GO.176 List of Therapies and Package Prices for Employee Health Schemes-Employee Health Cards

DISEASES LIST AND PACKAGE PRICES FOR EMPLOYEE HEALTH SCHEMEGO.No.176 Dt 1-11-2013 List of Therapies and Package Prices for Employee Health Schemes (Cashless Treatment Scheme to Employees)-Employee Health Cards. This GO.176 gives us the Complete List of Therapies and prices for Thearapy allowed under EHS. These shall be adopted by Aarogyasri Health Care Trust for treatment of patients in empanelled hospitals, under the Employees Health Scheme. In the letter From the Chief Executive Officer,Aarogyasri Healthcare Trust Letter No.AST/ 4768 /P&C/F.49/ 2013, dated: 06-09-2013, the Chief Executive Officer, Aarogyasri Healthcare Trust has submitted the ‘Final Therapy prices for Employees Health Scheme’ which include additional therapies in addition to the existing Aarogyasri therapies, prepared basing on the ‘Input Code Book’ and ‘Standard Scheduled of Rates (SSR 2012-13)’ already notified in the G.O. 9th read above. These final therapy prices are inclusive of OP evaluation. Vide GO.174 Govt has issued orders for implementation of Employee Health Scheme. Vide GO.175 Govt issued Orders for Operational Guidelines.

GO.176 List of Therapies (Diseases) and Package Prices for EHS

Reference GOs:
1. G.O.Ms.No.227 HM&FW (K2) Dept dated 09-06-2006.
2. G.O.Ms.No.184 HM&FW(M2) Dept dated 14-08-2012.
3. Govt Memo. No. 21233 /M2/2012-3 HM&FW (M2) Dept dated 06/02/2013.
4. Representation dated 30-03-2013 received from AP Speciality Hospitals Association (ASHA).
5. Representation dated:03-04-2013 received from AP Private Hospitals & Nursing Homes Association (APNA).
6. From the Chief Executive Officer, Aarogyasri Healthcare Trust, Hyderabad letter No.2349 /P&C/F.49/2013 dated 26-04-2013.
7. Govt Letter No.21233/M2/2012-4 HM&FW(M2) Dept dt.29-04-2013.
8. From the Chief Executive Officer, Aarogyasri Healthcare Trust,Hyderabad letter No.AST/2349 / P&C/F.49/2013 dated 29-
04-2013.
9. G.O.Ms.No.87 HM&FW (M2) Dept dated 27-06-2013.10. From the Chief Executive Officer, Aarogyasri Healthcare Trust
Letter No.AST/ 4768 /P&C/F.49/ 2013, dated: 06-09-2013.
11. Government Memo.No.16977/M2/2010, Dated: 30/10/2013.
12. From the Chief Executive Officer, Aarogyasri Healthcare Trust, Letter No.AST/ 4768 /P&C/F.49/ 2013, dated: 30-10-2013.
13. G.O.Ms.No.174, HM&FW (M2) Dept. Dated: 01/11/2013.
14. G.O.Ms.No.175, HM&FW (M2) Dept. Dated:01/11/2013.

Useful Information Links on Health Cards:
1.GO.174 Employee Health Schme Cashless Medical Treatment to Employees
2.GO.175 Operational Guidelines and Process for Issue of Health Cards.
3.GO.176 List of Therapies (Diseses) and Package Rates
4.GO.184,186 Health Cards Guidelines Issued Previous Year
5.GO.1837 Enrolling for Health Cards through MEESEVA and Rates for Enrolment
6.How to Appply for Health Cards - Video Tutorials click Here
  1. Government issued orders in the G.O. 9th read above, by notifying the ‘Input Code Book’, ‘Standard Schedule of Rates for 2012-13’, and the ‘Final Therapy Prices ’, for being adopted by the Aarogyasri Health Care Trust for determining the package rates for treatment of patients in empanelled hospitals, for Rajiv Aarogyasri Scheme.
  2. In the letter 10th read above, the Chief Executive Officer, Aarogyasri Healthcare Trust has submitted the ‘Final Therapy prices for Employees Health Scheme’ which include additional therapies in addition to the existing Aarogyasri therapies, prepared basing on the ‘Input Code Book’ and ‘Standard Scheduled of Rates (SSR 2012-13)’ already notified in the G.O. 9th read above. These final therapy prices are inclusive of OP evaluation.
  3. In the G.O., 9th read above, Standard Schedule of Rates for 2012-13 are approved according to which Rs.900/- per day is the rate prescribed for General Ward. Government have decided to consider Rs.1200/- per day for stay in semi-private ward and Rs.1500/- per day for private ward in the non-NABH accredited hospitals. In so far as the NABH accredited hospitals are concerned, the rates would be Rs.1500/- per day for semiprivate ward and Rs.2000/- per day for private ward. This would be an incentive to the NABH accredited hospitals for promoting quality of health care. The APIMA Rules adopt CGHS norms and the CGHS prescribes incentives to the NABH accredited hospitals for promoting quality of health care. Hence, NABH hospitals are considered for higher tariff so far as hospital stay is concerned. Moreover, the scheme will be reviewed after obtaining the actual data for six months, the rationalization of the above prices for semi-private ward and private wards would also be considered in the review. The Chief Executive Officer, Aarogyasri Health Care Trust will carefully monitor the implementation of the Scheme and after obtaining the actual data for six months, will place the same before the Steering Committee for considering rationalization of the above prices for semi-private ward and private wards.
  4. Government after careful examination hereby issue the following orders:-
  • a. List of therapies and the package prices are placed in the Annexure. These shall be adopted by Aarogyasri Health Care Trust for treatment of patients in empanelled hospitals, under the Employees Health Scheme.
  • b. The Chief Executive Officer, Aarogyasri Healthcare Trust is authorized to include any additional inputs, which may be required during the course of implementation of the scheme, code them, finalise the prices and append the same in the Medical Input Code Book and Standard Schedule of Rates (SSR) subsequently.
  • c. The following standard schedule of Rates are hereby approved 
  • i. Stay in Semiprivate ward Rs.1,200/- per day in non-NABH accredited hospitals and Rs.1,500/- per day in NABH accredited hospitals.
  • ii. Stay in Private ward Rs.1,500/- per day in non-NABH accredited hospitals and Rs.2,000/- per day in NABH accredited hospitals.
The Chief Executive Officer, Aarogyasri Health Care Trust, Hyderabad shall take further necessary action, accordingly in the matter.

24 comments:

  1. Is LASIK eye surgery covered under EHS ?

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  2. what r the hospital covered by EHS in hyd

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  3. sir the treatments which r not covered in EHS can be reimbursed?

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  4. After i login i entered my12 no aadharcard number then press retrive button . then i got the fields up to identification fields only , after that last posting details , pension issuing center details,card issuing center details, save ,reset buttons are not coming . how can save ,,,, i tried ie9, mozilla 25 versions .. please help me in this reg.

    ReplyDelete
    Replies
    1. Due to server Busy, it may happens some time. Just use the Mouse to scroll down. If any problem in scrolling down, use down arrow button, at Number keypad for better Navigation.

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  5. sir ,
    can the health use for mouth surgery

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  6. sir if u give reply soon ,it is very important to make surgery for my mom

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  7. Hi All,

    The following diseases will cover under this scheme is :

    http://www.ehf.gov.in/web/guest/specialities

    To find the hospitals which covers under this scheme. you can find using the following link

    http://www.apteachers.in/2013/12/list-of-network-referral-hospitals.html

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  8. orthopedic treatment comes under ehs or not

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    Replies
    1. Is shoulder replacement surgery in orthopediac covered under EHS for reibyursement

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  9. is laser eye treatment included in heath card scheme?

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  10. out patient consultation and medicines are covered under this scheme or not sir. if so how to follow.

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  11. Useful List of Therapies and package prices for EHS. Also thanks for sharing informative links on health cards.

    Thanks
    Doctorc.in

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  12. Sir,

    Can u plz. give the link for to know the disease packages details to know the permit/claiming amount for certain disease

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  13. for master health check up, whether we get reimbursement or not?

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    Replies
    1. presently health check up reimbursement amount enhanced or not

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  14. Is delivery of baby operation covered under EHF?

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  15. Is Squint eye Surgery comes under this Scheme?

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  16. Please guide me ..
    Is CRT-P Treatment for my father in cardiology covered under EHS.

    Thankyou in advance

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  17. IS KNEE REPLACEMENT COVERED UNDER GOVT SCHEME

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  18. may i know the list of hospitals. where free knee replacement is done under state government health scheme card in kurnool dist.

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  19. Is Lasik eye surgery comes under EHS please rly

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