Need for revision of medical reimbursement under CS(MA) Rules

Shri.Mohanan Narayanan is the author of this article.  He works as an Office Superintendent in a subordinate office under Ministry of Textiles in Mumbai.

While Government of India is still contemplating the introduction of a Health Insurance Scheme for Central Government Employees and Pensioners all over India, the existing medical reimbursement under Central Services (Medical Attendance) Rules, 1944 requires a revamp for time being as it provides very paltry reimbursement of money compared to actual medical expenses met out by the employees.  The bottom line is the reimbursement rate schedule is not equated to the current cost of medical treatment.

Let’s have a look at this problem in detail.

In terms of CS (Medical Attendance) Rules, 1944, as amended, the central Government employees and members of their family who reside in places not covered by CGHS are allowed to take treatment in any private hospitals nearer to him on emergency, subject to fulfillment of certain conditions prescribed in the rule. 

The reimbursement allowed in such cases is

  • Room Rent (Rs.50/- per day in A class cities and Rs.30/- per day in B class cities.
  • Consultation – Rs.32 for first consultation, Rs.16 for subsequent consultation. 
  • The maximum total consultation fee that would be payable in a particular case should be restricted to Rs.100/-.
  • Surgical operations (i) Major Rs.800/- (ii) Minor Rs.200/- 
  • Confinement (i)_ Normal Rs.200/- (ii) Complicated Rs.500/-  
  • Pathological, Bacteriological, Radiological or other similar tests undertaken during the diagnosis ( as per the rates charged by Govt. hospitals). 

The above mentioned rates appear to have been revised during the year 1977 or so and at that time the central govt. employees’ salary was very meager. More than 30 years have been passed and our salary has been increased in multiples but the rate for reimbursement of medical expenses to the govt. employees covered under CS (MA) Rules is still to be revised. 

Now a postgraduate doctor in a private hospital is charging his consultation fee ranging Rs.300-1500/- according to his status, area etc. whereas the central Govt. employees are entitled for reimbursement of  Major Operation charge of Rs.800/- only irrespective of the disease, except specialized treatments . 

It is very pathetic that if a central govt. employee claim for medical reimbursement of Rs.40000/- he may get Rs.4000/- or so according to the eligibility worked out as per the rates prescribed above.

I feel that Government should consider the revision of these rates and allow rates that compensate the actual medical expenses.

It is pertinent to mention here that the badly affected central government employees are those whose residence is nearer to the Metropolitan cities, where the rates charged in private hospitals are as comparable to the metropolitan city hospitals.

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