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Where the elderly are vulnerable to abuse
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Comprehensive procedure, guidelines and check list for empanelment of private hospitals – Railway Order
Comprehensive procedure, guidelines and check list for empanelment of private hospitals – Railway Order
GOVERNMENT OF INDIA
MINISTRY OF RAILWAYS
New Delhi, dated 25.4.2018
The General Managers,
All Indian Railways & Production Units,
Sub: Comprehensive procedure, guidelines and check list for empanelment of private hospitals.
Ref:- SER’s letter no.CMD/SER/Hosp. Tie-up/2303 Dated 14.11.2017.
PCMD/SER vide their letter under reference had sought necessary guidelines to be followed while empanelling private hospitals in consequence of powers delegated to the GMs for empanelment of private hospitals vide Railway Board letter no. 2017/Trans/01/Policy dated 18/10/17 and to the DRM’s for divisions and CWMs for workshops vide letter no.2017/Trans/01/Policy/Pt 1 dated 30/11/17. Such powers are to be exercised by the delegated officers in person and shall not be delegated below. Hence now no proposal for empanelment is required to be sent to Railway Board.
A comprehensive guideline for procedure and checklist to be followed while empanelling private hospitals are being issued as per Annexure enclosed. Any new guidelines issued from MoH & FW as and when issued shall be duly incorporated and advised.
This is in surprise of all earlier guidelines issued from Railway Board on this subject.
This issues with the concurrence of the Finance Directorate of the Ministry of Railways.
(Mrs. H.K. Sanhotra)
Comprehensive Procedure Guideline & Check List
For Empanelment of Private Hospitals
The empanelled hospitals have been broadly categorised into two groups:-
A. CGHS / E$l / ECHS empanelled hospitals and Government of India / Public Sector Undertaking hospitals like of SAIL, BHEL, Coal India, etc.
B. Other private hospitals which are neither empanelled by CGHS, ECHS & ESI nor are run by Government of India Public Sector Unit. (PSU).
The following guide lines and check list are to be kept in consideration while empanelling hospitals by Railways. The point common to both these types of hospitals are given below:-
1. Justification for the proposal mentioning the present status of Railway Hospital i.e. number of Doctors & Paramedical on roll vis. a vis. sanctioned strength, services provided by it, any future plan for expansion, no. of Honorary Consultants/Visiting Specialists (specialty wise) & CMPs and despite existing facilities why referral services are still required.
2. Justification for empanelment with technical aspect i.e. number of beds / facilities/specialties/services offered/medical set up etc. at the proposed hospital.
3. Total number of Railway beneficiaries catered by the Railway Hospital.
4. In the Specialties Specialties for which Railway hospital do not have facilities if there are any reputed Government Hospitals rendering services in those specialties.
5. In CGHS covered states/cities, hospitals should be empanelled only at CGHS rates (in case of Government of India, PSU hospital their own rate) or even lower or some discount etc offered by them. Names of the hospital empanelled by CGHS / ECHS /ESI can be obtained from respective website. Even in places not covered by CGHS, all out efforts should be made to empanel hospital on CGHS (city-specific) rates only. In case of any deviation from CGHS rates, justification to be given by MD / CMS / CMO in charge, duly concurred by Associate Finance before being approved by Competent Authority.
6. Comparative statement of package rates as well as diagnostic charges of the proposed hospital with (i) other empanelled hospitals in the city and (ii) the CGHS rates of that city or the nearest city in tabulated form.
7. Two copies of rate list of hospital duly verified by competent authority. After approval, one copy along with sanction letter to be sent to HQ for uploading on Zonal website.
8. Concurrence of the Associate Finance as applicable along with their verbatim comments
9. Proposal to be sent for approval of GM /DG (RDSO) /DRM /CAO /CWM as the case may be (both for the first time and as well as further renewals).
10. Validity of empanelment will be two years or till it is empanelled or revoked by CGHS / ECHS /.ESI whichever is earlier and for Government of India PSU hospitals too it will be for two years, Same for non CGHS / ECHS / ESI hospitals too. Overall performance of the hospital, patient’s feedback etc. to be kept in mind while extension
11. Further extension may be done with mutual consent of both parties, arid will be sanctioned by GM /DG (RDSO) /DRM /CAO /CWM as the case may be (also see para A((a) & B(d)).
A. CGHS / ESI/ ECHS empanelled hospitals and Government of India / Public Sector Undertaking hospitals like of SAIL’ 3HEL, Coal India, etc. –
(a) In case of CGHS / ECHS / ESI empanelled & Government of India/PSU run hospitals, a letter of willingness from the hospital be obtained and can be empanelled any time Rates as and when revised by CGHS can be agreed to.
B. Other private hospitals which are neither empanelled by CGHS, ECHS & ESI
a) An open advertisement should be floated once a year or as per requirement for empanelment of private hospitals.
b) Empanelment of such hospitals should be considered only if there is no other CGHS/ ECHS / ESI nor any hospital run by Government of India – Public Sector Undertaking like SAIL, BHEL, Coal India etc. empanelled hospital, preferably within a vicinity of 5kms from the hospital already empanelled.
c) Search committee should be constituted by MD / CMS / CMO, consisting of 3 doctors of at least JAG level and they may co-opt another doctor of particular speciality when required. They will visit the hospitals and give clear justification for approving this hospital.
d) For any increase in rates, at the time of extension same should be justified by MD/CMS/CMO and concurred by Associated Finance and accepted by the concerned competent authority. If such increase in rates is more than 5%, the proposal duly justified by medical in charge and vetted by associate finance and approval of DRM /CWM in case of Division and workshops to be sent to Headquarters for sanction of General Manger. In case of headquarter controlled Central hospitals and Pus, General Manager / DG*(RDSO) will approve such proposals. However, no enhancement in rate is permissible during that period of recognition of two years..
The recently-notified Finance Act 2018, which is applicable from 1st April 2018, has done away with exemption for transport allowance and medical reimbursement for salaried employees. How will you get impacted now? By: Sanjeev Sinha May 18, 2018 11:27
The recently-notified Finance Act 2018, which is applicable from 1st April 2018, has done away with exemption for transport allowance and medical reimbursement for salaried employees. How will you get impacted now?
By: Sanjeev Sinha May 18, 2018 11:27
Tax experts say that employers need to understand the mechanism of tax deduction at source while providing the benefit of standard deduction to the employees.
If you are a salaried employee working in any organisation, then most probably you would have by now received a mail from your HR department that with the recent changes in the Finance Act, both medical reimbursement and transport allowance have become taxable with effect from 1st April 2018, and accordingly, both these allowances have been merged with your special allowance. This has left many employees wondering, will they now have to pay tax on these two allowances? If yes, then what about standard deduction? Has this already been taken into account by their employers while computing taxes or will they have to claim the tax so deducted by filing their income tax return?
However, before knowing the impact of these changes on you and your salary income, let us first take a look at what has changed.
What has changed?
According to tax experts, the recently-notified Finance Act 2018, which is applicable from 1st April 2018, has done away with exemption for transport allowance and medical reimbursement for salaried employees. In lieu of these, a standard deduction of Rs 40,000 has been introduced.
What does this mean?
Up to the preceding financial year (FY), an employee was allowed to structure his/her salary for claiming exemption for transport allowance of Rs 1,600 per month (Rs 19,200 per annum) and a medical expense reimbursement of Rs 15,000 per annum by selecting these components in the salary structuring sheet. Further, to claim medical reimbursement as non-taxable benefit, the employee had to submit original medical bills as proof to the HR department.
However, “with the introduction of amendments made in the Finance Act, 2018, transport allowance and medical reimbursement exemption are no more available. Hence, an employee would no longer be able to select these components as part of his/her salary structure,” says Akhil Chandna, Director, Grant Thornton India LLP.
Now a total of Rs 34,200 (i.e. Rs 19,200 and Rs 15,000) would be added to the special allowance component of the employee. This amount would be paid to the employee on monthly basis after deduction of applicable taxes.
“It should, however, be noted that while computing the payroll taxes, standard deduction of Rs 40,000, which has been introduced from FY 2018-19, would be given effect for. Hence, it will provide a relief of income up to Rs 5,800 per annum,” says Chandna.
Thus, it is wrong to believe that employers will deduct taxes on these two allowances now, which may have to be claimed later by the employees.
In fact, “the introduction of standard deduction has provided the salaried class additional benefit in tax by reducing their taxable income by Rs 5,800 besides reducing administrative hassles in maintaining documentary records to claim medical reimbursements,” says Ashok Shah, Partner, N.A. Shah Associates LLP.
What is more, differently-abled employees can claim both standard deduction of Rs 40,000 as well as transport allowance of Rs 38,400.
Organisations implement new provisions
These new provisions have already been implemented by most organisations across the country. For instance, Edelman India has merged these two allowances into the special allowance as, it says, retaining them without any corresponding tax benefits may create confusion in the minds of its employees. And the tax impact of the same has been fully offset by the standard deduction which has been brought back into the Finance Act.
As a result of this, there is no action requir
Thursday, May 17, 2018
Eligibility of Permanently Disabled Unmarried Son of a CGHS Beneficiary to avail CGHS facility
Ministry of Health & Family Welfare
Department of Health & Family Welfare
Nirman Bhawan, New Delhi
Dated: the 7th May, 2018
Subject: Eligibility of Permanently Disabled Unmarried Son of a CGHS Beneficiary to avail CGHS facility – Reg.
The undersigned is directed to refer to this Ministry’s Office Memoranda of even number dated 31.05.2007, 29.08.2007 and 02.08.2010 vide which the entitlement of the son of a CGHS beneficiary beyond the age of 25 years was conveyed. As per the two Office Memoranda under reference, it was indicated that an unmarried son of a CGHS beneficiary suffering from any permanent disability of any kind (physical or mental) will be entitled to CGHS facility even after attaining the age of 25 years.
2. Since then this Ministry is in receipt of several representations for inclusion of more conditions in view of modification to the PwD Act, 1995 by “The Rights of Persons with Disabilities Act, 2016 (Act No. 49 of 2016)” as notified by Mlo Law and Justice, Govt. of India on 27.12.2016. The matter has been reviewed by the Ministry and it is now decided that for the purpose of extending the CGHS benefits to dependent unmarried son of CGHS beneficiary beyond 25 years of age , the definition of `Permanent Disability’ shall include the following conditions :
I. Physical disability:
A. Locomotor disability including
a) Leprosy cured person- suffering from loss of sensation in hands or feet as well as loss of sensation and paresis in the eye and eye-lid but with no manifest deformity or suffering from manifest deformity and paresis or having extreme physical deformity as well as advanced age which prevents him/her from gainful occupation
b) Cerebral palsy – caused by damage to one or more specific areas of the brain usually occurring before, during or immediately after birth.
c) Dwarfism- a medical genetic. condition resulting in an adult height of 147 ems or less;
d) Muscular dystrophy- a. group of hereditary genetic muscle diseases characterized by progressive skeletal muscle weakness
e) Acid attack victims – disfigured due to violent assaults by throwing acid or similar corrosive substance
B. Visual impairment:
a) Blindness- where a person has any of the following conditions after best correction:
(i) Total absence of sight or
(ii) Visual acuity less than 3/60 or less than 10/200(Snellen) in the better eye with best possible correction
(iii) Limitation of field of vision subtending an angle of less than 10 degree
b) “Low vision” means any of the following conditions:
(i) visual acuity not exceeding 6/18 or less th.an20/60 upto 3/60 upto 10/200 (Snellen) in the better eye with best possible corrections; or
(ii) limitation of the field of vision subtending an angle of less than 40 degree up to 10 degree
C. Hearing Impairment
(a) “deaf’ means persons having 70 db hearing loss in speech frequencies in both ears;
(b) “hard of hearing” means persons having 60 db to 70 db hearing loss in speech frequencies in both ears;
D. “Speech and Language disability” permanent disability arising out of conditions such as Laryngectomy or aphasia affecting one or more components of speech and language due to organic or neuronal causes.
II. Intellectual disability- characterized by significant limitation both in intellectual functioning (reasoning, learning, problem solving) and in adaptive behavior , which cover a range of every day, social and practical skills , including-, social and practical skills , including
(a) “Specific language disabilities” – a heterogeneous group of conditions wherein there is deficit in processing language, spoken or written, that may manifest itself as a difficulty to comprehend., speak, read, write, spell, or to do the mathematical calculations and includes conditions such as perceptual disabilities, dyslexia, dysgraphia, dyscalculia, dyspraxia and developmental aphasia.
(b) “Autism spectrum disorder” –– a neuro-developmental disorder typically appearing uz the first three years of life that significantly affects a person’s ability to communicate, understand relationships and relate to others, and frequently associated with unusual or stereotypical rituals or behaviour.
III. Mental behaviour
“Mental illness”- a substantial disorder of thinking, mood, perception, orientation or memory that grossly impairs judgement, behaviour, capacity to recognize reality or ability to meet the ordinary demands of life, but does not include retardation.
IV. Mental Retardation
V. Disability caused due to
(a) Chronic neurological conditions such as
(i) Multiple Sclerosis
(ii) Parkinson’s disease
(b) Blood disorder
(iii) Sickle Cell Disease
3. Bench Mark Disability- unmarried permanently disabled and financially dependent sons of CGHS beneficiaries suffering 40% or more of one or more disabilities as certified by a Medical Board shall be eligible to avail CGHS facilities even after attaining the age of 25 years.
4. This OM will be effective from the date of its issue.
Under Secretary to the Govt. of India