Consideration of medical reimbursement claims under the J&K Civil Services (Medical Attendance-Cum-Allowance) Rules, 1990 post launch of Ayushman Bharat PM-JAY-SEHAT Scheme
No.FD-Code/63/2021-734
Government of Jammu and Kashmir
Finance Department, (Codes Division)
Civil Secretariat, Jammu/Srinagar
Dated: 31-08-2021
CIRCULAR
Subject:- Consideration of medical reimbursement claims under the J&K Civil Services (Medical Attendance-Cum-Allowance) Rules, 1990 post launch of Ayushman Bharat PM-JAY-SEHAT Scheme.
Attention of all the Administrative Departments is invited to the Ayushman Bharat PM-JAY-SEHAT Scheme implemented in the Jammu & Kashmir. The Government is providing free health insurance cover to all the citizens of J&K for Rs 5 lakh per family per year on floater basis. The Government employees are also eligible for enrollment under the said insurance scheme.
However, it has been observed that large number of medical reimbursement claims of employees are not being preferred under the insurance scheme being provided by the Government due to various reasons.
The issue has been examined in the Finance Department and it has been decided that the claims for medical reimbursement of employees and their dependent family members pertaining to the post launch period of SEHAT Scheme shall invariably be preferred under the said scheme. The expenditure beyond the insurance cover shall continue to be reimbursed by the Government as per the provisions of the J&K Civil Services (Medical Attendance-cum-Allowance) Rules, 1990.
The medical claims of the Government Servants and their dependents, who are registered under the scheme shall be considered for reimbursement under Medical Attendance Rules, only for the amount beyond the insurance cover being provided under the SEHAT insurance scheme.
The medical claims of the Government Servants, where beneficiaries have applied for registration under the scheme but have not been registered will be considered for reimbursement under Medical Attendance Rules, provided it is established with documentary evidence that the application of the patient for registration under the scheme has been submitted prior to the date of under taking treatment.
Ayushman Bharat J&K online registration
The medical claims of the Government Servants and their dependents, who have not applied for registration under the scheme, shall be considered for reimbursement under Medical Attendance Rules, only for the expenditure incurred beyond the admissible Insurance cover.
All the Administrative Departments are, therefore, impressed upon to adhere to the above instructions and direct their subordinate offices accordingly.
Sd/-
(Atal Dulloo), IAS
Financial Commissioner
(Additional Chief Secretary)
Finance Department