West Bengal Health Scheme 2008 with amendments.

Government of West Bengal

Finance Department

Audit Branch

Notification

   No. 7287-F 19-09-2008- The Governor is pleased hereby to make, in addition to the West Bengal Services (Medical Attendance) Rules, 1964, as subsequently amended, the following scheme regulating the medical benefits for the State Government employees and the family members thereto, with a view to providing better medical facilities to such employees and their family members:-

Scheme

1. Short title and commencement-

   (1) This Scheme may be called the West Bengal Health Scheme, 2008.

   (2) It shall come into force on such date, as the State Government may, by notification in the Official Gazette, appoint.

2. Application-

   (1) This scheme shall apply to the employee and his beneficiary.

   (2) The provision of enrolment under this scheme shall be optional.

   (3) An employee shall not be entitled to draw the regular medical allowance with effect from the date of effect of such enrolment under clause 4.

   (4) An employee and his beneficiary shall be entitled to the facilities under this scheme in addition to the facilities under the West Bengal Services (Medical Attendance) Rules, 1964, as subsequently amended.

   (5) An employee shall have the liberty to opt out of this scheme at any time.

   Provided that where an employee or his beneficiary has enjoyed any benefit under this scheme, such employee shall not be allowed to opt out the scheme within five years from the month following the month in which he enjoyed the benefit.

*Government Decisions:-

   An opt-out employee/ pensioner will not get re-entry into the Scheme. (Vide Memo No. 797-F (MED) dt. 31-01-2011)

3. Definitions-

   In this Scheme, unless there is anything repugnant in the subject or context-

   (a) “approved rates” means such rates as may be notified by the Government from time to time for various services, procedures and investigations required in connection with the medical attendance and treatment of a beneficiary;

   (b) “beneficiary” means a member of the family of an employee;

   (c) “clause” means a clause of the scheme;

   (d) “employee” means an employee of the Government of West Bengal enrolled under clause 4;

   (e) “family”, in relation to an employee, means-

   (i) children including step-children and unmarried daughters,

   (ii) minor brothers,

   (iii) minor sisters,

   (iv) father or mother whose monthly income does not exceed rupees one thousand five hundred,

   (v) wife or husband, as the case may be;

   (f) “Form” means a Form appended to this scheme;

   (g) “Government” means Government of West Bengal;

   (h) “hospital or institution” means such hospital or nursing home or institution as may be recognised from time to time by the Government for the purpose of availing benefits of medical attendance and treatment under

this scheme;

   (i) “laboratory” means such laboratory or institution as may be recognised by the Government from time to time for availing benefits of medical attendance and treatment under this scheme;

   (j) “medical attendance” means attendance for professional advice and includes pathological, bacteriological, radiological or other methods of investigations for the purpose of diagnosis which are considered necessary by the attending physician and are carried out in a hospital or institution;

   (k) “specified” means specified by order;3

   (l) “treatment” means the use of medical and surgical facilities and includes-

   (i) the employment of such pathological, bacteriological, radiological or other methods of investigations as are considered necessary by the attending physician;

   (ii) the use of such medicines, vaccines, serum or other therapeutic substances as may be considered necessary by the attending physician;

   (iii) medical and surgical services and procedures;

   (iv) dental treatment;

   (v) accommodation according to the entitlement of the employee;

   (vi) such nursing as is ordinarily provided at the hospital or such special nursing at the hospital as the authorised medical attending physician at the hospital may certify, in writing, to be essential for the recovery or for the prevention of serious deterioration in the condition of the patient, having regard to the nature of the disease.

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