HYDERABAD: The Chief Minister N Kiran Kumar Reddy, as per
his assurance to the Government Employees, today decided to provide
comprehensive health care to all Government Employees, Pensioners, and their
family members, on cashless basis through an appropriate scheme in lieu of
present medical reimbursement system.
In order to implement the Scheme effectively, the
Government has held a series of meetings with the Joint Action Committee of
Employees, Teachers, Workers and Pensioners, and A.P. Secretariat Employees'
Coordination Committee representatives to discuss the scheme and its
implementation modalities. Based on the inputs received during these meetings,
the Government has decided to operationalise the scheme for comprehensive
health care for employees, pensioners and their families in a time-bound
Accordingly the Government constituted a Committee with
Commissioner, Health & Family Welfare, Y. Srilakshmi as Chairperson and CEO,
Arogyasri as Member-Convener and other officials concerned as members to
analyse all aspects of the scheme and make comprehensive recommendations for
its effective implementation.
The Committee will conduct a series of focus group
discussions with specialists from the Government and Private Hospitals,
representatives of employees and pensioners, with the administrators of the
private and public sector hospitals, experts on health insurance, health
economists, IRDA officials and insurance companies to consider all aspects of
the scheme and make appropriate recommendations with the following
Define the contours and content of comprehensive health
cover for employees - both current and retired - and their families, duly
considering the benefits provided under the existing regime; Review the
existing medical reimbursement scheme with reference to its coverage, content,
costs, methodology, institutional arrangements, etc., and recommend appropriate
design in terms of coverage - diagnostic, curative, rehabilitative, supportive
care - quality of care, cost of care, institutional architecture for efficient
management of cashless medical packages in order to extend the coverage to all
employees and pensioners eligible under the existing reimbursement scheme.
Defining the packages for high-end high cost procedures
such as replacement and transplant surgeries. Identify, design and recommend
protocols and packages for chronic ailments such as Hypertension, Diabetes,
Rheumatoid Arthrities, etc., requiring long term on out-patient basis and
recommend the content of preventive health check-ups. Methodology for approval
of treatment costs above the financial limit prescribed by the Government and
the modalities for treatment outside the state for employees and pensioners
living in boarder districts and outside the State, including New Delhi. Examine
the existing referral system and recommend appropriate system for the referral
of employees - both serving and retired - and their family members, along the
health service system. Recommend the most effective and efficient
institutional architecture for implementation of the scheme. Identify and
enumerate the risk factors that could affect the implementation of the scheme.
While the above process is under way, the Government
directs the Chief Executive Officer of Arogya Sri Health Care Trust to launch
the process for issue of Health Cards for the serving and retired employees and
their families in consultation with all concerned.