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,li No.2/8/88-1HB-III

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Financial Commissioner principalSecy. Govemment, & to Haryana, Health& MedicalEducitionDepartment All Headsof Departments The Commissioners, Ambala,Hisar,Rohtakand Gurgaon Division The Registrar,Punjab& HaryanaHigh Court,Chandigarh All Deputy Commissioners Haryana in All Sub-Divisional Officers(Civilj in Haryana Dated,Chandigarh, 2nd the May,2()11 Empanelment hospitalsand rerirnbursement medical expenses of of for Haryana Government employees/pensioners their dependents. and
In continuation of the State Gor,'ernment, Health Department letter No.2/g/gg-

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1HBIII dated 6th May. 2005, the Government has decided to amend the existing policy of empanelmenrof hospitals and reimbursementot' medical expenditure incurred by the Haryana Govemmentemployees/pensioners their dependents, follows; and as I I A$diition in the list of emBanell*d hospitg.lg ,-...r:. All existiqs e;rtoanelledi-rosDitals i'.'i!1 ::ue tc prc.;ijc serviccs i.isircitrc oil iile Same

terms and conditions but with modifications as specifiedin this policy. 2' The below listed hospitals are hereby empanelled in addition to the already empanelled

hospitals:-

S. No. z
J

Nameof the Hospital

,A,rtemis Medicare ServicesLimited. Sec.51.Gurgaon

4 5
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AsianInstituteof Medicalsciences. BadkalFlyoverRoad,Sector -A. Faridabad 2l GlobalHealthPrivateLtd., Sector-38. Gureaon Itaipur GoldenHospsital, 2-Institutional Area.Sec.lII"RohiniNew Delhi lv{ M, Institute MedicalSciences Research. of & Muliana(Ambala) Paras Hospsitaols, Sushani C-I, Lok, Sec.43. Phase-I, Gursaon
PushpanjaliHospital, John Hall Road, L-ivil Lines, Gurgaon

7 8
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DelhiHeart LungInstitute, MM-ll^ Panchkr-rian New Delhi & 3 Road,

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l,{CJJindal Instituteof Medical Care& Research. Model Town. Hisar lvlirpur ILslitute of Medical Sciences, V.Mirpur, Rewari FC-34,A-4, Paschim Vihar,New Delhi liri Balaji Action MedicalInstitute, FortisEscortsHeart Institute& Research CentreLtd.. Okhla Road-New Delhi FortisEscort tal, Neelam Bata Road. NlT. Faridabad Siun Hospital& Research Centre. PlotNo.l, sec.l6-4,, Faridabad

Expenditureincurred on the treatment in the newly empanelledhospitalswill be reimbursed PGI rares+7sohof the renraining on amountsubjectto other provisionsof this policy.

3.

Atl dready empanelled hospl{alsaswell as abovelisted hospitars wil remainempanelred : for n period of 2 years at a time which can be renewedfurther by the Govemment keepingin ttre perfoq*nce and track record of the hrspiral. The period of 2 years will be determined ;iew rrom lne daue issueof this order. of 5' HeallthDefartment reseryesthe right to call for record of treatment of any palient from any empanelted hfspital to ensurethat no mar-practice takesplace. All emparlelled hospitalsshall provide .rearment the ro employeesin the eventof a life : thre4lemng emefgencywithout asking for deposition of the cost of treatmentin advance. The *t:* $e duesbeforedischarge fronr rhehospitar,The hospital,however, shal verify :"t::t the i{entity of the pmproyee his&er dependenr or ro avoid impersonation. 7' All empanglled hospitalshall maintaina recordof the treatment of the patienrsunderthis policy in the form4t to be prescribed the by HealthDepartment.

Elherrever tmplantsare usedin the proccss trealmentof a patient,the cost of implants of Ehallbe reimburse{at the ratesnotified by GGHS and adopted by the Govemmentof Haryana from time to timei The rate of reimbursement various of implants reimbursableat rrresent is givenat Ary,pxq+pwith this policy. It is nredec[earthat the eostof implantswril be reimbursed ,rnly to the exteilrof the cost specif"red rhe Arrnexure of this policy as amendedfrom in time to time or the actual cost. whicheveris less' In case the actual cost of impiant is more than the cost specified in the 'Annexure this p$licy, then the excess of expencliture be borneby the patienthimself/herself. will 9' within next 2 monthscomprehensive package ratesfor major fifteen procedures will also be prescribed. srfplementary notificationin this regardwill A be issuedwithin next 2 months. 10' Sub Lirnits for room tariff dependingon the categoryof employee will be fixed and nptified separ#ly.

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Mh#h*lps
urdmarlly Ordinarily

relaxation from the policy shall be given. For the convenience 1o of the efirployees, hcweve]',relaxation in the policy can be ganted in exceptional caseswith the prior approrlal th'E of Hon'ble Chief Minister and FinaaceDepartment. Suchrelaxationcan be granted in'the eonditio*s$k{ treatmentof a very old person,highly sensitive natureof diseases involving multi-system dlisord{rand treatments takenin life threatening emergency situationetc. Jqstification srrc$expenditure, fcrr however,sh.rllhaveto be first obtainedfrom a Committeeof exprts heded by DFHS and two subjectspecialists postedin panchkulaor pGIMS Rohtak. rz. This $olicy will casrcinro force with imrnediatre effect.

-3issueswith the e.qf+se*ce af the Firpae Depggpnt een+es vide their

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for FinancialCommissioner principal Secretary & to Govt. Haryana,Health& MedicalEducdion Demrlnrent _ -#.l-r?tstrr copy is forwarded to all the Financial Commissioners and Principal
ioner and Secretariesfor information and neaessary action.

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Superintendent-Health_III for Financial Commissioner principal Secretay to & Govt. Haryanq Heatth& Medical Educationdpartnent

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To U.F'Np' the Financial Commissioners principal Secretaries/ & & Secretaries Ciovernment, to Haryana IHB-III Dated,Chandigarh, 2nd the May, 20l l copy is forwarded to the Prirx;ipal Secretary/Addil. principal Secetary_I&Ill for information. Suprintenderit- Health-I I{ for FinancialConunissiener prirrcipalSesrdaryto CoW., & Haryan4 Healrh& MedicalEducarion DepqHgL*Z\S\\ e_Priacipal secretarylAddi pri ncipalSecrerary-I&IvosD-I&II to cM. l. HB-flI batg{, cheqdiee$, ttre t"o l,t"y, ior

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copyis forwarded theFingncial to commissioners principalsecy.to Govt. and : Department information for with reference their U.o. No. rcngn\T$ to | 28-A4-20t1.

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for Financial Commissioner& principal Secrctaryto Govt., Haryanq Health &, Medical EducationDepartnent FinancialCommissioner principalSecy.to Govt. & FinanceDepartment HB.III Dated,Chandigarh, 2nd the May, Z0l I

Superintendent- Health- I I I

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En{st.No. 2i8l8 IHB-III Dated, Chandigarh 2nd the May,20l I A is forwarded AccountentGeneral(A&E and Audit) Haryan4 chandigarh
for information.

Superintendent-Health-l II for Finsrcial Commissioner& principal Secretaryto Govt., Haryanq Health & Medical EducationDepa4trrent 'IH

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is forwarded to the Director public Relations, Haryanacha*igarh. He i ide publicity.

Dated, Chandigarlr, the 2d May, 201 I

forFinancial Commissiorer &pnrcipalsecretary toGovt., Haryana,

Health & Medical EducationDeparftnent

Superintendent-Health-Ill

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Bglrgbgg*ueut of cardiologv Impranfatioa Devicesaod Coroaarv St"nt

Annexure

S.No.
2

Item
Rotabiator
Pacemaker (Single Chamber)..

-Maximum ceiling rate.

nr .so.oool- or the@

Pacemaker lOua-. trambe4 uypher Stent TaxusStent Endeavor Xience V.EECSS Yukon Choice. BareMetal Stent

(i) Without response, Rs.i7,000/-or rate the actualcost,which everis less. (ii) Withrare response. Rs.65,000/-or actualcost, the
whichever less. is less. Rs.95,000/-+VAT Rs.67,300/-+VAT
,vuu/-T v A I

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; 5

15 l

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) Rs.50.000/-1all inilusive

S. No.
z
J

Item

Hydrophobic Foldable IOJ SiliconFoldable IOL Hydrophilic Acrylic fins PMMA IOL

,!e51-um ceiting raG.

R s . 5 . 8 0 0i , _
R s 4 Q O / -|

eigcls$et
KneeImplant
Maximum

Rs.60,000/- +the cost of

Rsi,000/+the Rs. i, 00Ol- costoI lt onet euretrlrs-(,C 0,1 .l e

Reiqbursernent of Cost of Cochlear Imnlanrs S. No. i ltem Maximumceilin Rs.5,35,0001- i*ptun (fot the ear speech processor). Reimbursement shall be allowed,g ]OOV, in caseof childrenbetweenr ro 5 years, g0% in caseofihildren @ between to 10 yearsand 5 childre' between 0 to @ 50%in case-of r 16 years. 50o/:o the cost of wearablecomponents of e.g. Speech Processor,Microphone i:tc. (excluding cords, batteriesi f* tt. purpose of upgradationand./orreplacementevery 3 years, on the adviceof two ENT

gone Cme'r

Reimburserrrent CpAplBIpAp Machines of

S. No. Item CPAPMachine BII]AP Machine
Maximum

Rs.50,000/- the advice of concemed on Rs.1,00,000/- the advice ofconcerned on

Reimbursementof cost of Neuro-implants CeilineRate Rs.1,60.000/Rs.2.62.000/inal Cord Slimulators a.

3-5 vears Rs.2,25,000/-

b.

OnprerscribingtheNeurologist rheGovt./approved by of hospital. Iteplacrementbattery ofbefore years 4 mavbepermitted exceptional in cases thebasis on ofjustification fhetreating by specialist shallbeconsidered u case-to-case and on basis by DeprartmentHealth famity Welfare. of a