ANDHRA PRADESH STATE ROAD TRANSPORT CORPORATION

O/o the Managing Director

Bus Bhavan, Hyderabad-624

No.W6/468(1)/2011-PO-I

 PD & MEDICAL DEPARTMENT JOINT CIRCULAR NO. PD-28/2011, DT 02.09.2011

Sub : MEDICAL ATTENDANCE – Providing Medical Facilities to the Retired Officers/Employees and their spouses of APSRTC under Retired Employees Medical Facilities Scheme 2003 - instructions issued – Regarding.

Ref  : 1. Circular No.PD-58/2005, Dt. 08.12.2005.

2. Circular No.PD-10/2007,, Dt. 01.03.2007.

3. Circular No.PD-38/2008, Dt. 08.08.2008.

4. Circular No.PD-22/2009, Dt. 03.08.2009.

5. Circular No.PD-36/2009, Dt. 31.12.2009.

6. Circular No.PD-13/2010, Dt. 20.03.2010.

7. Notification No.PD-04/2010, Dt. 03.04.2010.

8. Notification No.HI/468(9)/2009, Dt. 9.1.09, 13.03.09 and 30.05.2009.

***

The modalities of the APSRTC Retired Employees Medical Facilities Scheme 2003 (REMFS 2003) were communicated time to time through the Circulars/Notifications referred above.

Several instances have come to light wherein ignorance on the part of retiring employees have made them ineligible, to become the Members of the Scheme, as they failed to exercise option within the stipulated period. Several such employees went on representing for condoning the delay in exercising the Option. Keeping in view such circumstances, it has been decided to make it mandatory to provide to the employees, the Option form for the Retired Employees Medical Facilities Scheme, along with the application for Gratuity i.e., Form ‘I’.

The Retired APSRTC Officers/Employees Associations have represented that the retiring employees are facing much difficulty as certification of concerned Unit, where the employee retired, is being insisted for extending necessary treatment. They further represented that great difficulty is being experienced in attending Tarnaka Hospital from outstations for obtaining referral letters.

          Considering the representation of the retired Officers/employees, the following guidelines are issued for strict compliance. For the purpose of implementation of these instructions, the term “retired employee” equally refers to retired Officers also.

1. The Unit Officer has to provide to the retiring employee, along with Form ‘I’, i.e., application of gratuity, the Option Form for Retired Employees Medical facilities scheme, and the proforma of Undertaking for recovery of the contribution amount towards REMFS, from the Gratuity amount payable to him/her. The contribution amount towards Retired Employees Medical facilities scheme shall be deducted from the amount of Gratuity payable to the  retiring employee who gives such undertaking, and while giving notice for payment of Gratuity, ie., Form ‘L’,  the amount deducted should be shown in ‘Form L’.  It is the responsibility of the PD Supervisor to supply to the retiring employee, the Option Form for Retired Employees Medical facilities scheme and the Undertaking for the recovery of contribution amount, along with Form ‘I’, i.e., application for Gratuity and to collect it back. If any retiring employee is not inclined to become member of the REMFS, his/her unwillingness shall be obtained along with ‘Form-I‘. The unwillingness once submitted is irrevocable.

2. The Scheme is applicable to only those employees/Officers who retire on attaining their age of Superannuation. The spouses of the retired deceased employees are not entitled to any benefits under the Scheme if the retired employee did not become a Member of the Scheme before his/her death. The concerned Unit Officer will be held responsible if the facility is extended to other than those who retired on attaining their age of superannuation.

3. If the Spouse of the retired employee is employed or retired after working in an Organisation, such spouse is not entitled for the benefits under the Scheme, unless a certification of the concerned Employer is submitted to the effect that the   spouse of the retired employee is not availing such facility in their Organisation.

4. At the time of enrolment into the Scheme, if the spouse of the retired employee is not alive, the maximum amount that can be spent by the Corporation for providing specialist treatment to the retired employee in notified referral hospitals would be Rs. 2.00 lakhs only.

5.  In the event of death of the retired employee/spouse after enrolment into the Scheme, the left over balance in the account of the deceased gets lapsed and it cannot be utilized for extending treatment to the surviving spouse/retired employee.

The intimation regarding the death of retired employee/spouse shall be made within one month to the Corporation, and the onus of such intimation lies with the surviving spouse/retired employee.

6.  I.D cards for retired employees under REMF 2003 shall be issued on the day of retirement by the Unit, wherever the employee is retiring. Health Books of retired employee shall henceforth be issued in RMs’ Offices after certification by Units on receipt of new application form   under REMF Scheme 2003.

7. The Health books and Identity Cards issued under the scheme shall be the sole criteria for extending medical care at APSRTC Hospitals / Dispensaries. The referral Hospitals also shall admit and treat the retired employees and their spouses solely on the strength of the directing letters issued by the respective Medical Authorities of APSRTC in the normal circumstances, and in emergency cases, on the basis of the I.D cards and Health Books issued under the scheme, subject to issue of directing letters within 48 hours of admission.

8. The Superintendent of Tarnaka Hospital/Medical Officers of the concerned Dispensaries shall arrange to maintain   member-wise accounts of expenditure incurred from time to time, together with the left over balance amount.  The integrated Identity Cards and Health Books shall be carried by retired employees/spouses, whenever they approach the Tarnaka Hospital/Dispensaries for availing facilities under the Scheme. Whenever the retired employees approach the Hospital/Dispensaries, the details such as the amount spent and the left over balance should be updated in their Health Books.

9.   The Superintendent / CMO of Tarnaka Hospital   are authorized to direct the retired employees and their spouses, to the notified referral Hospitals in twin Cities of Hyderabad. The Medical Officers of all Dispensaries are authorized to direct the retired employees and their spouses, residing outside Hyderabad, to the notified referral Hospitals in their respective jurisdiction, subject to ratification by Superintendent/CMO.

10.        In cases of emergencies (particularly for Cardiology and Neurology cases): 

a.     If the retired employee or spouse who is a member of the REMF Scheme 2003, requires admission into a notified hospital for emergency treatment, he/she may attend the referral hospital directly on the strength of the Identity Card and Health Book issued under the scheme.

b.     The retired Employee/ spouse/children/relatives of the retired employee shall give a written undertaking/declaration to the notified Hospital that he/she is liable for payment of the bill amount if it exceeds the amount payable by the Corporation. The Proforma of Declaration is at Annexure – ‘A’.

c.      However, before attending the hospital or soon after the admission, the retired employee or spouse or someone on his/ her behalf shall inform over telephone, the Duty Doctors/ Supdt/CMO Tarnaka hospital or Medical Officers of other Hospitals /Dispensaries for which opted. In addition to intimation over phone, the written communication shall also be sent, over FAX to the FAX Machine available (040-27003695) in the room of the Duty Medical Officer, Tarnaka Hospital.  A copy of the FAX message shall also be sent to the Office of the Regional Manager under whose jurisdiction, the dispensary for which the retired employee/spouse opted for treatment under normal circumstances, falls. The RM’s Office in turn should send it to the concerned Medical officer.

d.     After receiving the FAX message, the Duty Medical Officer/Tarnaka Hospital or Duty Medical Officers of other Hospitals/Dispensaries shall note the time and date of receipt in a register duly mentioning the details of the message. They shall arrange to issue a directing letter after proper verification.  At the same time the Medical Officer of the dispensary concerned shall also be informed, over phone.

e.     After admission in Hospital, it shall be the responsibility of the retired employee/spouse/their children/ relatives to arrange to obtain the referral letter from the Superintendent/ CMO or Medical Officer of the Dispensary concerned, within 48 hours and submit to the hospital where admitted, otherwise he/she shall be liable to pay the hospital bills. No reimbursement shall be allowed under any circumstances.

11.     The Medical Officers of the Dispensaries have to ascertain from Tarnaka Hospital, the balance amount available in the member’s account, over telephone/fax. Before directing the retired employee/spouse to a notified hospital, the Supdt.(Tarnaka)/CMO and  Medical Officers of the Dispensaries shall take undertaking from the retired employees/spouses/ their children to the effect that, they are liable to pay the amount, if the treatment cost exceeds the amount to which they are entitled as per the rules of the Corporation.

12.     In the referral letter, Supdt (Tarnaka)/CMO / the Medical Officers of the Dispensaries shall clearly mention the balance amount in the account of the member, to which the liability of the Corporation is restricted towards treatment of such retired employee/spouse and shall inform the referral Hospital that if the treatment cost exceeds such amount, the retired employee/spouse/ their children/relatives are liable to pay such amount.

13.     The initial referral letter for treatment in emergency cases shall be only to cover the expenditure for immediate life saving diagnostic tests and treatment like Angiogram, CT Scan, MRI etc. not exceeding Rs.10,000/-. For subsequent treatments like PTCA, Pacemaker, CABG etc; the referral hospitals shall furnish detailed estimates as per the agreed tariffs. These procedures can be carried out only after receipt of approval letter from Tarnaka Hospital duly furnishing the amount.

14.     If there is a critical emergency for immediate PTCA or CABG or any other procedure, the Medical Officers of dispensaries should contact the Superintendent/CMO on phone for urgent decision. As soon as possible, a directing letter may be obtained over FAX No.040-27003695 (Duty Doctor). In such cases, the Superintendent/CMO of Tarnaka hospital should take expeditious  action to issue a referral letter over FAX, through the concerned R.M, where fax facility is available, or to the referral hospital directly if FAX is available with them.

15.     The Medical Officers of the Dispensaries shall scrutinize and certify the bills and forward to Tarnaka Hospital, for payment. All the required file processing for sanctions of competent authorities shall be done by PO/Tarnaka Hospital and not at the Units. No payment shall be arranged at the unit level. No reimbursement shall be entertained for any amounts paid by the retired employees and their spouses directly to the referred hospitals.              

16.     The retired employee/spouse shall invariably produce the copy of the Party’s bill last issued by the referred hospital for verification to the Medical Officer(Dispensary)/Superintendent(TH)/Chief Medical Officer (TH) for succeeding referral.

17.     In case of public holidays when Tarnaka Hospital and the dispensaries are closed or in case of emergencies that arose  beyond the working hours of the dispensaries, the procedure laid down at 10 a to 10 e above shall be followed.

18.     If a retired employee/spouse falls sick while on tour or short visit to      a place located within the State, he/she can take treatment at such place in the notified referral hospital, only in case of emergencies. The procedure enumerated at item No. 10 a to 10 e, for treatment in Emergency shall hold good in such cases also.

19.     If the retired employee opts for one Dispensary at the time of retirement and wants to change the dispensary subsequently, he/she should make an application to the Medical officer of the concerned Dispensary. The Medical Officer should arrange to up date the Health Book of the retired employee and arrange to send the record to the Dispensary to which the retired employee/spouse opts for, duly intimating the left over amount that can be spent for treatment and duly informing the Superintendent, Tarnaka, about such transfer.

20.     If the Health Books or integrated Identity Card is lost, the retired employee/spouse has to pay Rs.100/- for obtaining duplicate Identity card and Health Book. Before issuing duplicate Health Book, the concerned unit shall insist for certification from Supdt/Tarnaka Hospital, regarding the balance left over amount to the credit of the retired employee and spouse. Before handing over the duplicate Health Book to the retired employee/spouse, the details as certified by Supdt/Tarnaka Hospital should be noted in the Book.

21.     The retired employees and their spouses are eligible for same class of accommodation at the referral hospitals, as applicable to their in-service counter parts. The type of accommodation for which various classes of in service employees are entitled are reproduced below:

However, if any retired employee or spouse opts for treatment with lower class of accommodation, to save on overall cost of treatment, it can be agreed to.

22.     The list of all Private Hospitals recognized as referral Hospitals by the Corporation is furnished at Annexure-B. In addition to these Hospitals, NIMS, Hyderabad continues to be a referral Hospital for all super specialties. The retired employees or their spouses shall be referred to any notified referral hospital only for treatment of those diseases, for which it is notified and not for any other ailments.

23.     In the unfortunate event of death of a patient (retired employee/ spouse) in the hospital, the relatives of the deceased shall Fax the message of death to Tarnaka hospital. Expeditious action shall be taken by Tarnaka Hospital to obtain the actual billed amount over Fax and verify the amount left over in the member’s account.  The same shall be informed to the concerned hospital specifying the extent of amount payable by the Corporation.

24.   The main objective of the scheme is to provide much needed medical facilities to the retired employees and their spouses in their hour of need. The Superintendent/CMO at Tarnaka Hospital and Medical Officers of APSRTC Dispensaries at other places, shall take prompt action for directing retired employees and their spouses to the notified hospitals, wherever required as elaborated in this Circular, to get the bills submitted by hospitals scrutinized and to arrange payment to the hospitals.

Please acknowledge.

Enclosure: Annexure A & B

Sd/- B.PRASADA RAO

VICE CHAIRMAN &

MANAGING DIRECTOR

To

All Officers of the Corporation.

// ATTESTED //

DY. CHIEF PERSONNEL MANAGER (IR&W)

Copy to:  Sr.RAO/AG: RTC Branch, Mushirabad, Hyderabad.

Copy to:  Secretary to Chairman/PS to VC & MD.

Copy to:  Dy.CAO(TA&INS)

Copy to:  PRO/HO for translation into Telugu.

Copy to:  PO(Trg.)/HO, for inclusion in monthly index of Circulars (4 copies).

Copy to: General Secretary, APSRTC National Mazdoor Union, 20/1, Vigyanpuri, Vidyanagar, Hyderabad.

Copy to: General Secretary, APSRTC Employees' Union, Satyanarayanareddy Marg, Azamabad, Hyderabad.

Copy to: General Secretary, APSRTC S&WF (State Office), Nanduri Prasada Rao, Bhavan, 1-7-130/5, Risala Khursheed Jahi, Zamistanpur, Hyderabad-20.

Copy to: General Secretary, APSRTC Class-II Supervisors Association, Flat No.102, H.No.16-1-30/A/36, Star Balasai Nest, Lokayukhta Colony, Saidabad, Hyderabad-500 059.

Copy to: General Secretary, APSRTC Security Staff Welfare Association, Hyderabad.         

Copy to: Notice Board & Incharge Record Room.

                                                                         ANNEXURE - A

Declaration/Undertaking to be submitted by a Retired Employee/ Spouse seeking Admission in to a notified Referral Hospital under APSRTC – REMF – Scheme – 2003.

Sri/Smt.___________________, E._______, Desgn._______, Unit________                                 OR

Sri/Smt.________________________, Spouse of above Solemnly declare as follows:

1.     I/We am/are Member/Members of APSRTC – R.E.M.F. Scheme 2003 with following IDs.

a.       ID Card No.________, Dt.__________Valid upto __________

b.       ID Card No.________, Dt.__________Valid upto __________

(Photo copy enclosed)

2.  I (Self/spouse) Sri/Smt_____________________ am seeking Admission into ________________________ Hospital for treatment _____________

(To be certified by Authorised Doctor with Hospital Seal)

 3. I have/have not availed Treatment earlier at a referral Hospital:

          Yes/No (Tick one)

          If ”Yes” furnish details.

A.                 Name of the Hospital

B.                 Date of treatment

C.                Ailment treated for

D.                Approximate expenditure incurred

4.     I hereby undertake to bear the Medical Expenses if any incurred over and above the amount available to my credit in my account under the APSRTC REMF Scheme 2003.

I hereby declare that the information furnished above by me is true and correct to the best of my knowledge and belief. If the same is found to be false or factually incorrect, I am bound by any penal action to be initiated by A.P.S.R.T.C. besides forfeiting the deposit amount paid by me under APSRTC R.E.M.F. Scheme-2003.

Station______________                      Signature of Rtd Emp/Spouse

Address_________________                          ______________

           _________________                                  Name (Block Letters)

           _________________

Tel________________

       ANNEXURE – B

LIST OF REFERRAL HOSPITALS & DIAGNOSTIC CENTRES IN TWIN CITIES

FOR DIAGONOSTIC PURPOSE ONLY: 

ZONAL/DISTRICT LEVEL RECOGNISED & EMPANELLED HOSPITALS

 ****