals, for Rajiv Aarogyasri Scheme.
4. In the letter 10th read above, the Chief Executive Officer, Aarogyasri Healthcare
Trust has submitted the ‘Final Therapy prices for Employees Health Scheme’ which
include additional therapies in addition to the existing Aarogyasri therapies, prepared
basing on the ‘Input Code Book’ and ‘Standard Scheduled of Rates (SSR 2012-13)’
already notified in the G.O. 9th read above. These final therapy prices are inclusive of
OP evaluation.
5. In the G.O., 9th read above, Standard Schedule of Rates for 2012-13 are
approved according to which Rs.900/- per day is the rate prescribed for General Ward.
Government have decided to consider Rs.1200/- per day for stay in semi-private ward
and Rs.1500/- per day for private ward in the non-NABH accredited hospitals. In so far
as the NABH accredited hospitals are concerned, the rates would be Rs.1500/- per day
for semiprivate ward and Rs.2000/- per day for private ward. This would be an
incentive to the NABH accredited hospitals for promoting quality of health care. The
APIMA Rules adopt CGHS norms and the CGHS prescribes incentives to the NABH
accredited hospitals for promoting quality of health care. Hence, NABH hospitals are
considered for higher tariff so far as hospital stay is concerned. Moreover, the scheme
will be reviewed after obtaining the actual data for six months, the rationalization of the
above prices for semi-private ward and private wards would also be considered in the
review. The Chief Executive Officer, Aarogyasri Health Care Trust will carefully monitor
the implementation of the Scheme and after obtaining the actual data for six months,
will place the same before the Steering Committee for considering rationalization of the
above prices for semi-private ward and private wards.
6. Government after careful examination hereby issue the following orders:-
a. List of therapies and the package prices are placed in the Annexure.
These shall be adopted by Aarogyasri Health Care Trust for treatment of
patients in empanelled hospitals, under the Employees Health Scheme.
b. The Chief Executive Officer, Aarogyasri Healthcare Trust is authorized to
include any additional inputs, which may be required during the course of
implementation of the scheme, code them, finalise the prices and append
the same in the Medical Input Code Book and Standard Schedule of Rates
(SSR) subsequently.
c. The following standard schedule of Rates are hereby approved
i. Stay in Semiprivate ward Rs.1,200/- per day in non-NABH
accredited hospitals and Rs.1,500/- per day in NABH accredited
hospitals.
Contd. P.3.,
-3-
ii. Stay in Private ward Rs.1,500/- per day in non-NABH accredited
hospitals and Rs.2,000/- per day in NABH accredited hospitals.
7. The Chief Executive Officer, Aarogyasri Health Care Trust, Hyderabad shall take
further necessary action, accordingly in the matter.
8. This order issues with the concurrence of Finance (Expr.M&H.1) Department
vide their U.O.No.360/A1/Expr.M&H.I/2013, Dated: 26/10/2013.
(BY ORDER AND IN THE NAME OF THE GOVERNOR OF ANDHRA PRADESH)
Dr. P.K. MOHANTY
CHIEF SECRETARY TO GOVERNMENT
To
The Chief Executive Officer, Aarogyasri Health Care Trust, Hyderabad.
The Commissioner of Printing, Stationary & Stores (Printing Wing), A.P, Hyderabad
(with a request to furnish 500 copies of the G.O. to Government .
Copy to:
The Commissioner of Family Welfare, AP., Hyderabad.
The Director of Medical Education, AP., Hyderabad.
The Director of Public Health & Family Welfare, AP., Hyderabad.
The Commissioner, AP Vaidya Vidhana Parishad, Hyderabad.
The Managing Director, AP Medical Services and Infrastructure development
Corporation, Hyderabad.
The Accountant General (A&E), AP., Hyderabad.
Finance (Expr.M&H-1) Dept.
S.F. / S.Cs.
// FORWARDED :: BY ORDER //
SECTION OFFICER