THE ALL INDIA SERVICES (MEDICAL ATTENDANCE) RULES, 1954
Rule 14. Saving. -
Government of India Decisions
1. Government has inherent power to grant any concession in deserving cases which are otherwise not provided in these rules: -
The effect of clause (i), as far as the member of the Service is concerned, is that he is not entitled to reimbursement of any cost ‘otherwise’ than as expressly provided in these rules. But, so far as the Government is concerned, its inherent power to grant, in suitable and deserving cases, ‘any’ concession relating to medical treatment or attendance not authorised by the rules is expressly saved by clause (ii). The expression not authorised must be construed to mean ‘not sanctioned’ or ‘not justified’ by these Rules.
[G.I. MHA letter No. 7/10/61-AIS (III), dated 10-07-1961.]
2. Reimbursement of expenditure other than a Government hospital can be granted in exceptional circumstances by the State Government: -
Clause (ii) can be invoked by the State Government for granting to a member of the Service reimbursement of expenditure incurred by him for the treatment of a member of his family in a hospital other than a Government hospital outside the State provided very exceptional circumstances justify such action.
[G.I. MHA letter No. 7/13/62-AIS (III), dated 01-02-1962.]
3.1. Additional concession can be granted by the State Government in individual, deserving and suitable cases for treatment abroad: -
Clause (ii) does not empower the Government to grant to the members of the All India Services general additional concessions not covered by the rules. But they can grant in individual, deserving and suitable cases any concession within or outside the framework of the rules. Accordingly the State Government can under this rule, permit reimbursement of the cost of medical treatment and attendance taken abroad in a suitable and deserving case, even though it is outside the scope of the rules as laid down in rule 1(2). In such cases, however, the Government of India do not, as a matter of principle, accept any liability, though, in very special cases, they make payment equivalent to what proper treatment would have cost in India itself.
2. The powers under clause (ii) can be exercised by the State Government without any limitations. Rule 13 of these rules does not control the action of the State Govt. in such cases. It is also not necessary for them to consult the Central Government in this regard.
[G.I. MHA F. No. 8/62/62-AIS (III), dated 29-08-1962.]
4. Guidelines to be adopted in dealing with cases relating to Medical Treatment abroad:-
The question of reimbursement of expenses incurred over treatment abroad for Central Government employees has been further considered and it has now been decided that the guidelines as in the annexure to Department of Personnel and A.R. letter No. 11023/7/83-AIS (III), dated 7th November 1983 (reproduced below) should be adopted in dealing with the cases relating to request for medical treatment abroad.
2. The above decision also applies to members of the All India Service serving at the Centre.
3. The State Government have been requested to consider adopting the same policy in respect of the members of All India Services working in connection with the affairs of the State as well as the State Government employees.
[G.I. DP&AR letter No.11023/7/83-AIS(III), dated the 7th November 1983.]
Guidelines to be adopted in dealing with cases relating to Medical Treatment abroad.
(i) As a rule, reimbursement of cost of medical treatment incurred abroad should not be allowed.
(ii) In exceptional cases necessitating treatment of a kind yet to be widely established in the country, where Government servants on medical advise choose to go on their own for treatment abroad, reimbursement could be authorised by the Director General of Health Services but should be limited to the expenditure that would have been incurred had such treatment been received in India in a Government Hospital or in a private hospital or nursing home specially recognised and accepted by the Director General of Health Service. The question of reimbursement of air passage in such cases should not arise at all.
(iii) Foreign exchange may be released to Government servants for purpose of treatment abroad to the same extent as is permissible to private citizens.
(iv) Hospitals and clinics indicated in paragraph 3 below have facilities for specialist treatment for which requests are generally received for treatment abroad and in ordinary of which treatment facilities in ordinary Government hospitals are still inadequate. The services provided by these hospitals may be availed by eligible Government servants. In such cases reimbursement should be allowed subject to D. G. H. S. being satisfied about the reasonableness of the claim.
(v) Pending cases of reimbursement claims may be dealt with on the basis of the guidelines indicated in (i) to (iv) above.
NOTE.- Only those cases which may have been brought up for consideration on or after 9th February, 1982 and not finally decided by that date would be deemed to be pending cases to qualify for such consideration.
2. The following ailments have been identified by the D. G. H. S. as being such for which facilities for treatment in India are not yet widely established.
(i) Cadaver Kidney Transplant.
(ii) Old operated by-pass surgery cases (in which the initial operation was done abroad) needing revascularization.
(iii) Bone Marrow transplant.
(iv) Operative correction for high myopia cases.
(v) Complex cyanote-Heart-Lesion and newly born infants suffering from heart diseases.
2.1 To consider cases of the above type, a Medical Board should be constituted at the State level by the State Director of Health Services. The Board should make specific recommendations and also give reasons for recommending treatment abroad. It should also certify that the treatment is not available in India. The certificate should be endorsed by the Director of Health Service, and sent to the Director General of Health Services, New Delhi, for his approval:
2.2 For purposes of reimbursement, as envisaged in these guidelines, the schedule of charges as applicable for private ward treatment at the All India Institute of Medical Sciences, New Delhi, in force from time to time should be adopted.
3. The following Institutions have been identified as having facilities for specialist treatment:-
(a) Bye-pass coronary surgery:
(i) Southern Railways Headquarters Hospitals, Perambur, Madras.
(ii) Christian Medical College and Hospital, Vellore.
(iii) K. E. M. Hospital, Bombay.
(iv) Jaslok Hospital, Bombay.
(v) Bombay Hospital, Bombay.
(vi) Kasturba Hospital, Bhopal.
(vii) Sree Chitra Tirunal Institute of Medical Sciences and Technology, Trivandrum.
(b) Kidney Transplant:
(i) Christian Medical College & Hospital, Vellore.
(ii) All India Institute Of Medical Sciences, New Delhi.
(iii) Post Graduate Institute, Chandigarh.
(iv) Jaslok Hospital, Bombay.
(c) Blood Cancer:
(i) Tata Memorial Hospital, Bombay.
(ii) Cancer Institute, Adayar, Madras.
(d) Complicated heart surgery cases:
(i) Southern Railway Hospital, Perambur, Madras.
(ii) Christian Medical College & Hospital, Vellore.
(iii) K. E. M. Hospital, Bombay.
(iv) All India Institute of Medical Science, New Delhi.
(v) Bombay Hospital, Bombay.
(vi) G. B. Pant Hospital, Delhi.
(vii) Sree Chitra Tirunal Institute of Medical Sciences and Technology, Trivandrum.
(viii) Post Graduate Institute, Chandigarh.
(ix) S. S. K. M. Hospital, Calcutta.
(x) Samaritan Hospital, Alwaye (Kerala).
(xi) Kasturba Hospital, Bhopal (BHEL).
(xii) N. M. Wadia Institute of Cardiology, Pune.
5. State Governments can issue executive instructions under this rule granting general additional concessions under the residuary powers in respect of officers serving in connection with the affairs of the State: -
The Government of India have held that executive instructions giving general additional concessions in the matter of medical treatment and attendance to the members of the All India Service (Medical Attendances) Rules, 1954, can be issued by the State Government not under rule 14 (ii) of the said Rules but under the residuary powers resting with the State Governments in respect of officers serving in connection with the affairs of the States.
[G.I. MHA letter No. 7/10/63-AIS(III), dated September, 1963.]
6. Reimbursement of the cost of medical treatment taken from a private practitioner can be allowed in exceptional cases if the State Governments are satisfied with the circumstances: -
The Govt. of India have held that ordinarily a member of the Service is expected to receive treatment from the ‘Authorised Medical Attendant’ which term includes ‘the principal medical officer’ appointed by the Government to attend its officers, a medical officer equal in rank or immediately junior to such principal officer and attached to the same hospital or dispensary.
In exceptional cases, however, re-imbursement of the cost of medical treatment incurred on the advice of the private practitioner can be reimbursed by the State Government by invoking Rule 14(ii) of the A.I.S. (Medical Attendance) Rules, 1954, if the State Government are satisfied of the existence of special circumstances in which treatment could not be had through the Authorised Medical Attendant and the refusal to re-imbursement such cost, is likely to cause undue hardship to the officer. In so far as Central Government employees are concerned, their cases are regulated in terms of Ministry of Finance O.M. No. 2192-EV(5)/62. dated the 17th April, 1963.
[G.I. MHA letter No. 7/10/63-AIS (III), dated 10-08-1964.]
7. No limit on the amount of reimbursement by the controlling officer has been prescribed:-
The Government of India have held that no limit has been prescribed for the amount upto which the controlling officer can allow re-imbursement either under the A.I.S. (Medical Attendance) Rules, 1954 or the Central Services (Medical Attendance) Rules, 1944. However sanction of the Government will be necessary if the claim is admitted in terms of rule 14(ii) of the A.I.S. (Medical Attendance) Rules, 1954.
2. The State Government are the competent authority to regulate such procedural matters.
[G.I. MHA letter No. 7/2/65-AIS (III), dated 20th April, 1965.]
8. State Governments are competent to grant any additional concession and to allow reimbursement not authorised under this rule in deserving cases: -
The Government of India have held that under rule 14(ii)-
(i) The State Governments are themselves competent to grant to an All India Service officer serving in connection with the affairs of the State any concession relating to medical attendance or treatment, which is not authorised under the A.I.S. (Medical Attendance) Rules 1954. The State Government can, therefore, grant ‘Nursing Home’ facilities to a member of the Service serving in connection with the affairs of the State under this rule.
(ii) It is open to the State Government to allow re-imbursement of expenses when treatment has been taken from a doctor other than the Authorised Medical Attendant in case of emergencies due to the non-existence of any Government/recognised hospital within a reasonable distance from the place where the patient fell ill.
[G.I. MHA letter No. 7/7/61-AIS (III), dated the 26th April, 1961.]