prior permission, the bills may be settled subject to scrutiny by
Director of Medical Educational about the entitlement.
18. Medical Treatment of Government/Retired Employees and their
dependants -Re-imbursement of Expenditure - Treatment in Private
recognised Hospitals within and outside the State - Admissibility
of Medical Expenditure, with 20% Cut on eligible amount without
referral from Nizam's Institute of Medical Sciences,
Hyderabad/Sri Venkateshwara Institute of Medical Sciences,
Tirupathi in cases of emergencies - Orders - Issued
(G.O.Ms.No. 175, H.M. & F.W. (Kl) Dept., Dt. 28-5-1997)
Ref. :- 1. G.O.Ms.No. 38, HM & FW, Dt. 23-1-1996.
2. G.O.Ms.No. 258, HM & FW, Dt. 15-6-1996.
3. From the President, APNGO's Association,
Representation dated 22-3-1996 and representation
from certain service Associations.
4. From Dir. of Medical Edn., Lr. No. (RC) 3773/MA.A/96,
Order :-In the Government orders 1st and 2nd read above orders
were issued permitting the State Government Employees, both
serving and retired to secure treatment in Private Hospitals
within and outside the State indicating therein that under Rule 7
of the Andhra Pradesh Integrated Medical Attendance Rules, 1972,
on a reference made by Nizam's Institute of Medical Sciences/Sri
Venkateshwara Institute of Medical Sciences.
2. In the reference 3rd read above the Andhra Pradesh Non-
Gazetted Officer Association and some other Service Associations
represented that the orders issued in the Government Orders 1st
and 2nd read above are not beneficial to the employees because of
the condition that the employee has to obtain a referral
certificate from Nizam's Institute of Medical Sciences, Tirupathi
to get treatment in Super Speciality Hospitals within or outside
the State and requested that this stipulation be omitted.
3. It has been observed that a number of cases are being
referred to Government for relaxation of the Andhra Pradesh
Integrated Medical Attendance Rules, 1972 when the treatment has
been obtained directly at the Private Hospitals without referral
from Nizam's Institute of Medical Sciences, Hyderabad/Sri
Venkateshwara Institute of Medical Sciences, Tirupathi in view of
the serious nature of the patient and lack of sufficient time to
obtain such referral letter from the hospitals stated above.
4. After careful consideration of this issue in consultation
with the Director of Medical Education, the Government have
decided to permit employees both serving and retired and also to
their dependants, to secure treatment in the Private Hospitals
recognised in the Government Orders 1 st and 2nd read above, when
the case is serious which required immediate treatment and there
is no sufficient time to get referral letter from Nizam's
Institute of Medical Sciences, Hyderabad/Sri Venkateswara
Institute of Medical Sciences, Tirupathi. All the competent
authorities are therefore permitted to sanction reimbursement of
Medical expenses for the treatment in Private Hospitals
recognised in the Government Orders 1st and 2nd read above after
satisfying themselves that the patient was admitted in the
hospital in a very serious condition and it was an emergency
case and there was no sufficient time to obtain referral letter
from Nizam's Institute of Medical Sciences, Hyderabad/Sri
Venkateswara Institute of Medical Sciences, Tirupathi, if
necessary after obtaining a certificate from the hospital to that
effect and after obtaining copy of the case sheet. In all such
cases of the treatment without referral letter, a 20% cut has to
be imposed on the eligible amount after getting the bills
scrutinised by the Director of Medical Education, Hyderabad.
5. All the Departments of Secretariat and all Heads of
Departments are also informed that such cases covered under para
4 above need not be referred for relaxation and the authority
competent to sanction the medical reimbursement can sanction such
reimbursement in the above cases also. In all other cases where
the competent authority though not satisfied with the alleged
seriousness of the condition of the patient, but when the patient
has obtained treatment at a private hospital directly on his own
choice shall be referred to Government for relaxation when the
Heads of Departments consider that there is genuine cause for
anxiety and recommend for relaxation.
6. All Departments of the Secretariat and all Heads of
Departments are informed that the rejected cases shall not be
reopened and the cases pending as on the date of this order with
the concerned competent authorities may be disposed of as per
19. Medical Attendance to Government Employees/Retired Employees
-Reimbursement of treatment etc. incurred - Raising of maximum
ceiling from Rs. 50,000 to Rs. 75,000/- - Orders - Issued.
(G.O. Ms. No. 161, H. M & F.W (Kl) Dept, dated 05-05-2000)
Ref. :- 1. G.O. Ms. No. 170, M & H, Dept., dated 14-03-1985.
2. G.O. Ms. No. 281, H. M & F.W, Dept, dated 01-05-1989.
3. G.O. Ms. No. 184, H. M & F.W (Kl), Dept, dated 02-
Order :-Orders were issued in the Government Order third read
above, fixing the maximum limit at Rs. 50,0007- (Rupees fifty
thousands only) to Government employees towards reimbursement of
expenses incurred by them on medical treatment, subject to the
conditions specified therein.
2. The President, A.P. Retired Government Employees Association
and Andhra Pradesh Non-Gazetted Officers Association in their
representations fourth and fifth read above, have requested the
Government to enhance the ceiling from Rs. 50,0007- to Rs.
1,50,000/- since the cost of treatment is invariably exceeding
3. The Pay Revision Commission, 1999 has recommended to enhance
the ceiling limit from Rs. 50,000/- to Rs. 75,000/- for
reimbursement of the medical expenses to State Government
4. Government after careful examination of the matter, have
decided that the maximum ceiling of Rs. 50,0007- reimbursable to
Government employees/ Retired employes and their dependents,
towards reimbursement of medical expenditure shall be raised from
Rs. 50,0007- to Rs. 75,0007- (Rupees seventy five thousand only)
subject to the conditions existing now. Any expenditure in excess
of the enhanced ceiling limit of Rs. 75,0007- shall however be
borne by the Government employees/Retired Employees and their
dependents themselves. However, the procedure of requirement of
referral letter by NIMS or SVIMS to obtain treatment in
recognised private hospitals shall be continued.
20. Certain guidelines for referral of Insured Persons and their
beneficiaries and reimbursement of medical bills - Orders -
(G.O. Ms. No. 117, HM & FW(Q2) Department, dated 27-03-2000)
Note :-This Order is printed at page 237 of this book.
21. Reimbursement of expenditure for the treatment at private
recognised hospitals within and outside the State and at
Government Hospitals - Imposing of 20% cut on the admissible
amount - Scrutiny of bills by Director of Medical Education and
by the Superintendents of Government Hospitals - Orders - Issued.
(G.O. Ms. No. 373, H. M. & F. W. (Kl) Dept., dated 20-10-2000)
Note :-This Order is printed at page 239 of this book.
22. Recognition of A.P. Super Speciality Dental Hospitals as
Referral Hospitals for the treatment of Government employees,
retired employees and their dependents - Reimbursement of
expenditure - Orders - Issued.
(G.O. Ms. No. 38, H. M. & F. W. (Kl) Dept., dated 24-01-2001)
Note :-This Order is printed at page 240 of this book.
23. Nizam's Institute of Medical Sciences - Medical treatment of
State Government Employees, Retired Employees and their
Dependents - Reimbursement of Expenditure for all diseases
without referral letter, etc. - Orders - Issued.
(G.O. Ms. No. 134, HM. & F.W. (Kl) Dept, dated 09-04-2001)
Note :-This Order is printed at page 241 of this book.