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State of Rajasthan - Section

Section 6 in Rajasthan Civil Services (Medical Attendance) Rules, 2008

6. Free Medical Attendance and Indoor I Outdoor Treatment to Government servant and his family in a Government Hospital.

(1)A Government servant and his family, except those who opt for medical insurance, will be provided free medical attendance and treatment, in accordance with provisions of these rules in a Government hospital.
(2)
(I)Expenses incurred by a Government servant, while availing medical attendance and treatment in a Government hospital shall, on production of essentiality certificate from the authorised medical attendant or such other authority as prescribed, or upon self certification to, where so prescribed, be reimbursed to him to the extent and in manner provided as under:
(a)Cost of allopathic drugs and medicines (including sales tax), vaccines, sera or other therapeutic substances not available in the government hospital, except allopathic drugs, medicines, included in Appendix-ill (negative list);
(b)Cost of ayurvedic and yunani drugs of approved preparations only not available in government hospital, as included in the list of drugs and medicines in Appendix-IV
(c)Cost of homeopathic drugs of approved preparation only, not available in government hospitals, from pharmacists included and medicines listed in Appendix-V.
(d)Ambulance charges incurred to carry patient from place of illness to a government hospital, vice versa or from one government hospitals to another for treatment or examination.
(e)Blood transfusion charges.
(f)Cost wholly or partly of hearing aid or artificial limb (including cost of replacing a limb) or calipers. Cost of hearing aid will be reimbursed as under: -
(i)For first time : -
  Cost of Hearing Aid Limit of reimbursement
(a) First Rs.5,000/- 100%
(b) Next Rs.5,000/- 80%
(c) Rest amount 50% of the remaining amount, subject to maximumof Rs. 10,000/-
An example of calculation of cost of reimbursement: - I the cost of hearing aid is Rs.20,000/-, then reimbursable amount will be Rs.5,000/- + Rs.4,000/- + Rs.5,000/- = Rs.14,000/-.
(ii)In case hearing aid equipment is required to be purchased again, in the opinion of the competent Authorised Medical Attendant or earlier equipment is beyond repairs, reimbursement would be limited to 50% of the amount as would have been admissible for first purchase as per rule (i) above.
(g)Consultation fee charged by the authorized medical attendant for treatment at residence of Government servant to the extent and as per scale prescribed in the Rajasthan Medical Officers Fees Rules, 1964 as given in Schedule in Appendix - X of Rajasthan Service Rules, Vol.-II.
(h)Fee paid to compounder / nurse per visit for administering injection at the residence of the Government servant to the extent and on scale laid down in the Rajasthan Medical Officers Fees Rules, 1964 as given in Schedule in Appendix - X of Rajasthan Service Rules, Vol.-II.
(i)Charges paid under auto finance scheme for pathological, bacteriological and radiological tests, x-ray, dialysis and investigations on prescription of authorized medical attendant.
(j)Actual cost of intra-ocular lens implantation and treatment thereto.
(k)Cost of Subcutaneous Infusion Pump - an instrument for use of blood transfusion.
(l)Cost of disposable surgical sundries used during surgical and other operations and which cannot be re-used including items of common surgical materials like gauge, I.V. Set, bandage, Leucoplast, Cotton, Crepe Bandage etc., if not supplied by the hospital.
(m)Charges paid by the Government servants to the Rajasthan Medicare Relief Societies, established in accordance with the government instructions, for pathological, bacteriological and radiological tests, x-ray, dialysis and investigations etc., which are considered necessary by the Authorised medical attendant, (n) Charges paid by the Government servant to the private diagnostic centres / labs etc, installed in Government hospitals through Rajasthan Medicare Relief Societies for pathological, bacteriological and radiological tests, x-ray, MRI, CT-Scan etc., at the rates as may be approved by the Rajasthan Medicare Relief Society from time to time.
(o)Charges paid by the Government servant to the private diagnostic centres / labs etc. for the tests undertaken on advice of Authorised Medical Attendant, under conditions and to the extent as under: -
(i)After obtaining NAC from Government hospital. -
(a) If the facility of that test 100% of Government exists in Government hospitalhospital rate
(b) If the facility does not exist in Governmenthospital 70% of the incurred amount
(ii)Without obtaining NAC from Government hospital. -
(a) If the facility of that test exists in Government hospital 80% of Government hospital rate
(b) If the facility does not exist 50% of the incurred amount in Government hospital
Note 1: Rates of private diagnostic centers established in the Government hospitals through Rajasthan Medicare Relief Society shall be treated as Government hospital rates for this purpose. In case where such facility is not available in Govt, hospitals outside Jaipur (but within State), but it is available in SMS Hospital, Jaipur then rates of SMS Hospital shall be treated as Government hospitals rates for this purpose.Note 2: (i) For outdoor patients, MRI, Stress Thallium and other costly tests (charges above Rs. 1500/-) shall be got conducted only after recommendation of the Professor / Unit Head of the concerned department of Medical College.
(ii)For Indoor patients in a Government Hospital MRI, Stress Thallium, CT Scan and other costly tests (charges above Rs.1500/-) in case of emergency shall be got conducted on recommendation by the Medical Attendant on duty in the hospital.
(p)Cost of implants including stents, valves, joints, pacemaker, ICD, Cochlear Implant etc., considered necessary to be implanted in the body of the patient and angioplasty / balloonplasty to the extent as may be prescribed by orders of the Government from time to time, on the advice of Medical Benefits Advisory Committee.
(q)
(i)Free of charge accommodation in the Government Hospital as classified below, subject to availability:-
Pay Slab Class ofAccommodation
(a) Rs.25,000/- orabove Deluxe or CottageWard
(b) Rs.14,000/- orabove but below Rs.25,000/- Cottage Ward
(c) BelowRs.14,000/- but above Rs.6,600/- Rental Ward of thelowest category.
Note : The above pay slabs are subject to corresponding revision on implementation of Sixth Pay Commission Report.
(ii)If the class of accommodation to which a Government servant is entitled to under sub-clause (i) above is not available, accommodation of a higher class may be provided if the admission of patient cannot be delayed without danger to his health. The Superintendent / Principal, Medical & Health Officer of the hospital shall record this fact in the appropriate hospital records.
(r)Ordinary nursing facilities available in a Government hospital.
(s)Sums actually paid on account of medical attendance and treatment including charges for surgical operations.