EHS Costs Amendments-G.O.NO.82 Dated:18-5-17
GOVERNMENT OF ANDHRA PRADESH
ABSTRACT
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
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
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Amendment
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Point No. 4
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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.
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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.
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Point
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Dr.NTR
VS Trust shall empanel
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Dr.NTR
VS Trust shall
empanel clinical
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No. 5
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clinical audit agencies and it
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audit agencies and it would be mandatory
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would be mandatory for hospitals
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for hospitals to undergo third party clinical
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to undergo third party clinical
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audit from any of the empanelled
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audit from any of the empanelled
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agencies, for appropriateness and
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agencies, for appropriateness
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adequacy of care. Non-compliance to
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and adequacy of care. Non-
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audit
shall attract a
penalty of 2%. The
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compliance to audit shall attract a
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clinical
audit sample size
and periodicity
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penalty of 2%. The clinical audit
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shall
be notified by
Dr.NTR Vaidyaseva
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sample size and periodicity shall
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Trust. The Audit changes will be paid by
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be notified by Dr.NTR
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the Dr.NTR Vaidyaseva Trust.
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Vaidyaseva Trust.
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Point No.6
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Hospitals would need to undergo fresh empanelment before 31st
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No fresh empanelment is needed for already empanelled hospitals.
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March 2017 declaring all
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Empanelment shall be made for all
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specialties they have.
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additional specialties existing with the
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Empanelment application shall be
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respective hospitals within 4 months from
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made
for all specialties
existing
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the date of issue of this order.
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with the respective hospitals and
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not
piece-meal basis to reduce
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rejection
of patients.
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4.
The Chief Executive Officer, Dr.NTR Vaidya Seva Trust,
A.P., shall take necessary action accordingly.
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