reimbursed from the State funds under the Medical Attendance
(4) The advances shall be treated like advances of travelling
allowance and pa on transfer and recovery must be effected by
adjustment of claim for reimbursement c medical expenses.
(G.O.Ms.No. 1274, M&H, Dt. 29-2-197)
(5) The Head of the Office competent to draw pay bills of his
office, ma sanction, draw and disburse the advances to all the
Non-Gazetted employees workin under him; where the Head of an
Office drawing pay bills happens to be Non-Gazette Employee, the
advance has to be sanctioned to him by the Officer immediately
superii to him but he may himself draw the advance.
(6) The amount of the advance shall be limited to the amount
required to me actual reimbursable medical expenses certified by
the Authorised Medical attendant of tl employee or the nearest
Civil Assistant Surgeon subject to a maximum of Rs. 50/- at time.
If the sanctioning authority is satisfied that the case is
emergent, he may sanction an advance upto a maximum limit of Rs.
507- without insisting upon completion of necessary formalities.
(G.O.Ms.No. 317, M&H, Dt. 14-4-197)
(7) When an advance is sanctioned to a non-permanent Government
Employee has to be drawn and disbursed to him only after a bond
in Form II of the Andhra Prade Financial Code, Volume I is
executed by him together with the surety of a permane Government
Servant drawing a pay not less than the borrower.
(8) (a) The advance should be adjusted in full within a period
of three mont from the date of drawal of the advance by
presenting the claim in the form prescrib under the Medical
Attendance Rules irrespective of the fact that the treatment last
for me than three months. The claim should be furnished to the
Director of Medical and Hea Services or the Special Officer,
Indian Medicine, as the case may be, through t Authorised Medical
Attendant and the Medical Officer who gave the treatment. After t
claim is received back from the Director of Medical and Health
Services/Special Offu Indian Medicine, it should be presented to
the Treasury or the Accountant-General, Andl Pradesh, as the case
may be by the Heads of Offices for adjustment against advance
(b) A second advance of this kind should not be granted until the
first c has been fully adjusted. The Bill for the 2nd advance
should be accompanied by the certificate from the sanctioning
authority that the previous advance has been adjusted full.
If the advance is not adjusted or returned within a period of
three months it shoi summarily be recovered from his salary.
(9) When any portion of the claim for reimbursement of medical
expense is any reason disallowed, such amount should be recovered
from the salary of the individ in four instalments starting with
the pay drawn immediately after the claim has been disallowed.
(10) In every office the drawal of these advances should be
recovered in register of temporary advances and their recovery by
adjustment or refund should watched. When a borrower is
transferred to a new office the details of the advance shoi be
closed. In the new office which the borrower joins, the
particulars of the advance shoi be entered in the Register and
the recovery watched.
(11) Ordinarily not more than one advance shall be granted in
respect of the sa illness or injury, but when the amount of the
first advance has already been spent, a second advance can be
sanctioned when the sanctioning authority is satisfied that the
previous advance has already been spent and the Medical Officer
concerned has certified the necessity of further expenditure. The
total amount of both the advances shall not exceed Rs. 30 or four
month's pay which ever is less. There is no objection to the
borrower if a claim for the adjustment of the first advance even
before the treatment is over and later on presenting a second
claim regarding the further expenses to be adjusted the second
(12) The term "Pay" for this purpose shall mean the pay actually
drawn, including personnel pay, as on the date of application but
shall exclude special pay.
II. The advance granted under these rules should be accounted for
under new subhead, "Advance for Medical Attendance and Treatment"
to be opened under the head "T.III. Deposits Advances I. Civil
Certificate to be furnished by the Medical Officer under Rule 6
Certified that Sri/Smt.................. a member of the family
of Sri/Smt............working as...................in the office
of..............at............is suffering from.............and
that a sum of Rs.............(Rupees................) only is
necessary as advance to cover the medical expenses reimbursement
by Government in this case.
Date : Signature :
Station : Designation :
Certificate by Medical Officer under Rule 11
Certified that Sri/Smt.............a member of the family of
Sri/Smt.................working as.....................in the
Office of the.................. at...............(Place) is still
suffering from...........................and that a further sum
of Rs...........(Rupees.........) only is necessary as advance to
cover the reimbursable medical expenses in this case as from this
Date : Signature :
Station : Designation :
Note :-Strike off the unnecessary portion when the certificate
relates to the Government Employee himself.
Rules relating to Medical Attendance of Central Government
Employees and their Families, Military Personnel, Merchant Navy
and Special Police Establishments.
Note :-Not Printed.
Facilities of admission and treatment to pensioners at Government
hospitals Consolidated orders - Modifications
[G.O.Ms.No. 718, M. & H. (Kl), Dt. 26-11-1981]
Note :-For the text of the G.O. see Instruction No. 2 of next
2. Medical Advance - Treating like T.A. Advance
[U.O. Note No. 5463A/167/A & L/82-1, Fin. & Pig. (Fin. Wing.
Accts. & Loans), Dt. 30-3-1982]
Ref :_ i. From the Acctt.-Genel., A.P., I, Hyd., Lr.No.
TM/I/II/12-53/76-79/4, Dt. 27-4-1979.
2. G.O.Ms.No. 426, M. & H. (KI), Dt. 28-7-1981.
Order :-In the reference first cited, the Accountant-General,
Andhra Pradesh, I Hyderabad has suggested amendments to the
Andhra Pradesh Integrated Medical Attendance Rules, 1972 and has
requested the Government to issue specific instructions to all
the drawing and disbursing officers/all the Treasury Officers and
the Pay and Accounts Officers to treat Medical Advance like
advance of T.A. and Pay on transfer.
2. The matter has been considered carefully, keeping in the
changed conditions the Drawing and Disbursing Officers, and the
Treasury Officers and the Pay and Accounts Officers are hereby
directed to treat the advance for Medical treatment as an advance
of T.A. and Pay on transfer and efforts shall be made that such
an advance for Medical treatment is adjusted within the time
stipulated, avoid probable objections at a later date.
3. Advances for Medical Treatment
[Memo. No. 39027/724/BG/82, F.& P. (Fin. Wing-B.G.), Dt. 21-9-
Ref. :-G.O.Ms.No. 1274, M. & H., Dt, 29-12-1978.
Order :-Under the revised accounting classification which has
come into force with effect from 1-4-1974, the expenditure on
Medical advances was being classified under "766. Loans to
Government Servants-MH. 25 Other Advances, SH (03) Advances for
Medical attendance and treatment. But in consultation with the
Accountant-General, Andhra Pradesh, Hyderabad certain amendments
were issued to the A.P. Integrated Medical Attendance Rules,
1972, through the reference cited. Among other things it was also
ordered therein that the Medical advances shall be treated like
advances of Travelling Allowance and pay on transfer and the
recovery must be affected by adjustment from the claim for
reimbursement of medical expenses. Even though orders have been
issued to the above effect, it has been brought to the notice of
the Government that the Medical advances are still being
accounted for under "Loans and Advances".
2. The Director of Treasuries and Accounts is therefore requested
to issue suitable instructions to all District Treasury Officers
to adopt the revised classification debiting the expenditure on
Medical advances to the Service head of account instead of Loans
and Advances head of account.
4. Reimbursement of Medical expenditure - Instructions
[U.O. Note No. 3142/K1/85-1, M. & H, Dt. 17-4-1986]
Order :-According to Rule 5(3) (ii) of the Integrated Medical
Attendance Rules, all claims for refund of expenses incurred on
account of the purchase of the special medicines should be
preferred in the manner indicated in Appendix-Ill. According to
2 (ii) of the said Appendix, the reimbursement bills arising in
the Hyderabad City will be scrutinised and passed for payment by
the Superintendents of the concerned Hospitals. According to Para
4 of the said Appendix, claims for reimbursement should be
accompanied by an Essentiality Certificate from the Authorised
Medical Attendant or from the Medical Officer in-charge of the
case in the hospital.
2. With reference to the provisions referred to in Para 1 above,
employees, of various departments of Secretariat are claiming
reimbursement of expenditure incurred by them on medicines for
treatment of self and family members on the basis of essentiality
certificate and certificate of non-availability of the drugs
given by the Authorised Medical Attendant of the concerned
Hospital and sometimes certificate of non-availability of these
drugs in the Secretariat dispensary, issued by the Medical
Officer of Secretariat Dispensary. The Departments of Secretariat
are referring such claims for reimbursement of expenditure to the
Medical and Health Department for concurrence.
Reference of such cases to this department has been on the
increase resulting in avoidable work load in this department and
delay in reimbursing the claims. The Secretariat departments are
therefore informed that the proposals for sanction of
reimbursement of expenditure incurred by Government Servants
which are in accordance with the provisions of rules referred to
in Para 1 above, Viz., the calims for reimbursement of
expenditure for treatment in Government Hospitals within the
State which are accompanied by an Essentiality Certificate and
certificate of non-availability of medicines from the Authorised
Medical Attendant and when they are satisfied that the claim is
in accordance with the provisions in Appendix-III to Andhra
Pradesh Integrated Medical Attendance Rules, 1972, need not be
referred to Medical and Health Department for remarks/acceptance.
This applies to the cases referred by Heads of Departments to the
Administrative Departments of Secretariat also.
3. However as provided in the note under Para 2 (ii) of the
Appendix - III to the Integrated Medical Attendance Rules, 1972,
all cases requiring Special sanction or relaxation ;
clarification or interpretation of the State Medical Attendance
Rules should be referred to this department invariably.
5. Treatment underwent in the Appollo Hospital, Madras, etc.,
for by-pass surgery, etc., - Certain instructions issued
(G.O.Ms.No. 69/K1/89-1,, H.M. & F.W. Dept., Dt. 14-3-1989)
Ref. :- 1. G.O.Ms.No. 317, M&H (Kl), Dt. 7-5-1986.
2. G.O.Ms.No. 72, I&CAD (Irrigation Ser. II) Dept., Dt. 4-2-1988.
Order :-Certain instructions were issued in the Government Order
1st cited in respect of availment of medical treatment for Kidney
transplantation and Coronory Bypass Surgery in private hospitals
in the State by the Government employees. Government servants and
others entitled for treatment under the Medical Attendance Rules,
1972 were permitted to undergo Kidney transplantation operation
in the Mahavir Hospital, Hyderabad and Coronory Bypass Surgery in
the Durga Bai Desmukh Hospital, Andhra Mahila Sabha, Hyderabad,
on the letter of advice given by the Authorised Medical Attendant
in the Osmania General Hospital/Nizams's Institute of Medical
Sciences, Hyderabad respectively where the above operations are
done. A condition was also stipulated in the G.O. first cited to
the effect that those who obtain prior permission of the Director
of Medical Education, Kidney Transplantation and Coronory Bypass
Surgery will be eligible for reimbursement of all admissible
expenditure including charges for accommodation and also for an
advance as per the estimate given by the concerned hospital
undertaking the operation.
2. Though the above facilities were extended to the Government
employees for treatment, some of the Heads of Departments are
sending proposals to Government recommending for sanction of the
claims of the Government employees for reimbursement of the
expenditure incurred by them for their treatment for Coronory
Bypass Surgery and Kidney transplantation, etc., in private
hospitals, like Appollo, etc., outside the State in deviation of
the instructions issued in the Government Order 1st cited and
though relevant instructions were issued from time to time.
3. The Government after careful consideration have decided not
to reimburse the claims of the Government employees who undergo
treatment in Appollo Hospital, Madras or any other institutions
outside the State or in Hyderabad hereafter, which are not in
accordance with the instructions issued in the Government Order
1st cited unless specific prior permission is obtained from the
6. Medical treatment to Government Employees - Reimbursement of
Medical expenditure incurred - Fixing the maximum ceiling to *Rs.
[G.O.Ms.No. 281, H.M. & F.W. (K), Dt. 1-5-1989]
Note :-These orders as amended subsequently are applicable to the
non-teaching staff of all Universities in the State -Vide of
G.O.Ms.No. 542, Edn., Dt. 20-11-1998.
Ref. :- \. G.O.Ms.No. 170, M&H(K1), Dt. 14-3-1985.
Order :-In the G.O. first read above, orders were issued fixing
the maximum limit of */**Rs. 40,0007- to Government Employees
towards reimbursement of expenses incurred by them on medical
treatment, subject to the condition specified therein.
However, several instances have come to the notice of the
Government to the effect that Government Employees are claiming
huge amounts towards medical treatment beyond the permissible
ceiling limit of Rs. 40,0007- fixed by the Government.
Since the Government is providing free treatment to persons
belonging to Weaker Sections of the society who are green-card-
holders, the Government after careful examination have decided
and direct that the maximum ceiling limit of */**Rs. 40,0007-
(Rupees forty thousand only) be fixed for the State Goveniment
employees towards their medical reimbursement, whether they
obtain treatment in the State Government Hospitals, or in other
States in India, or outside India, includes Air Passage of
patient and expenditure incurred towards Personal Attendant. If
the treatment is required abroad, or outside the State, the
Authorised Medical Attendant should certify to the effect that
there is need for obtaining the treatment of the patient, i.e.,
outside the State, or outside India and prior approval of the
Director of Medical Education/Government in Health Medical and
Family Welfare Department should also be obtained by the person
who wants to obtain treatment outside the State, and outside the
Country. A certificate from the Director, Medical Education is
also to be obtained by the Department concerned who process the
claim putforth by the individual for sanction of the expenditure
by producing the bills/ vouchers to be reimbursed. These orders
shall come into force with effect from 1-5-1989.
All the Departments of Secretariat and all the Heads of
Departments are informed that any claim of the Government
Employees for reimbursement of their medical expenditure beyond
the maximum limit of *Rs. 40,0007- as specified in Para 3 above
shall not be entertained and they should issue instructions to
all their subordinates to follow these orders strictly.
7. Medical Treatment - Cardiac Surgery - Free of charge to
members of public belonging to weaker sections in Government
hospitals - Orders - Issued
(G.O.Ms.No. 580, H.M. & F.W. (SCK) Dept, Dt. 30-9-1989)
Order :-Of late several requests are being made by the members of
public directly or though their representatives for financial
help towards payment of expenses on medical treatment and on
cardiac surgery undertaken by certain hospitals under the control
of the Government where such facilities are available. Govt.
depending on the eligibility of the person and need for such
medical treatment have been authorising the concerned hospitals
for giving free treatment or for free cardiac surgery as the case
may be with a request to send necessary bills to the Revenue
Department for effecting payment towards the cost of consumable,
disposables from out of Chief Ministers Relief Fund.
As requests for financial aid towards cardiac surgery are ever
increasing and in order to rationalise the entire procedure the
following guidelines are issued:
1. All requests made by the members of public belonging to
weaker sections of society, recommended by any Department,
M.L.As., MPs, Ministers, etc., shall be forwarded for examination
by the Government in Health, Medical and Family Welfare
Department. No representations made by any individual or
representatives of the patients shall be received by any hospital
either for examination or for treatment free of cost unless
specific orders are issued by the Government.
2. The applicant requesting free medical treatment/cardiac
surgery shall be a member of weaker sections of society and shall
possess a green ration card.
3. The bonafides of the applicant requesting free treatment for
his dependent shall be verified to ascertain that the dependent's
name figures in the green ration card possessed by him and is the
same person for whom medical treatment is sought.
4. The beneficiary shall execute a bond on a five rupee stamped
paper (non-Judicial) to the effect that he/she is member of the
family of the green ration card holder.
5. The applicant shall affix a passport size of latest
photograph of the beneficiary/ dependent on the righthand top
corner of the applicant for and also enclose a xerox copy of the
green ration card before sending to the Government.
6. Government in Health, Medical and Family Welfare Department
after verifying the application form and if it found that the
applicant or his dependent fulfills all conditions for free
medical treatment/free Cardiac Surgery necessary orders will be
issued to the hospitals under the control of Government where
such facilities are available for free medical treatment/free
cardiac surgery and only after issue of such orders the cases
shall be admitted and given free treatment/surgery. Expenditure
on consumables/disposables, if any shall be met by Government
from out of Chief Minister's Relief Fund.
7. The concerned hospitals where cardiac surgery is done free of
Cost to any person on the orders of Government in Health, Medical
& Family Welfare Department, shall at the end of every month send
a statement, quoting relevant references from the Government in
Health, Medical and Family Welfare Department of Health of
patients, treatment given, surgery conducted and the costs
involved with regard to consumables or disposables to the Revenue
Department for purposes of effecting necessary payment from out
of Chief Minister's Relief Fund under intimation to Health,
Medical & Family Welfare Department.
8. Medical Attendance - Issuing of letter of advice to undergo
treatment / Open Heart Surgery outside the State - Certain
(Memo.No. 2113/K1/89-1, H.M. & F.W. Dept., Dt. 4-10-1989)
Order :-It is observed that despite the instructions issued by