Medical attendance rules

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issued to amend the Andhra Pradesh Integrated Medical  Attendance

Rules, 1972. As per this amendment the cost of Artificial  Limbs,

Hearing  Aids, Corrective Glasses, Artificial Teeth  and  Invalid

Chatirs  are  reimbursable  to  the  eligible  patients  who  are

entitled to the facilities for sanction of medical reimbursement.


2.   Government after careful reconsideration of the above  order

issued  in G.O.Ms.No. 175, HM & PW, dated 7-3-1990  hereby  order

the cancellation of G.O.Ms.No. 175, HM&FW, dated 7-3-1990.


3.  All existing claims which have been received pursuant to  the

issue of G.O.Ms.No. 175, HM&FW, dated 7-3-1990 will be settled by

30-6-1993.  These  existing  claims  should  pertain  to   claims

received in pursuance of G.O.Ms. No. 175, HM &FW, dated 7-3-1990,

till the date of the cancellation of the Government Order.


4.   For settlement of the existing claims received  pursuant  to

issue  of  G.O.Ms.No. 175, HM & FW, dated 7-3-1990 the  scale  at

which the settlements have to be made has been considered by  the

Government  and  after taking into  consideration  the  proposals

received from the Director of Medical Education the Govt.  hereby

decide that the maximum expenditure eligible for reimbursement to

the Government Employees and their family members for  settlement

of  the  existing claims preferred by them before issue  of  this

Government Order will be as follows :-


(i)  Corrective Eye Glasses            Rs.200/-(Rupees two

     inclusive of frame                hundred only)


(ii) Hearing Aids-All types            Rs.300/-(Rupees three

                                       hundred only)


(iii) Hearing Aids-All types           Rs.1,500/-(Rupees one

                                       thousand five hundred



(iv) Dentures :


    (a)  Complete Denture              Rs.300/- (Rupees three

         Rehabilitation                hundred only)

         (Upper and Lower Jaw)


    (b)  Single complete denture       Rs.150/- (Rupees one

         prosthesis against natural    hundred and fifty only)

         detention (only upper

         Lower Jaw)


    (c)  Bilateral Partial edentulous  Rs.50/- (Rupees fifty

         condition Glass-I             only)

         (Replacement of single teeth)


    (d)  Crown- acrylic JC/Dowel       Rs.50/- (Rupees fifty

         Dowel Crown                   only)


    (e)  Crown Porcelain.              Rs.150/- (Rupees one

                                       hundred and fifty only)


5.    Necessary  order  amending the  Andhra  Pradesh  Integrated

Medical  Attendance  Rules, 1972 in this regard  will  be  issued



14.  Medical  Attendance  to State Government  employees  at  Sri

Venkateswara  Institute  of  Medical  Sciences,  Tirupathi   with

eligibility for reimbursement / medical advance - Orders - Issued


       (G.O.Ms.No. 544, H.M. & F.W. Dept., Dt. 9-11-1993)


Ref. :- 1.  G.O.Ms.No. 445, H.M. & F.W. Dept., Dt.  19-7-1991.


        2.   G.O.Ms.No. 184, H.M. & F.W. Dept., Dt. 2-4-1992.


        3.   G.O.Ms.No. 86, Fin. & Pig. (FW) Dept., Dt.  1-6-1992.


Order :-The medical attendance to State Government employees  and

their  dependent family members is governed by the provisions  of

Andhra  Pradesh Medical Attendance Rules, 1972. As an  additional

facility  orders were issued in the Government Orders first  read

above  allowing them to obtain treatment at Nizam's Institute  of

Medical  Sciences  directly without reference  in  the  following

medical  situations  with eligibility for  reimbursement  of  the

admissible expenditure therefore or for advance with reference to

the  estimate  furnished  by the  Nizam's  Institute  of  Medical

Sciences subject to the monetary ceiling fixed by the  Government

from time to time.


(a)   Acute Mycardinal Infraction (Cardiology Department)


(b)  Acute Renal Failure (Nephrology Department)


(c)    Severe  cases  of Head and  Spinal  injury  (Neuro-surgery



(d)  Cases of Coma (Neurology Department)


In  all  other cases also the facility of treatment for  them  at

Nizam's"  Institute  of  Medical Sciences  with  eligibility  for

reimbursement  or advance is made available subject to  reference

to  that  Institute by a Specialist Head of the Department  of  a

teaching  hospital  and  subject  to  the  monetary  ceiling   as

mentioned  above. Orders have also been issued in the  Government

Order  third  read  above  delegating  powers  to  the  Heads  of

Departments  for  the sanction of advances  within  the  monetary

ceiling  for  the  treatment  at  Nizam's  Institute  of  Medical

Sciences as indicated above.


2. In quite a number of cases the employees working in the border

districts  of  Nellore,  Chittoor  and  Cuddapah  are   obtaining

treatment in neighbouring States and coming up with requests  for

reimbursement.  Each of these cases are being examined on  merits

and  such  of those cases, where the required  treatment  is  not

available  in State Government Hospitals within the area  of  the

State,  a liberal view is being taken and such claims  are  being

allowed  in relaxation of rules on compassionate grounds in  view

of the distance involved in coming to State capital.


3.   Now  the Super Speciality Hospital, viz.,  Sri  Venkateswara

Institute  of Medical Sciences, Tirupathi,  financed by  Tirumala

Tirupathi Devasthanam, has commenced functioning at Tirupathi  as

a Society with the following specialities :


1.  Cardiology


2.  Cardio Thoracic Surgery


3.  Neurology


4.  Urology


5.  Nephrology


6.  Endocronology


The  President, Andhra Pradesh Non-Gazetted Officers  Association

in  his  representation  fourth  read  above  has  requested  for

according  permission  for treatment at this  institution  as  at

Nizam's Institute of Medical Sciences, Hyderabad.


4.   Government have reviewed the matter including the policy  as

mentioned  in  para  2 above and hereby extend  the  facility  of

treatment  at  Sri Venkateswara Institute  of  Medical  Sciences,

Tirupathi  to all those who are eligible for  Medical  Attendance

under Andhra Pradesh Integrated Madical Attendance Rules, 1972 on

the  same  lines  as  applicable for  the  treatment  at  Nizam's

Institute   of   Medical  Sciences,   Hyderabad   including   the

eligibility  for  advance. Simultaneously, Government  have  also

decided  not  to allow relaxation of  Andhra  Pradesh  Integrated

Medical  Attendance Rules, 1972/Orders in the cases of  the  type

mentioned in para 2 above with immediate effect.


5.   These orders will have prospective effect from the  date  of

issue of this orders.


15.  Medical Attendance facilities of admission and treatment  to

the  Pensioners  and  their  dependants  in  Super   Specialities

Hospitals at Nizam's Institute of Medical Sciences, Hyderabad and

Sri  Venkateswara Institute of Medical Sciences,  Tirupathi  with

eligibility for reimbursement/medical advance - Orders - Issued


        (G.O.Ms.No. 579, H.M. & F.W. Dept, Dt. 1-12-1993)


Ref. :- 1.   G.O.Ms.No. 401, H.M. & F.W. Dept., Dt. 25-6-1991.


        2.  G.O.Ms.No. 445, H.M. & F.W. Dept, Dt. 19-7-1991.


        3.  G.O.Ms.No.  184, H.M. & F.W. Dept, Dt. 2-4-1992.


        4.  G.O.Ms.No. 86, Fin. & Pig. (FW) Dept, Dt.  1-6-1992.


        5.  G.O.Ms.No. 544, H.M. & F.W. Dept, Dt. 9-11-1993.


        6.  From   the  President,   State   Govt.   Pensioners

            Association, Dt. 16-7-93.


Order  :-Orders were issued in the Government order  second  read

above  allowing  the  government employees  and  their  dependant

family  members  to  obtain treatment  at  Nizam's  Institute  of

Medical  Sciences,  Hyderabad directly without reference  in  the

following  medical situations with eligibility for  reimbursement

of  the  admissible  expenditure therefor  or  for  advance  with

reference  to the estimate furnished by the Nizam's Institute  of

Medical  Sciences,  subject  to the  monetary  ceiling  fixed  by

Government from time to time :


(a)  Acute Mycardial Infraction (Cardiology Department)


(b)  Acute Renal Failure (Nephrology Department)


(c)    Severe  cases  of head and  spinal  injury  (Neuro-Surgery



(d)  Cases of Coma (Neurology Department).


In  all  other cases also the facility of treatment for  them  at

Nizam's  Institute  of  Medical Sciences,  with  eligibility  for

reimbursement or advances is made available subject to  reference

of  the  patient to that Institute by a  Specialist/Head  of  the

Department  of  a teaching Hospital and subject to  the  monetary

ceiling  as mentioned above. Orders have also been issued in  the

Government Order fourth read above delegating powers to the Heads

of  Departments for the sanction of advances within the  monetary

ceiling  for  the  treatment  at  Nizam's  Institute  of  Medical

Sciences, Hyderabad as indicated above.


2.   In  the  G.O.  fifth read  above  orders  have  been  issued

extending the facility of treatment at Sri Venkateswara Institute

of Medical Sciences, Tirupathi to all those who are eligible  for

medical  attendance  under  Andhra  Pradesh  Integrated   Medical

Attendance  Rules, 1972 on the same lines as applicable  for  the

treatment  at  Nizam's Institute of Medical  Sciences,  Hyderabad

including the eligibility for advance.


3.   In  respect  of State Government  Pensioners,   orders  were

issued  in  the Government order first read above to  the  effect

that  medical  treatment  be provided  at  Nizam's  Institute  of

Medical  Sciences, Hyderabad to the retired Government  employees

and their dependants on par with serving Government employees who

suffer with serious ailments of the Heart, Kidney, Brain,  Cancer

or  any  other disease or surgery for which  facilities  are  not

available  in any of the teaching hospitals in the State and  for

reimbursement of the cost of the treatment including  consumables

and  disposables  and medicines direct to  Nizam's  Institute  of

Medical Sciences, Hyderabad subject to however to a maximum limit

of  Rs.  40,000/-  (Rs.  Forty thousand  only)  or  as  fixed  by

Government from time to time as in the case of serving Government

employees. It was also ordered therein that the Nizam's Institute

of  Medical  Sciences,  Hyderabad shall take  up  cases  only  on

authorisation  by  Authorised Medical Attendant of  any  teaching

hospitals as in the cases of serving Government employees.


4.   The  President  State  Government  Pensioner's  Association,

Hyderabad in his representation sixth read above, has stated that

the  pensioners  are  facing  difficulties  on  account  of   the

cumbersomeness  of  the  existing procedure  and  they  are  also

experiencing delays in the referral of emergency cases to Nizam's

Institute   of  Medical  Sciences,  Hyderabad  by  the   teaching

Hospitals.  He has therefore requested to issue orders  extending

the  concessions  and facilities provided to  serving  Government

employees in G.O.Ms.No. 445, Health, Medical and Family  Welfare,

Department  dated  19-7-1991  and  G.O.Ms.No.  86,  Finance   and

Planning  (FW)  Department  dated 1-6-1992  to  State  Government

Pensioners.  Further, he has also requested that  the  Pensioners

and their dependants in Rayalaseema Region and Nellore  Districts

may  be  permitted to obtain treatment at  the  Super  Speciality

Hospital, Tirupathi on the analogy of the procedure laid down  in

respect of Nizam' Institute of Medical Sciences, Hyderabad.


5.  After careful examination, the Government here by extend  the

facility  of treatment at Nizam's Institute of Medical  Sciences,

Hyderabad  and  Sri Venkateswara Institute  of  Medial  Sciences,

Tirupathi to the State Government Pensioners and their  dependent

Family member on the lines similar to those provided for  serving

Government  employees  and  their  dependant  family  members  as

detailed  in  paras  first and second read  above  including  the

facility  of  advance  to the extent of  ceiling  amount  of  Rs.

50,000/ - as per G.O. fourth read above.


16.   Sanction  of  Medical Advance  to  Government  employees  -

Reimbursement  for  treatment, etc., for second time -  Orders  -



       (G.O.Ms.No. 223, H.M. & F.W. Dept., Dt. 23-4-1994)


Ref.  :- 1.  G.O.Ms.No.  170, M&H, Dt.  14-3-1985.


         2.  G.O.Ms.No. 281, H.M. & F.W. Dept., Dt.  1-5-1989.


         3.  G.O.Ms.No.  184, H.M. & F.W. Dept., Dt. 2-4-1992.


Order  :-Orders  were issued in the Government  orders  2nd  read

above  fixing ceiling of reimbursement amount for  the  treatment

obtained  inside or outside India as Rs.  40,000/-.  Subsequently

orders  were  issued  in  the Government  order  3rd  read  above

increasing  the ceiling of reimbursable amount from Rs.  40,0007-

to 50,000/-.


2.   The issue as to how the ceiling is applicable to  Government

officials  was examined earlier and it was decided that  it  will

apply  to  the  entire  treatment of  an  ailment  including  the

expenditure towards tests and examination, operations if any  and

for post operative treatment whatever may be the duration of  the

treatment.  Subsequently  this  decision  was  again  revised  in

consultation with Finance and Planning (FW) Department  regarding

the  applicability  of ceiling for each spent  in  treatment  and

whether the employees can be allowed reimbursement or advance, as

the  case  may  be,  according,  to  rules  for  the  second  and

subsequent operations even including the operations for the  same



3.   The Government, therefore hereby order that  the  Government

officials  shall be allowed reimbursement or advance as the  case

may  be  according  to  rules  for  the  second  and   subsequent

operations even including the operations for the same ailments.


17.  Medical treatment of Govt. employees/retired  employees  and

their  dependents - Reimbursement of expenditure -  Treatment  in

private hospitals within the State and outside the State - Orders

- Issued


     (G.O.Ms.No. 38, H.M. & F.W. (Kl) Dept., Dt. 23-1-1996)


Ref.  :- 1.   G.O.Ms.No. 609, HM & FW, Dt. 21-11-1988.


         2.  G.O.Ms.No. 445, HM & FW, Dt. 19-7-1991.


         3.  G.O.Ms.No.  184, HM & FW, Dt. 2-4-1993.


         4.  G.O.Ms.No. 544, HM & FW, Dt. 9-11-19893.


         5.  G.O.Ms-No. 579, HM & FW, Dt.  1-12-1993.


         6.  From the D.M.E. Lr.Rc.No. 20739/MA.A/94,  Dt.  9-2-



Order :-The Pay Revision Commission has made certain observations

in  regard to the medical facilities to the Government  employees

and retired employees and their dependents in teaching  hospitals

and  also private hospitals within the State as well  as  outside

the State.


2.   The Government have constituted a Committee to go  into  the

recommendations  of  the  Pay  Revision  Commission  and   submit

suggestions/recommendations.  The  said committee  suggested  the

following recommendations :


(i)  that the existing system of reference of teaching  hospitals

shall be continued.


(ii)  that they have reiterated the recommendations made in  1986

to  extend the facility of wellknown hospitals outside the  State



(iii)  the maximum ceiling of Rs. 50,000/- may be  continued  and

the same could be reviewed periodically. In respect of  treatment

in  hospitals  outside  the  State with  the  permission  of  the

Government  the  bills  may be settled  subject  to  scrutiny  by

director  of  Medical  Education regarding  entitlements  of  the

officials who undergo treatment in such hospitals.


(iv)  Even  in  respect of twin cities  also,  where  specialised

treatment  is  available only in private hospitals which  is  not

available in Government hospitals, the employees may be given the

benefit  of  treatment  in  such  hospitals  subject  to  payment

according  to the entitlements and within the ceiling subject  to

scrutiny of bills by the Director of Medical Education.


(v)  In  respect  of suggestions at items  (ii)  to  (iv)  above,

reference      from     Superintendent     of     a      teaching

hospital/Superintendent   of  District  Headquarters   hospitals,

except  in respect of cases like "Acute Mycordial Infraction"  as

may be specified, shall be necessary.


3.   The above recommendations have been sent to the Director  of

Medical  Education for his remarks and to suggest  the  hospitals

which  could be recognised for purposes  of  reimbursement.   The

Director of Medical Education considering  the recommendations of

the  High Power Committee has submitted proposals to  Government.

After  careful  consideration  of  the  recommendations  of   the

Director  of  Medical  Education, Government  hereby  permit  the

employees  both  serving and retired to secure treatment  in  the

private hospitals both within and outside the State.


4.   Under Rule 7 of the AP.I.M.A. Rules 1972  Government  hereby

recognised the following Private Hospitals within and outside the

State   for  treatment  to  the  Government  employees,   retired

employees and their dependents.


I.  Private Hospitals within the State :


1.  Appollo Hospital, Hyderabad.


2.  Medwin Hospital, Hyderabad


3.  C.D.R. Hospital, Hyderabad.


4.  Mediciti Centre, Hyderabad.


5.  Satya Kidney Centre, Hyderabad.


6.  Seven Hills Hospitals, Visakhapatnam.


7.   Kamineni Hospitals Limited, L.B. Nagar, Hyderabad.


8.   Sree   Padmvathi  Orthopaedic  &  Surgical   Nursing   Home,

     Himayatnagar, Hyderabad-29.


9.   Durga Bai Deshmukh Hospital and Research Centre, Hyderabad.


10.  Bibi General Hospital and Cancer Centre


11.  Citi Cardiac Research Centre, Vijayawada.


12.  Owaisi Hospital, Hyderabad.


13.  L.V. Prasad Eye Institute, Hyderabad.


14.  Mahavir Hospital, Hyderabad.


15.  Yashoda Super Speciality Hospital, Malakpet, Hyderabad


16.  Usha Cardiac Centre, Hyderabad.


17.  Care Hospital, Hyderabad.]


18.  Swatantra Hospitals, Rajahmundry.


19.  Indo-American  Cancer  Institute  and   Research   Centre,

    Hyderabad.     [G.O. Ms. No. 133, HM & FW, Dt. 9-4-2001]


20.  Aware Hospital, Hyderabad.


                    [G.O.Ms.No. 328, HM & FW, Dt. 23-08-2001]


21.  Mytri Multi Speciality Hospitals, Hyderabad.


                    [G.O.Ms.No. 329, HM & FW, Dt. 23-08-2001]


22.  Image Hospitals, Hyderabad.


                    [G.O.Ms.No. 462, HM & FW, Dt.  11-12-2001]


23.   Pratima Institute of Medical Sciences, Nagunur, Karimnagar.


                     [G.O.Ms.No. 36, HM & FW, Dt. 13-02-2002]


Private Hospitals Out-side State :


1.  Apollo Hospitals, Madras.


2.  Sankar Netralaya, Madras.


3.  Adayar Cancer Centre, Madras.


4.  Vijaya Hospital, Vijaya Heart Foundation, Chennai.


5.  C.M.C., Vellore.


6.  N.I.M.H.A.N.R., Bangalore.


7.  Kidwai Memoral Cancer Hospital, Bangalore.


8.  Tata Memorial Cancer Hospital, Bangalore.


5.  The above Private Hospitals both within the State and outside

the State shall be regarded as referral hospitals subject to  the

following conditions :


(a)   The above private hospitals will be referral hospitals  for

all  types of cases including Acute Mycordial Infracture ;  Acute

Coronary  Disease, Acute Renal Failure; Severe cases of Head  and

Spinal Injury and cases of Coma.


(b)   Referral of patients to the above private hospitals  should

be  from  the  Director, Nizam  Institute  of  Medical  Sciences,

Hyderabad/Sri   Venkateswara  Institute  of   Medical   Sciences,

Tirupathi in respect of above cases, only on a Certificate  given

by   the  Director,  Nizam's  Institute  of   Medical   Sciences,

Hyderabad/Director,   Sri  Venkateswara  Institute   of   Medical

Sciences,  Tirupathi  stating that Nizam's Institute  of  Medical

Sciences/ Sri Venkateswara Institute of Medical Science will  not

be able to cope with the work load in the interest of the  health

of  the  patient  such  a  reference  to  Private  Hospitals   is



(c)   The  referring  hospitals  should  ensure  that  facilities

available  in  those hospitals are fully utilised  in  the  first



6.   The  ceiling of Rs. 50,0007- (Rupees  Fifty  thousand  only)

fixed  by  the Govt. vide G.O.Ms.No. 184,  Health,   Medical  and

Family Welfare,  dated 2-4-1992  for reimbursement to  Government

employees including pensioners will be continued.


7.   In respect of treatment in the above Private Hospitals  with

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