Clarification sought on Delegation of powers to Heads of Departments in various Ministries/Departments for settling permission cases and for approval relating to medical reimbursement under CS(MA) Rules, 1944-reg.
No.6-1/2021-Medical Government of India Ministry of Communications Department of Posts (Medical Section) Dak Bhavan, Sansad Marg, New Delhi- 110 001 Dated:25th November, 2021
Sir, I am directed to forward herewith a copy of O.M. No. S.14025/01/2014-MS dated 5th June, 2014 (copy enclosed) issued by the Ministry of Health & Family Welfare on the subject mentioned above for further necessary action at your end.
2. In this connection, it is informed that the Ministry of Health & Family Welfare vide their ID No.S.14025/35/2021-EHS dated 29.10.2021 have clarified that O.M.No.S.14025/01/2014-MS-dated 05.06.2014 issued by them in respect of CS (MA) beneficiaries is still valid. Permission/reimbursement case of CS (MA) beneficiaries may accordingly be dealt with as per the instructions contained therein.
3. Enhancement of ceiling rate from Rs.2 Lakhs has been extended upto Rs.5 Lakhs in the CGHS beneficiary case only (O.M. No. S.l 1011/20/2014-CGH_S (P)/ EHSS dated 23.11.2016).
Delegation of powers to heads of Departments in various Ministries/Departments for settling permission cases and for approval relating to medical reimbursement under CS (MA) Rules, 1944.
The undersigned is directed to state that this Ministry has been receiving references from different Ministries/Departments in respect of medical claims for clarification and concurrence even when ·the admissible amounts calculated are as per the approved rate list. This generates extra burden in this Ministry when the matter can be settled in the referring Ministry itself.
2. The ma11er has been examined and it has been decided now to delegate powers as follows:
(i). A serving Central Government employee covered under CS (MA) Rules, 1944 who is taking treatment in Government hospital and desires to obtain treatment in a private hospital recognized under CGHS/CS (MA) Rules, the Head of Department may grant him permission for indoor treatment on the basis of medical prescription issued by the 'concerned Authorized Medical Attendant.
(ii). The Heads of Departments may decide the cases of reimbursement of medical claims in respect of treatment obtained in emergency at private hospital/private nursing home/private clinic, subject to item-wise ceiling as per rates prescribed under CGHS/CS (MA) Rules.
3. It has been decided with the approval of the competent authority to delegate powers to Departments/Ministries to settle all cases where there is no relaxation of rules and the entitlement has been worked out with reference to the rate list prescribed. The delegation would, however, be subject to the condition that the Heads of the Departments/Ministries may settle cases upto the limit of Rs.2,00,000/-(Rupees Two Lakhs only) (worked out with reference to the prescribed rate list).
In respect of payment exceeding Rs.2,00,000/- (Rupees Two lakhs only) but as per the prescribed rate_ list, the Departments/Ministries concerned may settle such cases in consultation with their respective Internal Finance Division. Only in those cases where the settled rules are required to be relaxed, should the case be referred to the Ministry of Health and Family Welfare.
4. This issues with concurrence of Integrated Finance Division vide CD No.335 dated 28.05.2014.
