CGHS : Revised ceiling for reimbursement of Medical Claims 

नवोदय विद्यालय समिति
NAVODAYA VIDYALAYA SAMITI
शिक्षा मंत्रालय / Ministry of Education
(स्कूल शिक्षा एवं साक्षरता विभाग)
(Dept. of School Education & Literacy)
भारत सरकार / Govt. of India

F.No.3-58/2021/ NVS/ F&A/ Medical /168

Dated: 07.06.2021

Sub.:-Revised ceiling for reimbursement of Medical Claimsm -reg.

In partial modification of this office circular no.3-8(89)/2002-03/ NVS/F&A(IA)/188 dated:26.10.2005 and even no.122 dated 26.09.2011 on the subject I am to convey the approval of Commissioner, NVS, the revised ceiling for pre audit of medical reimbursement claims for treatment obtained for day to day ailments by the employees of samiti for self and their dependent family members are as follows-

SI. NO.	Category of claim	Sanctioning Authority	Existing ceiling limit (per employee per annum)	Revised ceiling limit (per employee per annum)
I	For Vidyalaya Staff (excluding Principal)
(i)	Treatment from Govt./ CGHS Recognised Hospital	Principal	Rs.5000	Rs.25000
(ii)	Treatment from AMA	Principal	Rs.5000	Rsl 5000
II	For Regional Office and NLI Staff (excluding Deputy Commissioner)
(i)	Treatment from AMA	Dy. Commissioner	Rs.15000	Rs.15000
(ii)	Treatment from Govt./ CGHS Recognised Hospital	Dy. Commissioner	No limit	No limit
III	For Hqrs. Office Staff
(i)	Treatment from AMA	Dy. Commissioner (Admn.)	Rs.15000	Rs. 15000
(ii)	Treatment from Govt./ CGHS Recognised Hospital	Dy. Commissioner (Admn.)	No limit	No limit

All other terms and conditions mentioned in the letter dated 26.10.2005 ibid will remain unchanged and which are reproduced as follows-

1. The ceiling for treatment taken from Govt./ CGHS recognised hospital for passing the claim at Vidyalaya level (excluding Principal) per employee per annum has been revised from Rs.5000 to Rs.25000 with effect from 14.05.2021 to till further order.

2. The ceiling for treatment taken from AMA for passing the claim at Vidyalaya level (excluding Principal) per employee per annum has been revised from Rs.5000 to 15000 with effect from 14.05.2021 till further order.

3. The proposals for appointment of private medical practitioners as AMAs should be in accordance to the Govt. of India decision as notified under CS(MA) rules and the proposals complete in all respect for appointment of AMAs at JNV level will be submitted to regional offices for approval and after getting the approval the claim at Vidyalaya level will be processed in accordance to above financial ceiling.

4. Before getting the proposals for appointment of private medical practitioners as AMAs , the regional office will issue comprehensive guidelines to all Principals for empanelment of AMAs and the same comprehensive guidelines will also be followed by regional office, while engaging the AMAs.

5. All the medical claims in respect of JNVs staff exceeding 25000 (Per employee per annum) for the treatment taken in Govt./ CGHS recognised hospital, will be sent to concerned regional office as per existing practice for pre audit and sanction.

6. All the medical claims in respect of Principals would be forwarded to regional office concerned for pre audit and sanction.

7. All the claims irrespective of amount seeking relaxation as per CS(MA) rules, 1944 shall continue to be sent to F&A wing at NVS after proper pre audit and recommendation of concerned RO for getting approval of Commissioner, NVS.

8. All other conditions as conveyed vide this office circular dated 04.2003 and the rules framed as per CS(MA) 1944 will remain unchanged and is to be followed strictly.

(Sameer Pandey)
Joint Commissioner (Admn.)

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