Chhattisgarh Civil Services (Medical Attendance) Rules, 2013

Published vide Notification No. F 21-5/2010/9/55, dated 14th March, 2013

Last Updated 16th October, 2019 [cg219]

Notification No. F 21-5/2010/IX/55 dated the 14th March, 2013. - In exercise of the powers conferred by Article 309 of the Constitution of India, the Governor of Chhattisgarh, hereby, makes the following rules for regulating the medical attendance and treatment of employees employed under the State Government, namely:-

1. Short title and commencement. - (1) These rules may be called the Chhattisgarh Civil Services (Medical Attendance) Rules, 2013.

(2) These rules shall come into force from the date of their publication in the Official Gazette.

2. Scope and application. - (1) These rules shall be applicable to the following :-

(a) all Government Servants under the control of State Government when they are on Government duty or on deputation or under training or on leave or under suspension or posted outside the State of Chhattisgarh;

(b) employees employed on contract basis;

(d) full-time employee getting salary from contingency establishment;

(e) member of work-charge establishment continuously employed on monthly salary in all departments or in the projects initiated by the State Government;

(f) Judicial Officers, subject to rules/orders/modifications issued by the Law Department, from time to time, keeping in view the directions issued by Hon'ble the Supreme Court of India in the matter of All India Judges Association v. Union of India, AIR 2002 SC 1752.

(2) These rules shall not be applicable to the following

(a) retired employees;

(b) part-time employees;

(d) daily wages employees;

(e) members of All India Services.

3. Definitions. - In these rules, unless the context otherwise requires,-

(a) "Authorised Medical Attendant" means the medical officer as defined under rule 3(h) of these rules;

(b) "AYUSH" means the Ayurved, Yoga and Naturopathy, Unani, Siddha and Homeopathic system of medicine;

(d) "Family" means-

(i) wife or husband of an employee;

(ii) employee's parent, minor son, unmarried daughter, in which legally adopted child/children and step child/children is/are also included, who is/are fully dependent on the employee;

(iii) if a divorced daughter(s) is/are fully dependent on the employee then, she/they shall be treated as included in his/her family for the purpose of medical re-imbursement;

(iv) the parents of a woman employee who are fully dependent on her, residing generally throughout year along with the woman employee and they have no other support except her and also no any other source of income :

Provided that a written declaration should be taken from the woman employee in this context, that her parents are fully dependent on her and they reside with her and they have neither any other source of income nor they have any other support;

(v) in case of specialized treatment, the pensioner parent of the government servant shall also be considered as included in the family.

(e) "Form" means Form appended to these rules;

(f) "Hospital" means-

(i) a hospital maintained by the State Government or Local Authority;

(ii) any other hospital aided financially by the State Government;

(iii) such private hospitals which have been recognized as hospital under these rules.

(g) "Medical College Hospitals" means the Government Allopathy, Dental, AYUSH Medical College Hospital or any other medical college hospital aided financially by the State Government, which have been recognized for the purpose of these rules;

(h) "Medical Officer" means Civil Surgeon, Specialist Doctor posted in hospital, Medical Officer, AYUSH Medical Officer or AYUSH Assistant Medical Officer, Casualty Medical Officer of Medical Colleges, as the case may be, and such member of teaching cadre of Medical College Hospital is also included in this, who treats the patients in the hospitals attached to such colleges;

(i) "State Government" means the Government of Chhattisgarh;

(j) "Specialized Treatment" means treatment and/or surgery of diseases mentioned in Schedule-I, which may be amended by the State Government from time to time;

(k) "Treatment" means all the medical and surgical treatment, facilities which are available and used in the hospital, where an employees is treated and it includes the following :-

(i) pathological, Bacteriological, X-ray related diagnosis and treatment, Radio Imaging or use of any other such diagnosis which are considered necessary by the Authorised Medical Officer/ Attendant;

(ii) supply of such medicines, vaccines, serum and other medical articles, which should be generally available in the hospital;

(iii) such treatments which are generally made available by the hospital to in-patients;

(iv) blood transfusion;

(v) ultra-violet light,

(vi) general nursing,

(vii) dialysis and haemodialysis,

(viii) lithotripsy,

(ix) in case of women-

(a) treatment during maternity, antenatal and postnatal treatments;

(b) douching;

(x) panchkarma and kshar-sutra treatment;

(xi) such other facilities which are being notified from time-to-time by the State Government.

4. Treatment by Authorised Medical Attendant. - An employee shall be entitled for free medical treatment/services or Authorised Medical Attendant.

5. Treatment of mental patient. - An employee suffering from mental disease shall be entitled for free medical treatment, accommodation and diet for the maximum period of two years from the date of admission into any hospital of the State Government, or Government Mental Hospital, as the case may be.

6. Treatment and re-imbursement. - (1) The Medical Officer-in-Charge of hospital may keep the patients in such ward as he deems fit.

(2) The employees shall be entitled for free treatment, free flood grouping and blood cross-matching in the hospital, if the amount is paid by the employees for such treatment, accommodation or for any other reason in the hospital, then its re-imbursement shall be made upto such extent which are provisioned in these rules.

(3) The employees shall firstly, make the payment of bill(s), if any, for the treatment, service, room rent or any other charge(s), and then only he/she can claim for the reimbursement after having obtained countersign by the Medical Officer concerned under these rules.

7. Limitations to re-imbursement. - A Government servant shall be entitled for reimbursement upto following limit(s) for the expense(s) incurred by him/her in relation to medical service, treatment, nursing and accommodation purpose :-

(1) In the case of out-door patient, cost in full after buying the medicines as prescribed by the Authorized Medical Attendant, but-

(i) such employees, who are receiving medical allowances as prescribed by the State Government shall not be entitled for the reimbursement of medical expenses incurred under these rules,

(ii) for other cases, apart from para (1) above-

S. No.	Amount	Competent Authority	Conditions
1.	1,500/-	Controlling Officer.	Four times in a Financial Year with the limit of 3 months at a-stretch.
2.	From 1,501/- to 5,000/-	For District-Civil Surgeon/ District Ayurved Officer, as the case may be. For Medical College- Superintendent/Deputy Director or Officer authorized by him.
3.	From 5001/- to 25,000/-	Divisional Joint Director, Health Services, Chief Medical and Health Officer, Concerned Subject Specialist/District Ayurved Officer and possible AYUSH subject specialist.
4.	25,001/-and more	Director Health Services, Director AYUSH, Director Medical Education after the recommendation of a committee of three specialists constituted in the Directorate of concerned system.

(2) cost incurred upto the limit provisioned under rule 8 on treatment in case of in-door patient;

(3) the provision of rule 7(1)(ii) mentioned above shall not be applicable in case of reimbursement of bills relating to those patients, who are suffering from those diseases for which the concerned Chief Medical and Health Officer/District Ayurved Officer has issued a certificate in the prescribed format that the treatment may be continued for a prolonged period or may continue for a long period;

Note. - Such Certificate shall not be issued for a period of more than one year at first time, but its renewal may be made from time to time for . such period as may be necessary, which shall not be for more than a . period of one year at a time and Chief Medical and Health Officer/District Ayurved Officer shall maintain register of each with the specification of certificates issued by him, in such form as maintained by the Government.

(4) total expenditure incurred on providing Oxygen;

(5) the expenditure incurred on purchase of blood, for blood transfusion;

(6) total expenditure incurred for treatment during maternity in which Antenatal and Postnatal treatment and Abortion treatment is/are included;

(7) total expenditure incurred in I.C.U.;

(8) the expenditure incurred in relation to room rent in the hospital, in which the expenditure to be incurred on electricity or electric fan(s) where it is/they are generally part of hospital facilities i.e. where it is/they are part of ward or room, shall be full in case of Class-IV Government Servants and the employees obtaining their salary from casual establishment and in other cases it shall be 50 percent only;

(9) total expenditure incurred on Surgery and Pathological, Bacteriological, X-ray related diagnosis and treatment, Radio Imaging and on other tests/ examinations, which is/are deemed necessary by Authorized Medical Attendant and a certificate has been issued accordingly;

(10) the expenditure incurred by Government Servant(s) in relation to utilization of ambulance or any other vehicle shall not be reimbursed;

(11) the cost of requisite equipments like caliper, artificial part(s) shoes of deformed leg(s), handicapped bandage/plaster, neck collar, hearing aids etc. shall be borne by the Government at first time;

(12) total expenditure incurred on Panchkarm and kshar-sutra treatment.

8. Rate of treatment. - The re-imbursement of the expenditure incurred on diagnosis and treatment carried out on in-patient in a Private Hospital shall be reimbursed upto the rates prescribed from time to time for B-l category city by the Central Government Health Services, New Delhi or actual expenditure, whichever is less. Where the rates of facilities are not prescribed by the Central Government Health Services, in such cases, the State Government may prescribe rates.

9. Medical advance. - (1) A medical advance upto maximum limit of 80 percent may be sanctioned by Competent Officer of the concerned department on recommendation of District Civil Surgeon/District Ayurved Officer, as the case may be, under the provision of rule 8 and rule 9(3) of these rules, for the treatment in private hospitals recognized within the State/outside the State. For this, the employee has to submit expenditure estimate having received from concerned hospital.

(2) The medical advance shall be sanctioned only in those cases where the treatment of the patient is being carried out or to be carried out in the hospital recognized by the State Government for this purpose as an in-patient and a referral certificate has been obtained in the case.

(3) The eligibility for medical advance shall be on estimated medical expense of Rs. 30,000/- or more in case of Class-I and Class-II Officers and Rs. 15,000/- or more in case of Class-III and Class-IV employees.

(4) The sanctioned medical advance shall be made available directly to the concerned hospital, which shall be adjusted in Medical Re-imbursement Bill.

(5) The final adjustment of medical advance has to be made by employee receiving advance within one month period from the date of discharge of patient from the hospital, otherwise it shall be the duty of the head of the office to recover the dues from the employee's salary.

(6) The unadjusted amount of medical advance shall be recovered from employee's salary or from other source of income of the employee.

(7) The withdrawal of advance amount cannot be made before 15 days of actual need.

(8) This delegation shall not be applicable to the treatment carried out in foreign country.

10. Referral for investigation/treatment. - (1) Investigation/treatment of the employee(s) or their family member(s) shall generally be carried out in Primary Health Centre, Community Health Centre, District Hospital/AYUSH dispensaries. District AYUSH Hospitals.

(2) In case of non-availability of requisite facilities in the said centres, Civil Surgeon/District Ayurved Officer, as the case may be, may refer to Medical College Hospitals of the State or to the Private Hospital recognized by the Government.

(3) In case of non-availability of facility of investigation/treatment of concerned field/subject specialist in Medical College Hospital, Joint Director-cum-Superintendent/ Deputy Director, as the case may be, may refer to Government/recognized Private Institutions.

(4) Medical Institutions recognized under various schemes of Health Department and the Institutions functioning under Public-Private-Partnership (PPP) Policy shall be considered as recognized for the treatment of government servants, there shall be no need of referral for the treatment in the said Institutions.

(5) The Government Hospitals of other States shall also be considered as recognized hospitals.

(6) Only recognized Medical Institutions are valid for follow-up treatment, the competent approval, as needed in this context, has to be obtained.

(7) In case of emergency cases, the applicant/family member must intimate to Director Medical Education/Director AYUSH, as the case may be, and to Head of Department of concerned department within the time-limit of 48 hours from the commencement of treatment.

11. Post-facto sanction. - (1) In emergency circumstances, in cases of treatment obtained in recognized private hospitals located within the State or outside the State, a post-facto sanction has to be obtained. In absence of post-facto sanction, no reimbursement of the expenses incurred for treatment in such cases may be made.

(2) The case regarding post-facto sanction shall be sent to Director Medical Education/Director AYUSH, as the case may be, after duly investigated by Controlling Officer of employee, having made its abrogation on the basis of merits/demerits, post-facto sanction shall be issued by the Director Medical Education/Director AYUSH.

(3) The cases of post-facto sanction of the treatment obtained from non-recognised private institutions within the State/outside the State shall be sent to the State Government, Health and Family Welfare Department with the recommendation of Director Medical Education/Director AYUSH, as the case may be, for abrogation.

(4) Director Medical Education/Director AYUSH can constitute a Specialist Committee for the investigation of the cases of post-facto sanction.

(5) The following committee shall be constituted as under for the abrogation of cases of post-facto sanctions at State Government level;-

1.	Principal Secretary/Secretary, Health and Family Welfare Department.	- Chairman
2.	Director, Medical Education	- Member
3.	Director, AYUSH	- Member
4.	Director, Health Services	- Member
5.	Representative of Finance Department (Officer not below the rank of Deputy Secretary)	- Member
6.	Two Subject Specialists (Nominated by the State Government)	- Member

12. Recognition to Private Institutions for investigation/treatment. - (1) The Private Medical Institutions located within the State or outside the State may apply to Director Medical Education/Director AYUSH, as the case may be, in prescribed form along with fees as prescribed from time to time by the State Government for getting their institutions recognized for the investigation/treatment of employees.

(2) After duly scrutinising, the application(s) received for recognition, it/they shall be inspected by a Committee constituted by Director Medical Education/Director AYUSH, as the case may be.

(3) On the basis of advice given by Director Medical Education/Director AYUSH, as the case may be, the State Government may grant recognition to Private Medical Institutions located within the State/outside the State.

(4) The State Government may constitute a high-level Committee for the purpose of granting recognition to Medical Institutions of National level or renowned Private Hospitals of different discipline for the treatment of specific disease(s) considering the availability of high quality treatment facilities in the Medical Institutions of National level or renowned Private Hospitals, after the recommendation of such Committee the State Government may grant recognition to such institutions.

13. Claim for medical re-imbursement. - (1) For medical expenses reimbursement an application in Form-I shall be submitted to Controlling Officer within a period of six months from the date of incurring expenses :

Provided that where the employee himself is Controlling Authority, the calculation of six months period shall be made with reference to date of submission of demand to the Treasury Officer.

(2) Alongwith each application submitted under sub-rule (1) of this rule, the requisite certificate in Form-II duly signed by Authorised Medical Attendant and cash memo receipt in relation to the payments for the expenditure of the treatment and room rent duly countersigned by him shall be submitted :

Provided that where the medicines prescribed by Authorised Medical Attendant are out of the rate list of medical stores depot, in such cases, where he himself is not Authorised Medical Attendant, the requisite certificates shall be countersigned by the Civil Surgeon/District Ayurved Officer, as the case may be :

Provided further that having obtained treatment in Medical College, it shall be countersigned by Controlling Officer, Joint Director-Cum-Superintendent/Deputy Director of the Hospital.

14. Record of treatments. - The Authorised Medical Attendant shall keep the details of treatment performed by him or date of investigation and place in a diary and memo in relation to each employee, which shall be the basis of certificate given by him in Form-II.

15. Abrogation of claims. - (1) Under these rules, the requisition of medical expenditure re-imbursement of employee shall be abrogated by concerned Drawing and Disbursement Officer (D.D.O.).

(2) The Controlling Authority, who is competent to countersign on T.A. Bills of concerned employee, shall make countersign on such Bills. It shall be duty of Controlling Authority that prior to signing or countersigning on requisition relating to medical expenses, he should examine carefully that the requisition is factual and are as per rules, and necessary cash memo, receipts, certificates etc. are attached in support of expenditures claimed. The Controlling Authority may reject such claims which are not as per rules.

(3) The amount due on account of re-imbursement of medical expenses incurred shall be drawn on Form C.G.T.C. 24A and shall be payable to the applicant/claimant.

(4) The expenditure related to medical service and treatment, shall be debitable in the "In re-imbursement of Medical expenditure" Detailed Head 015 under "Pay and Allowances etc." Object Head 01 under related Principal Head, but in the case of members of work charged establishment that expenditure shall be debitable directly under the related work accounts.

16. The limit of treatment of family members of an employee. - (1) These rules shall be applicable to the family members of an employee through the same mode/ procedure and upto the same limit as they are applicable to the employee by such mode/procedure and prescribed limit:

Provided that where any employee has three or more surviving children, then the third child and onward shall not be entitled to get permissible re-imbursement under these rules, but such third child born prior to 26th January, 2001 shall also be entitled for permissible medical re-imbursement under these rules :

Provided further that in case of birth of twins children in the case of second delivery, both the children shall be entitled for medical re-imbursement.

(2) The employees shall also be entitled for the re-imbursement of expenses incurred for treatment during maternity (in which pre-natal and post-natal treatment and abortion treatments are also included):

Provided that if three or more children are alive on the date of such delivery, then no re-imbursement shall be made.

17. Interpretation. - If any query/question arises relating to the interpretation of these rules, it shall be referred to the State Government, whose decision thereon shall be final.

18. Relaxation. - The relaxation of these rules shall not be made generally, but in exceptional cases the State Government shall have right to relax the rules.

19. Power to amend the rules. - The State Government may amend/modify the rules from time to time as considered necessary.

20. Repeal and saving. - The Chhattisgarh Civil Services (Medical Attendance) Rules, 1958, shall be deemed as repealed on these rules coming into effect:

Provided that these rules shall not have any effect on any work done or action taken under rules so repealed. The clarifications/directions/guidelines issued under the Chhattisgarh Civil Services (Medical Attendance) Rules, 1958, shall apply to these rules to the extent they are not inconsistent or contrary to these rules :

Provided further that all the requisitions regarding medical re-imbursement prior to coming into effect of these rules shall be governed by previous rules applicable to concerned employees.

Schedule-I

[See rule 3(j)]

1. All types of Cancer Diseases,

2. All types of Heart Diseases (Open Heart Surgery/Bypass Surgery, Angioplasty with Stent, Angioplasty without Stent, etc.),

3. Organ Transplantation,

4. Complicated Ophthalmic Surgery,

5. Neuro-surgery,

6. Joint Replacement Surgery,

7. Such treatment and/or Surgery, which is not available in Government or Recognized Hospitals in the State and for which, the patient has been referred to the hospital situated outside the State.

Form-I

Form of Application for Medical Re-Imbursement

[See Rule 13 (1)]

(N.B.-Separate Form should be used for each patient)

1.	Name and designation of the Government Servant (in block letters).	…..................................................................................
2.	Office in which employed	…..................................................................................
3.	Pay of the Government servant as defined in the Fundamental Rules, and any other emoluments, which should be shown separately	…..................................................................................
4.	Place of duty	…..................................................................................
5.	Actual residential address	…..................................................................................
6.	Name of the patient and his/her relationship to the Government servant
	(in the case of children, give the following information also namely):-
	(i) Date of birth	…..................................................................................
	(ii) Number in order of birth	…..................................................................................
	(iii) Total number of children	…..................................................................................
7.	Place at which patient fell ill	…..................................................................................
8.	Nature of illness and its duration	…..................................................................................
9.	Details of the amount claimed :-	…..................................................................................
	I-Medical attendance :-
	(i) Fees for consultation indicating :-
	(a) The name and designation of the Medical Officer consulted and the hospital or dispensary to which attached.	…..................................................................................
	(b) The number and dates of consultations and the fees paid for each consultation.	…..................................................................................
	(c) Whether consultations were held at the hospital, the consulting room of the Medical Officer or at the residence of the patient.	…..................................................................................
	(ii) Charges for pathological, bacteriological, radiological or other similar tests undertaken during diagnosis indicating :-
	(a) The name of the hospital or laboratory where the tests were undertaken, and	…..................................................................................
	(b) Whether the tests were undertaken on the advice of the authorised medical attendant; and if so, a certificate to that effect should be attached.	…..................................................................................
	(iii) Cost of medicines purchased from the market.	…..................................................................................
	(list of medicines, cash memos and the essentiality certificate should be attached).	…..................................................................................
	II-Hospital treatment:-
	Charges for hospital, treatment, indicating separately the charges for-
	(i) Accommodation (state whether it was according to the status or pay of the Government servant and in cases where the accommodation is higher than the status of the Government servant, a certificate should be attached to the effect that the accommodation to which he was entitled was not available).	…..................................................................................
	(ii) Diet	…..................................................................................
	(iii) Surgical operation or medical treatment	…..................................................................................
	(iv) Pathological, bacteriological, radiological or other similar tests indicating :-	…..................................................................................
	(a) the name of the hospital or laboratory at which undertaken; and	…..................................................................................
	(b) whether undertaken on the advice of the medical officer-in-charge of the case at that hospital. If so, a certificate to the effect should be attached.
	(v) Medicines	…..................................................................................
	(vi) Special medicine	…..................................................................................
	(list of medicines, cash memos and the essentiality certificate should be attached).
	(vii) Ordinary nursing	…..................................................................................
	(viii) Special nursing, i.e., nurses, specially engaged for the patient. State whether they were employed on the advice of the Medical Officer in-charge of the case at the hospital or at the request of the Government servant or patient. In the former case a certificate from the M.O. I/c of the case and countersigned by the Medical Superintendent of the hospital should be attached.	…..................................................................................
	(ix) Any other charges e.g., charges for electric lights, fans, heaters, air conditioning, etc. State also whether the facilities referred to are a part of the facilities normally provided to all patients and no choice was left to patient.	…..................................................................................
	Note.-If the treatment was received by the Government servant at his residence, give particulars of such treatment and attach a certificate from the authorised medical attendant.
10.	Total amount claimed
11.	List of enclosures

Declaration to be signed by the Government Servant

I hereby declare that the statement in application are true to the best of my knowledge and belief and that the person for whom medical expenses were incurred is wholly dependent upon me.

Dated...........200....

Signature of the Government servant

and Office to which attached

Form-II

Form of Essentiality Certificate

[See Rule 13(2)]

A-In case of medicines not included in the priced Vocabulary of the Medical Stores Depot.

Certified that Shri/Shrimati/Kumari..............................Son/Wife/Daughter of Shri....................employed in the.....................has been under my treatment from.................to...............for...................(name of the disease) at the .....................hospital as indoor/outdoor patient and that the undermentioned medicines have been prescribed by me in this connection. These medicines are not included in the priced Vocabulary of the Medical Stores, nor are the preparations which are primarily food, toilets or disinfectant. These medicines were absolutely essential for the treatment of the aforesaid patient:-

Name of the Medicines

(1)	........................................	........................................	........................................
(2)	........................................	........................................	........................................
(3)	........................................	........................................	........................................
(4)	........................................	........................................	........................................
(5)	........................................	........................................	........................................
(6)	........................................	........................................	........................................

Signature and designation of the authorised Medical Attendant/
Signature of the Medical Officer I/c. of the case at the hospital.

B-In case of medicines included in the priced Vocabulary of the Medical Stores Depot.

Certified that Shri/Shrimati/Kumari................................Son/Wife/Daughter of Shri........................employed in the..................has been under my treatment, from.................to..................for..................(name of the disease) at the .....................hospital as indoor/outdoor patient and that the undermentioned medicines have been prescribed by me in this connection. These medicines are included in the priced Vocabulary of the Medical Stores, and are out of stock/not available in the..................hospital (They do not include any medicines proprietary/or otherwise outside the aforesaid priced vocabulary nor are the preparations which are primarily food, toilets of disinfectants).

	Name of medicines	P.V.M.S. No.	Cost
	(1)	(2)	(3)
			Rs.	P.
(1)	…...............................................	…...............................................	…...............................................
(2)	…...............................................	…...............................................	…...............................................
(3)	…...............................................	…...............................................	…...............................................
(4)	…...............................................	…...............................................	…...............................................
(5)	…...............................................	…...............................................	…...............................................
(6)	…...............................................	…...............................................	…...............................................

Signature and designation of the authorised Medical Attendant/
Signature of the Medical Officer I/c. of the case at the hospital.

C-In case of Insulin Treatment

Certified that Shri/Shrimati/Kumari...........................Son/Wife/Daughter of Shri/ Shrimati...................has been under my treatment for diabetes at my hospital and that insulin prescribed by the.......................................was for treatment during the initial stage/in the hospital of the disease, for which no reimbursement has been made extending over the period from..............................................the patient having developed complications necessitating hospitalisation.

Authorised Medical Attendant/
Medical Officer I/c. of the case at hospital.


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