West Bengal Health Scheme for the Journalists, 2016

Download: Revised Application Forms of Maavoi

Operational Guideline for the Maavoi – West Bengal Health Scheme for the Journalists, 2016

As per Notification No. 509-ICA(N) dated 25.02.2016, Maavoi West Bengal Health Scheme for the Journalists, 2016 has taken effect from 01.03.2016 and the Journalists accredited with the Department of I & C A may avail the benefit of the Scheme.

For this purpose, operational guideline given below, may be followed:

1. Enrolment

An accredited Journalist seeking enrolment in the Health Scheme alongwith dependent family members shall apply to the Pr. Secy., I & C A/ OSD & E.O. Spl. Secy. I & C A Department in prescribed Form “A” and duly filled-in form may be submitted to Kolkata Information Centre, 1/1 A. J. C. Bose Road, Kol-20 (Journalists’ Health Scheme Cell) (for Kolkata) and to the D.I.C.O. (in District). Dependent family members means:-

i) Spouse

ii) Parents, whose monthly income does not exceed Rs.5000/-

iii) Children includes step-children/legally adopted children

iv) Son is considered to be dependent till he starts earning or attains the age of 25 years whichever is earlier. Son suffering from permanent disabilities either physically or mentally will be considered dependent without any age limit.

v) Dependent unmarried/widow/divorced sisters of any age

vi) Minor brothers and minor sisters

2. In support of relationship, self attested copy of Voter Card/Aadhar Card/Ration Card/Pan Card/Birth Certificate etc. to be furnished alongwith form A by the applicant.

3. Three stamp size photographs and two passport size photographs are required to be furnished alongwith form A by the applicant.

4. Photocopy of Press Accreditation Card is required to be submitted alongwith form A by the applicant.

5. Form A is required to be countersigned by the Editor/Channel Head/News Editor with rubber seal and date.

6. On receipt of the same and its verification a Certificate of Enrolment will be issued in Form “B” and subsequently issued Printed Health Card.

2. Facilities

i) An accredited Journalists or a beneficiary of such Journalist shall be entitled to the following facilities namely;

a) medical attendance and treatment as an indoor patient in a hospital or an institution; and

b) medical attendance and treatment at out patient department of a hospital or an institution, or clinic attached to such hospital or institution for such diseases, and under such circumstances, as may be specified.

ii) Medical attendance and treatment as an indoor patient in a hospital – A Journalist shall be entitled to reimbursement of the cost of his or his beneficiary’s medical attendance and treatment, as an indoor patient in a hospital or an institution.

Explanation: For the purpose of this clause, the expression “cost of medical attendance and treatment” shall include-

a) The amount charged by the hospital or institution in accordance with the approved rates;

b) The cost of medicines purchased from outside on the advice of the attending physician at the hospital or institution;

c) The charges for such pathological, bacteriological, radiological or the methods of investigations as are considered necessary by the attending physician and carried out, on the advice of the attending physician in a laboratory or institution, other than the hospital or institution in which the patient is treated.

iii) Medical attendance and treatment as an OPD (Out-patient Department) patient in a hospital:

1. A Journalist shall be entitled to reimbursement of the cost of his or his beneficiary’s medical attendance and treatment as an OPD patient in a hospital or institution in the following cases:-

i) Malignant diseases#,
ii) Tuberculosis,
iii) Hepatitis B/C and other liver diseases,
iv) Insulin-dependent diabetes**,
v) Heart diseases,
vi) Neurological disorder/cerebrovascular disorders
vii) Malignant malaria,
viii) Renal failure,
ix) Thallasaemia/ Bleeding orders/ Platelet disorders,
x) Injuries caused by accidents*.

2. A Journalist or his beneficiary shall also be entitled to reimbursement of the cost of follow-up medical attendance and treatment relating to Neuro Surgery, Cardiac Surgery (Including Coronary Angioplasty and implants), Cancer Surgery/ Chemotherapy/ Radiotherapy, Renal Transplant, Hip/ Knee replacement Surgery and Accident cases received as an OPD patient in a hospital or institution.

Explanation- For the purpose of this clause, the expression “cost of medical attendance and treatment” shall include-

a) The amount charged by the hospital or institution in accordance with the approved rates,

b) The cost of medicines purchased from outside on the advice of the attending physician at the hospital or institution,

c) The charges for such pathological, bacteriological, radiological or other methods of investigations as are considered necessary by the attending physician and carried out, on the advice of the attending physician, in a laboratory or institution, other than the hospital or institution in which the patient is treated.

3. Accommodation

In the case of medical attendance and treatment as an indoor patient in a hospital or an institution, an applicant or his beneficiary shall be entitled to/Semi-Private Word/General Accommodation as per availability.

4. Tenure

The cost incurred on account of related medical attendance and treatment received in a hospital or an institution during the period upto 30 days prior to hospitalisation and 30 days from the date of discharge, shall be reimbursable.

5. Issue of Identity Card to journalist and beneficiary

(1) The applicant and his beneficiary shall be issued a photo-identity card with a unique identification number under the seal and signature of the issuing authority.

(2) The identification number of the applicant and his beneficiary shall consist of three numbers, for example x/y/z, where “x” denotes the code number of the applicant i.e. accreditation no. of the journalist, “y” denotes the serial number of the beneficiary belonging to the family of the applicant (it being 1 in the case of the applicant himself) and “z” denotes the total number of cards issued for the family of the applicant.

(3) The identity card shall consist of two parts of which the issuing authority shall retain the first part and the second part shall be handed over to the applicant concerned.

(4) A list of applicant to whom identity cards have been issued shall be forwarded to the Drawing and Disbursing Officer and also to the Director of Information Department.

(5) The identity card shall have a standard format and shall contain such particulars as the name, the date of birth and the relationship of the beneficiary with the employee.

(6) For the purpose of availing the benefits under this scheme, the applicant or his beneficiary shall show his identity card to the hospital, laboratory or institution where he receives medical attendance and treatment.

(7) The identity cards issued under this scheme shall be surrendered to the Information & Cultural Affairs Department at the time of retirement/ resignation from service.

6. Intimation of medical attendance and treatment

An applicant shall give an intimation to the Information & Cultural Affairs Department within three days of commencement of his or his beneficiary’s medical attendance and treatment:

Provided that where a journalist himself is undergoing medical attendance and treatment and not in a position to intimate personally, any member of his family may give such intimation.

7. Claims for reimbursement of the cost of medical attendance and treatment

(1) An application for reimbursement of the cost of medical attendance and treatment shall be made by an applicant in Form C.

(2) The application for settlement of claim under this scheme shall be made within three months of the completion of treatment to the Health Scheme Cell of the Journalists, Information & Cultural Affairs Department.

(3) The application referred to in sub-clause (1) shall be accompanied with the following documents:-

(a) essentiality Certificates in Form D;

(b) photocopy of the identity card issued to the journalist, and where the claim relates to a member of the family of the journalist, photocopy of the identity card issued to such member of the family of the journalist;

(c) all original bills verified by the hospital, laboratory or institution;

(d) all original vouchers, cash memos and money receipts;

(e) detailed lists of all medicines, laboratory tests, investigations, procedures, number of doctors’ visits, etc. with dates, duly countersigned by an authorised person of the hospital where the beneficiary has received medical attendance and treatment, along with a certificate from such authorised person that all charges are as per approved rates. In the bill prepared by the hospital, each service, procedure and investigation for which the beneficiary is charged should be specified, along with this reference number in the approved list;

(f) detailed list of all medicines purchased from outside and all laboratory tests, investigations and procedures done in a laboratory, institution or hospital other than the hospital where the patient has received medical attendance and treatment, along with a certificate from an authorised person of the hospital that such medicines had to be purchased or such laboratory tests, investigations and procedures had to be done on the advice of the attending physician of the hospital;

(g) photocopy of the intimation given to the Information & Cultural Affairs Department regarding medical attendance and treatment of the journalist or the beneficiary member of the family of the journalist;

(h) Check List in Form E.

8. Settlement of claims

(1) The application made under sub-clause (1) of clause 12 for reimbursement shall be processed by the Journalist Health Cell, Information & Cultural Affairs Department and the admissible cost of medical attendance and treatment shall be worked out on the basis of the approved rates.

(2) The sanctioning authority for reimbursement of the cost of medical attendance and treatment in the case of a journalist working in the Kolkata shall be the Secretary:

Provided that the Secretary may delegate this power to a Special Secretary, or a Head of Department not below the rank of Special Secretary to the Government, subject to the limits of-

(i) for medical attendance and treatment as an indoor patient in a hospital, Rs. 50000/-,

(ii) for medical attendance and treatment as an OPD patient in a hospital, Rs. 5000/-.

(3) The sanctioning authority in the case of a journalist working in the District shall be the District Information & Cultural Officer, where the claim does not exceed Rs. 20000/- for indoor treatment and Rs. 2000/- in case of OPD treatment, and the Secretary of the Department where the claim exceeds these limits.