Streamlining of Procedure for disposal of Medical Reimbursement Claims (MRCs) in CGHS

F. No. S.11024/8/2011/CGHS(P)

Government of India

Ministry of Health and Family Welfare

Department of Health and Family Welfare

Directorate General of C,G.H.S.

Nirman Bhawan, New Delhi

Dated the 14th November, 2011

CIRCULAR

SUBJECT : Streamlining of Procedure for disposal of Medical Reimbursement Claims (MRCs) in CGHS

The pensioner CGHS beneficiaries and their dependent family members are entitled to get cashless medical treatment In CGHS empanelled private hospitals on a referral by a Government medical specialist / CMO in-charge, after obtaining prior permission from the CMO in-charge of the CGHS Wellness Centre/Dispensary they are attached to. They are however, also entitled to obtain the medical services from any un-empanelled hospital in emergency condition and get reimbursement of medical expenses incurred by themselves or any of their dependent family members. They can file Medical Reimbursement Claims (MRCs) with the respective CGHS Wellness Centres they are attached to- The CMO In charge is expected to scrutinize the claim papers with reference to the prescribed Checklist and forward the same to the Office of AD/ JD in charge of the zone/city. The Office of AD/JD processes the claim and arranges reimbursement of the admissible amount to the pensioner beneficiary at the earliest.

2. A number of complaints are being received from the pensioner beneficiaries about the slow and tardy pace of disposal of MRC claims by CGHS, Complaints have also been received about the unnecessary harassment of pensioner beneficiaries who are also senior citizens, affecting them mentally and financially, and thereby creating a bad image for CGHS. CGHS is responsible for taking care of healthcare needs and well being of the central government employees and pensioners. It has therefore been decided to lay down a comprehensive procedure to be followed by all concerned in CGHS to ensure timely and hassle free disposal of the MRC claims by CGHS in order to facilitate prompt reimbursement of medical expenses to the pensioner beneficiaries.

3. The procedure to be followed by CGHS for dealing with MRC cases shall be as

follows;

• i. The beneficiary will submit the MRC in the prescribed format with all relevant supporting vouchers/documents in original, to the CMO-I/C of the relevant CGHS Wellness Centre. The CGHS Wellness Centre shall verify and ensure, before accepting the claim papers, that all relevant documents are enclosed as per the prescribed checklist and issue a dated acknowledgement to the claimant in token of receipt of the MRC by CGHS.
• ii. The CGHS Wellness Centre shall forward the MRC papers online to the Office of Zonal AD/JD, CGHS for further processing for reimbursement of claims. The physical papers shall be sent to the office of the AD/JD within one / two days of receipt of claim papers.
• iii. If there are still any deficiencies / gaps found in MRC documents/papers, the Office of AD/JD, shall retain the papers and communicate the list of deficiencies / observations, preferably online, to the CMO-I/C for removing the shortcomings. The MRC may also be returned in original to the CMO- I/C, if it is absolutely necessary for doing the needful to remove the deficiencies inconsultation wïth the beneficiary.
• iv. The CMO-I/C shall contact the beneficiary concerned and inform him about the shortcomings in the MRC papers and request him to submit the requisite information / documents. The CMO I/C shall not return the MRC in original unless it is rejected in total.
• v. The MRCs should be scrutinized and processed by the Office of AD/JD as far as possible through computerized software as per the extant policy and instructions issued from time to time about the CGHS rates and admissibility of claims under CGHS.
• vi. The amount found admissible as per the CGHS guidelines may be passed for payment and forwarded online / manually to the PAO for making payment. The original documents should also be forwarded simultaneously to the PAO for making payment of the admissible amount to the claimant.
• vii. When a bill is sent to the PAO, the details pertaining to the claimant will be entered through computer and the claimant shall be informed of the same along with bill number, amount admissible and details of disallowances clearly indicating the specific reasons / grounds for deductions.
• viii. The Office of AD/ID of the zone / city shall submit a weekly report in Form —‘MRC-I’ and Monthly Return in Form — ‘MRC — II’ indicating the details of disposal of MRC cases, to the Office of AD(HQ), CGHS for Delhi & NCR and to the Office of Additional DDG (HQ), CGHS for other than Delhi and NCR CGHS cities.
• ix. A separate analytical statement shall be attached with the Monthly Return in Form-’MRC- II’ giving therein, the details of the MRCs pending for 2 months and above, clearly indicating the reasons there for and steps taken to dispose of such cases.
• x. The Office of AD (HQ), CGHS, New Delhi and Office of Addi. DDG (HQ), CGHS shall compile the Monthly returns received from the respective zones andc ities and submit a consolidated Monthly Return on MRC cases (Zone-wise/City wise) to the Director, CGHS for monitoring of MRC cases on a monthly basis. A copy of this Monthly Return shall also be endorsed by AD (HQ), CGHS and Addi. DDG (HQ), CGHS to Additional Secretary and Director General, CGHS for his information.

4. All the CMO — I/C of the CGHS Wellness Centres and the ADs and JDs of the zone /city are herby directed to follow the above procedure religiously in both letter and spirit to ensure speedy and timely disposal of the Medical Reimbursement Claims (MRCs) filed by the pensioner CGHS beneficiaries.

End: Forms – MRC-I & II

sd/-

(L.C.Goyal)

AS&DG (CGHS)

Source: http://msotransparent.nic.in/cghsnew/index.asp

Central Government Employees News 2011

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INDUCTION OF TRADE APPRENTICES FOR TRAINING IN OFB

INDUCTION OF TRADE APPRENTICES FOR TRAINING UNDER THE APPRENTICES ACT1961 AND DISABILITIES ACT 1995 IN ORDNANCE & ORDNANCE EQUIPMENT FACTORIES

Ordnance Factory Board-OFB (Ministry of Defence) published an advertisement for Induction of Trade Apprentice for Training under The Apprentice Act’1961 and Disabilities Act’1995 in Ordnance & Ordnance equipment Factories. Eligible candidates can apply only through ON-LINE in its Website ‘www.ofb.gov.in’

On-line’ Application is invited from Indian Citizen for TRADE APPRENTICESHIP training in Ordnance & Ordnance Equipment Factories for the year 2011-12.Particulars of training and induction process are given below:-

AGE:

1. Between 14 to 22 years – As on 01-10-2011

2. Relaxation in Upper age limit is permitted by -

(a) For SC/ST Candidates – 05 (Five) years.

(b) For OBC candidates – 03 (Three) years

(c) For Physically Handicapped (PH) / Physically Challenged (PC) Candidates- 10(Ten) years.

(d) For ITI Candidates – upper age limit will be relaxed by the period of training already undergone by them in any Institute recognized by NCVT or SCVT, duly covered through Gazette Notification of Ministry of Labour & Employment.

ESSENTIAL QUALIFICATION:

1. For non-ITI applicants: – Passed Madhyamik (Class – 10th Standard) or Equivalent Examination with 40% marks in aggregate and 45% marks in each of Mathematics & Science (Physics and Chemistry).

2. For ITI applicants: – Should be passed out from the ITI, duly recognized by NCVT or SCVT and covered through Gazette Notification of Ministry of Labour & Employment, with minimum two years duration.

FACTORY-WISE TRADE- WISE VACANCY:

(One Candidate is Eligible to apply against one Factory & one Trade only)

Application is to be addressed to the Senior General Manager/ General Manager of any of the factories, where from the applicant intend for the Trade Apprenticeship training and to appear for the competitive induction Examination.

HOW TO APPLY:

Please keep the following data / details ready before you start filling up the form ONLINE:

Candidate must apply online through Ordnance Factory Board (OFB) website http://ofb.gov.in . After submission of the on-line application , the applicant should take a print of the registration slip, as submitted through on-line, affix recent colour passport size photograph, sign and put left thumb impression in the specified place and send to the concerned Ordnance Factory, where he/she intends to apply. The hard copy of the application must be supported with the following documents .

(a).Age proof certificate.

(b).Qualification Certificates(Madhyamik or Equivalant Examination/ITI Examination)(All copy of Certificate must be attested by any central/state Govt. Gazetted officier/Principal/Headmaster/Mistress of the college/ School .).

(c).SC/ST/OBC/PH (PC) Certificate(issued by competent authority) .

(d).Indian postal order (where applicable).

(e) . IPO of Rs. 30/-, in favor of the Sr.GM/GM of the Ord. Fy. where the candidate has applied for

Grade and CGPA to be converted into percentage as per guidelines given on your marksheet.

Valid e-mail id with validity for minimum period of six months,kindly keep the record of the same for your future reference.

TO APPLY ONLINE CLICK HERE

TO VIEW THE ADVERTISEMENT CLICK HERE

FREAQUENTLY ASKED QUESTIONSCLICK HERE

Online Registered User to check submission of application or viewing or re-printing your applicationCLICK HERE

source:OFB courtaesy:gservants.com"

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VII Pay Commission for Central Govt.Employees-INDWF

Today (14-11-2011) the INDWF –Indian National Defence Workers Federation is Celebrating its Golden Jubilee Year in New Delhi. A rally to Talkatora stadium is organized by the Federation as a part of the Golden Jubilee celebration. In which around 10000 of its delegates across India are expected to participate. Sources Close to the INDWF revealed that the Supreme command of the Congress Party Smt. Sonia Gandhi is also expected to participate in the Meeting to be held at Talkatora Stadium in the evening. The Prime Minister Dr.Manmohan Singh,Defence Ministers and Shri.Ragul Gandhi.are also invited to attend the meeting.

A list of around 30 Demands also been published by the Federation to put before the Government in its Meeting.The Federation Demands the Government, Particularly the Ministry of Defence that,

The Defence Procurement Policy to be reviewed, so that privatization and out sourcing may be avoided.

MACP should be granted to Central Govt.Employees on Promotional Hierarchy.

VII Pay Commission for Central Govt.Employees should be constituted at the earliest so that it can be reviewed and implemented in time.

Employment should be provided to the wards of employees those who are willing to go in VRS Scheme like in Railways.

The Bonus ceiling to be removed and one full month salary may be granted as Bonus to all Central Govt.Employees

One Increment should be granted to Central Govt.Employees whose annual increment falls between 01-02-2006 to 30-6-2006

source:gservants.com

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Grant of Dearness Relief to Central Government pensioners who are in receipt of provisional pension or pension in the pre-revised scale of 5th CPC w.e.f. 1.7.2011

F. No. 42/15/2011-P&PW(G) 

Government of India 

Ministry of Personnel, Public Grievances & Pensions 

Department of Pension & Pensioners’ Welfare

3rd Floor, Lok Nayak Bhavan, 

Khan Market, New Delhi – 110003 

Date: 21st October, 2011

OFFICE MEMORANUDM

Subject : Grant of Dearness Relief to Central Government pensioners who are in receipt of provisional pension or pension in the pre-revised scale of 5th CPC w.e.f. 1.7.2011.

In continuation of this Departments OM No. 42/15/2011-P&PW(G) dated 11th April, 2011 sanctioning the Dearness Relief to those Central Government pensioners who are in receipt of provisional pension or pension in the pre-revised scales of 5th CPC, the President is pleased to grant the Dearness Relief to these Central Government pensioners as under:

(i) Those who are in receipt of provisional pension or pension In the pre revised scales of 5th CPC are entitled to Dearness Relief @ 127% w.e.f 1.7.2011.

(ii) The surviving CPF beneficiaries who have retired from service between the period 18.11.1960 to 31.12.1985 and are in receipt of ex-gratia @ Rs. 600/p.m. w.e.f. 1.11.1997 under this Department’s OM No. 45/52/97-P&PW(E) dated 16.12.1997 are entitled to Dearness Relief @ 127% w.e.f. 1.7.2011.

2. The following categories of CPF beneficiaries who are in receipt of ex-gratia payment in terms of this Departments OM No. 45/52/97-P&PW(E) dated 16.12.1997 are entitled to DR @ 119% w.e.f. 1.7.2011.

(I) The widows and dependent children of the deceased CPF beneficiary who had retired from service prior to 1.1.1986 or who had died while in service prior to 1.1.1986 and are in receipt of Ex gratia payment of Rs. 605/- p.m.

(ii) Central Government employees who had retired on CPF benefits before 18.11.1960 and are in receipt of Ex-gratia payment of Rs, 654/-, Rs. 659/-, Rs. 703/- and Rs. 965/-.

3. Payment of DR involving a fraction of a rupee shall be rounded off to the next higher rupee. In their application to the pensioners/family pensioners belonging to Indian Audit and Accounts Department, these orders issue in consultation with the C&AG.

4. This issues with the concurrence of Ministry of Finance, Department of Expenditure vide their OM No. 1(4)/EV/2011 dated 21st October, 2011.

5. Hindi version will follow.

sd/- 

(S. P. Kakkar) 

Under Secretary to the Government of India

Source: www.pensionersportal.gov.in

[http://circulars.nic.in/WriteReadData/CircularPortal/D3/D03ppw/DR_5CPC_211011.pdf]

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Grant of Child Care Leave to Civilian Female Industrial Employees of Defence Establishments

No.12012/2/2009-Estt.(L) 

Government of India 

Ministry of Personnel, P.G. & Pensions 

Department of Personnel & Training 

*****

New Delhi, the 20th  October, 2011.

OFFICE MEMORANDUM

Subject:- Grant of Child Care Leave to Civilian Female Industrial Employees of Defence Establishments

The undersigned is directed to state that the matter regarding extension of the benefit of Child Care Leave to civilian industrial employees working in Defence Establishments at par with the Non industrial Central Government employees covered by the CCS (Leave) Rules, 1972 has been under consideration of this Department.

It has been decided in consultation with the Ministry of Finance (Department of Expenditure) to extend the benefit of Child Care Leave to civilian female industrial employees working in Defence Establishments at par with the non industrial Central Government employees covered by the CCS (Leave) Rules, 1972 subject to the conditions provided in rule 43-C of the CCS (Leave) Rules, 1972, as amended from time to time.

These orders shall take effect from the date of issue.

Hindi version will follow

sd/- 

(Zoya C.B.) 

Under Secretary to Government of India

Source: www.persmin.nic.in
[http://circulars.nic.in/WriteReadData/CircularPortal/D2/D02est/12012_2_2009-Estt-L-20102011.pdf]

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Commuted Leave to a Govermnent Servant who has opted out of CGHS facilities and is availing the medical facility provided by the employer of his / her spouse

No.13015/1/2011-Estt. ( Leave)

Government of India

Ministry of Personnel. P.O. and Pensions

(Department of Personnel & Training)

New Delhi. the 19th October, 2011

Office Memorandum

Sub: Commuted Leave to a Govermnent Servant who has opted out of CGHS facilities and is availing the medical facility provided by the employer of his / her spouse – clarification.

This Department has been receiving references from various Ministries Departments seeking clarification regarding admissibility of Commuted Leave on the basis of medical certificates issued by Hospitals/Medical Practitioners approved by the employer of the spouse in cases where the concerned employee has been allowed to avail such facilities from the employer of the spouse. The matter has been considered in the light of clarification given by the Ministries of Health and Family Welfare.

It is clarified that leave on medical grounds may be allowed on the basis of certificates issued by Hospitals / Medical Practitioners approved by the employer of the spouse in such cases.

Hindi version will follow.

sd/-
(Zoya C.B.)
Under Secretary to Government of India

Source: www.persmin.nic.in
[http://circulars.nic.in/WriteReadData/CircularPortal/D2/D02est/12012_2_2009-Estt-L-20102011.pdf]

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Railway Employees Cadre Restructuring meeting is scheduled to be held on 20.9.2011 and 21.9.2011

After the implementation of 6 CPC  recommendations with effect from 01-01-2006, subsequently cadre re structuring proposals in all the Departments would have been worked out for implementation well before.If sources are to be believed,very few Departments only asked the Federations of unions to come out with cadre review proposals for discussion.As for as settling the issues related to government servants,the railway federations are doing well comparing to the other federations. Now the General Secretaries of AIRF and NFIR are invited by railway board to attend  the meeting of Cadre Restructuring Committee,which is scheduled to be held on 20.9.2011 and 21.9.2011

AIRF News

Railway Employees Cadre Restructuring meeting is scheduled to be held on 20.9.2011 and 21.9.2011

The Railway Board has informed to the General Secretaries of AIRF and NFIR that the meeting of Cadre Restructuring Committee will be held on 20.09.2011 and 21.09.2011 at 1500 hrs in the Committee Room, 3rd Floor, Rail Bhawan, New Delhi. Board also requested to them to attend alongwith thier nominated member

source:gservants.com

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CABINET APPROVED 7% HIKE IN DEARNESS ALLOWANCE TO BE PAID FROM JULY-2011 TO ALL CENTRAL GOVERNMENT EMPLOYEES

DEARNESS ALLOWANCE  TO BE PAID FROM JULY-2011 TO ALL CENTRAL GOVERNMENT EMPLOYEES IS 58%

The Union Cabinet committee  today decided to Enhance the Rate of Dearness Allowance by 7% to all the Central Government employees.

Dearness Allowance (DA) will be enhanced from 51% to 58% w.e.f.July -2011.

Release of additional installment of dearness allowance for this year to Central Government employees and Dearness Relief to Pensioners from July-2011 is to compensate the price hike of essential commodities.

The revised rates of Dearness Allowance from 1.7.2011 to 30.3.2011 may be paid in cash as arrears and for the month of April may be disbursed with the salary.

The enhancement of Dearness Allowance is in accordance with the accepted formula, which is based on the recommendations of the 6th Central Pay Commission.

Government Order from Finance Department will be published very soon.

gservants

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