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EHS Costs Amendments-G.O.NO.82 Dated:18-5-17

               EHS Costs Amendments-G.O.NO.82 Dated:18-5-17

                          GOVERNMENT OF ANDHRA PRADESH 
                                                         ABSTRACT
HM & FW Dept., - Employees  Health Scheme – Escalation of costs pertaining  to     Employees            Health            Scheme             -      Certain                         amendments             –    Orders                                 issued.
    HEALTH, MEDICAL AND FAMILY WELFARE (I.1) DEPARTMENT

G.O.Ms.No. 82      Dated:18 /05/2017

Read:G.O.Ms.No. 12, HM & FW (I.1) Dept., dt: 23.01.2017.


ORDER:In the G.O. read above, Government has issued orders pertaining to Employees Health Scheme enhancing the prices of procedures by 21.11% applicable from 1st February , 2017.
2.                     In addition to the escalation of prices under Employees  Health Scheme and  Working Journalists Health Scheme, certain orders were issued by the Government with respect to NABH incentive to the network hospitals having full NABH accreditation, empanelment of hospitals and clinical audit by Dr.NTR Vaidyaseva Trust.3.                   Government, after careful examination of the matter, hereby issues the following amendments to the above G.O read above.



Present
Amendment
Point No. 4
The principles o Insurance shall    be made applicable, in a manner that for NABH empanelled hospitals, NABH incentives shall  be made applicable uniformly for all categories of patients under all schemes. The rate  shall  be  placed  realistically  at  2% above
the revised EHS package costs.
Incentive for NABH accredited network hospitals under EHS and WJHS shall be 11% over and above the  package  prices and 2% incentive under Dr.NTRVS over and above the package prices.
Point
Dr.NTR  VS  Trust  shall empanel
Dr.NTR  VS  Trust  shall  empanel  clinical
No. 5
clinical   audit   agencies   and    it
audit agencies and it would be  mandatory

would be mandatory for  hospitals
for hospitals to undergo third party  clinical

to    undergo   third   party    clinical
audit    from     any    of     the    empanelled

audit from any of the  empanelled
agencies,      for      appropriateness      and

agencies,     for     appropriateness
adequacy   of   care.    Non-compliance   to

and  adequacy     of    care.    Non-
audit  shall  attract  a  penalty  of  2%. The

compliance to audit shall attract a
clinical  audit  sample  size  and periodicity

penalty of 2%. The clinical audit
shall  be  notified  by  Dr.NTR Vaidyaseva

sample size and periodicity shall
Trust. The Audit changes will be paid by

be    notified            by         Dr.NTR
the Dr.NTR Vaidyaseva Trust.

Vaidyaseva Trust.

Point No.6
Hospitals would need to undergo fresh   empanelment   before 31st
No fresh empanelment is needed for already            empanelled         hospitals.

March       2017       declaring      all
Empanelment   shall    be    made    for    all

specialties            they            have.
additional   specialties   existing   with   the

Empanelment application shall be
respective hospitals  within 4 months from

made  for  all  specialties  existing
the date of issue of this order.

with the respective hospitals  and


not  piece-meal  basis  to  reduce



rejection of patients.


4.                              The Chief Executive Officer, Dr.NTR Vaidya Seva Trust, A.P., shall take necessary action accordingly.


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                          EHS Costs Amendments-G.O.NO.82 Dated:18-5-17

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