Wednesday, September 8, 2010

REIMBURSEMENT OF MEDICAL EXPENSES PROCEDURE OF DISPOSAL

CORRIGENDUM 

REIMBURSEMENT OF MEDICAL EXPENSES PROCEDURE OF DISPOSAL

Arising out of demand by staff side in the meeting held with DC/JCM in August 2009,
regarding  Reimbursement  of  Medical  Expenses,  Ministry  of  Railways (Railway  Board)  have
amended the procedure of reimbursement of medical expenses (Para 647 and 648 of IRMM)
and issued the Corrigendum of letter No. 2005 / H/6-4/Policy – II dated 31.1.2007 as follows:

Para 647(1) – (i) The existing note under Para 647 (1) may be read as “Note1.”

(ii) Add Note 2 under Para 647 as under: -

“2  When  the  patient  is referred  to  any  Govt./Recognized  hospitals by  Authorized
Medical Officer, the referral covers treatment / investigations in that hospital only. Only those
cases where it has been specifically certified by the AMO that re-reference was done with his
approval will be considered for reimbursement. However, in cases where the condition of the
patient  is such  that  there  is  essential  need  to  transfer  the  patient  to  another  hospital
immediately,  where  facilities for  management  (treatment,  investigations)  of  that
emergency/critical  condition  exist,  the  same  can  be  considered  from  AMO.  However,  the
employee / his family  member should intimate the occurrence  of  the event at the earliest to
the AMO or nearest Railway Medical Officer”.

Para  648  (3)  (I)  In  the  last  line,  above  (a):  replace  the  words “parameters are  to  be
examined” with the words “parameters may be examined”.

Para 648 (3) (1) (a) replace (iv) with (iii) in ACS to Board’s letter No. 2005 / H/6-4/Policy – II
dated 31.1.2007

Para 648 (3) (1) (b) Replace  the first  sentence as under:  “Clinical findings at  the time of
admission. Following findings should be examined and critically evaluated.”

Para  648  (3)  (1)  (b)  Replace  the  existing  numbering  (xi)  to  (xx)  with  (i)  to  (x)  Add  (d)
after para 648(3) (1) (c) as under:

“(d)  If  any  of  the  above  parameter/s is not  available  for  examination,  conclusion  regarding
emergency should be made on other available parameters.”

(Authority: Board’s letter No. 2005/H/6-4/Policy II dated 22-6-10)
SOURCE;IRTSA

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