HEALTH CARDS FOR EMPLOYEES AND PENSIONERS

GOVERNMENT OF ANDHRA PRADESH 
ABSTRACT
Employees Health Care – Cashless treatment to Government Employees, Pensioners and their 
family members – Constitution of the Technical Committee – Orders – Issued. 
HEALTH, MEDICAL & FAMILY WELFARE (M2) DEPARTMENT 
G.O. Ms. No. 1049                Dated: 31 May 2011 
       Read the following:  
Govt. Letter No.16977/M2/2010-2, HM&FW (M2) Department, dated: 12.05.2011 
ORDER: 
1. The Government has decided to provide comprehensive health care to all Government 
Employees, Pensioners, and their family members, on cashless basis through an appropriate 
scheme in lieu of the present medical reimbursement system. In order to implement the Scheme 
effectively, the Government has held a series of meetings with the Joint Action Committee of 
Employees, Teachers, Workers and Pensioners, and A.P. Secretariat Employees’ Co-ordination 
Committee representatives to discuss the scheme and its implementation modalities. Based on 
the inputs received during these meetings, the Government has decided to operationalise the 
scheme for comprehensive health care for employees, pensioners and their families in a time 
bound manner. 
2. Accordingly, the Government hereby constitute a Committee with the following 
members to analyse all aspects of the scheme and make comprehensive recommendations for its 
effective implementation:  
1 Smt. Y. Srilakshmi, IAS Commissioner of Health& Family Welfare Chairperson 
2 Dr. Venkatesh, Principal, Gandhi Medical College, Secunderabad Member
3 Dr. Rammohan, Prof. of Surgery, Osmania Medical College, Hyderabad Member 
5 Dr. Sai Babu, Additional Director (Population Stabilisation), 
Commissionerate of Health & Family Welfare, Hyderabad 
Member 
6 Dr. P. Padmaja, Superintendent,  Govt. Maternity  Hospital, Sultan 
Bazar, Hyderabad 
Member 
7 Dr. Ranganath, Professor of Paediatrics, Niloufer Hospital, Hyderabad Member 
8 Dr. G. Balaramaiah, President, Indian Medical Association Member 
9 Dr. P. Visweswara Rao, President, APNA Member
10 Dr. Bhaskar Rao, President, A.P. Speciality Hospitals Association Member 
11 The Addl. Secretary/Joint Secretary to Government, General 
Administration (SW) Department 
Member12 The Addl. Secretary/ Joint Secretary to Government, Finance (Expr. 
M&H) Department 
Member 
13 The Joint Secretary to Government, HMFW Department Member 
14 The Additional Director of Medical Education, O/o Director of Medical 
Education, Hyderabad 
Member
15 The Joint Director (Medical), O/o Director of Medical Education, 
Hyderabad 
Member 
16 The Joint Commissioner (Medical), O/o Commissioner, A.P. Vaidya 
Vidhana Parishad, Hyderabad 
Member 
17 The Chief Executive Officer, Aarogyasri Health Care Trust, Hyderabad MemberConvener 
3. The Committee will conduct a series of focus group discussions with specialists from the 
Government and Private Hospitals, representatives of employees and pensioners, with the 
administrators of the private and public sector hospitals, experts on health insurance, health 
economists, IRDA officials and insurance companies to consider all aspects of the scheme and 
make appropriate recommendations on the following Terms-of-Reference (TOR):  
a) Define the contours and content of comprehensive health cover for employees – both 
current and retired – and their families, duly considering the benefits provided under the 
existing regime;  
b) Review the existing medical reimbursement scheme with reference to its coverage, 
content, costs, methodology, institutional arrangements, etc., and recommend 
appropriate design in terms of coverage – diagnostic, curative, rehabilitative, supportive 
care - quality of care, cost of care, institutional architecture for efficient management of 
cashless medical packages in order to extend the coverage to all employees and 
pensioners eligible under the existing reimbursement scheme. 
c) Defining the packages for high-end high cost procedures such as replacement and 
transplant surgeries. 
d) Identify, design and recommend protocols and packages for chronic ailments such as 
Hypertension, Diabetes, Rheumatoid Arthritis, etc., requiring long term on out-patient 
basis and recommend the content of preventive health check-ups. 
e) Methodology for approval of treatment costs above the financial limit prescribed by the 
Government and the modalities for treatment outside the state for employees and 
pensioners living in boarder districts and outside the State, including New Delhi.  
f) Examine the existing referral system and recommend appropriate system for the referral 
of employees – both serving and retired – and their family members, along the health 
service system.  
g) Recommend the most effective and efficient institutional architecture for implementation 
of the scheme 
h) Indentify and enumerate the risk factors that could affect the implementation of the 
scheme. i) Any other matter that the Committee deems appropriate based on its deliberations with 
stakeholders and experts.   
4. The Committee is advised to obtain necessary technical advisory services from the 
National Health Systems Resource Centre (NHSRC), Administrative Staff College (ASCI), 
Access-Health International, ISB, Gachibowli, etc., as deem appropriate. The Committee is 
required to complete its deliberations with all  stakeholders and experts and submit a 
comprehensive report on or before 30 June 2011. The Government directs that all costs incurred 
for technical consultations and advisory services shall be paid from the Arogya Sri Trust funds.  
5. While the above process is under way, the Government directs the Chief Executive 
Officer of Arogya Sri Health Care Trust to launch the process for issue of Health Cards for the 
serving and retired employees and their families in consultation with all concerned.  
(BY ORDER AND IN THE NAME OF THE GOVERNOR OF ANDHRA PRADESH) 
Dr. P.V. RAMESH 
PRINCIPAL SECRETARY TO GOVERNMENT 
To 
The Commissioner of Health & Family Welfare, A.P. Hyd., 
The Chief Executive Officer, Aarogyasri Health Care Trust, Hyderabad 
The Director of Medical Education, A.P., Hyderabad 
The Secretary to Govt, G.A. (Ser.) Dept., 
All Members of the Committee  
The General Administration (SW) Department 
The Finance (Expr. M&H) Department 
The P.S. to Chief Secretary to Govt., 
The P.S. to Spl. Chief Secy. to Hon’ble CM 
The Director General, Administrative Staff College of India, Khairathabad, Hyderabad 
The Executive Director, National Health Systems Resource Center, New Delhi 
The Director, Access-Health Systems, Gachibowli, Hyderabad 
The Executive Director, Indian School of Business, Hyderabad  
The O.S.D. to Hon’ble Min (M&H) 
The Chairman, A.P. Secretariat Employees Coordination Committee, Secretariat, Hyderabad 
The Chairman, JAC of Employees, Teachers and Workers Association, NGO Home, Hyd., 
The President, A.P. State Govt. Retired Employees Association, Hyderabad 
  
//FORWARDED: BY ORDER// 
SECTION OFFICER