PESHAWAR: The Khyber-Pakhtunkhwa health ministry has revised the West Pakistan Medical Attendance Rules, 1959. Besides other changes, the revision now enables government servants to avail medical check-up at private facilities upon the recommendation of a casualty medical officer.
The rules were framed in 1959 whereby medical claims submitted by government employees for their own or a family member’s checkup or hospitalisation would be reimbursed by their department of employment.
The rules remained intact for year. After the Civil Servants Act of Pakistan, 1973, K-P adopted it with minimum changes. However, with the finance department facing immense problems in processing the medical claims, it was decided that the rules need to be revised.
“There were certain things which needed to be changed since there was no proper mechanism for processing bills,” a health official told The Express Tribune. “This decision was taken following concerns expressed by the finance department.”
He said there was no proper referral system in place. Furthermore, sometimes fake bills were processed by employees misusing the system. Employees preferring treatment in other countries was also an issue.
According to the health official, employees on deputation were entitled to treatment abroad but some officials would go abroad for treatment and claim expenditures later.
He added the ministry decided to form different committees which will go through the bills and would forward them for clearance.
The revised rules, a copy of which is available with The Express Tribune, state that in case of serious or life threatening conditions the case may be referred to a nearby government health facility. However, if the treatment is not available at a government facility, the medical attendant may refer the patient to a private hospital with full justification and with prior approval of the directorate general of health services.
“The approval of the director general health services for the referral shall be communicated within seven working days of the referral request,” the documents read, adding that the medical officer, following approval of the director general of health, could also refer the patient to hospitals in any other province.
One of the most important changes is that payment can be provided in advance in certain cases. This too shall be decided by the committee.
The copy also states medical attendance card issued to government employees could be used anywhere across the country. “The card will be used for medical checkup however since a health insurance policy is being introduced for government employees, the same card will be used as insurance card,” Health Sector Reforms Unit Deputy Chief Dr Ijaz Ahmad told The Express Tribune.
The rules now clearly say that employees posted abroad are entitled to claim reimbursement for treatment they take abroad. However, their routine medical checkups will not be paid for.
“The treatment shall be limited to the country and state where the civil servant has been posted on duty,” Ahmad said. He added if a patient is unable to travel due to illness, their authorised attendant shall be entitled to a travelling allowance at tour rates for the journey to and from the initial referral point.
The amended rules suggest the medical bills shall be reimbursed by the government on production of the certificate in writing by an authorised medical attendant.
Published in The Express Tribune, August 16th, 2016.
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