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Permission for Treatment if Cost exceeds 2.5 Lac

Finance

Government of West Bengal
Finance Department
Audit Branch
Medical Cell

No. 71(80)-F(MED)-WB Dated: 09.10.2013.

From: Shri Samiran Pal, W.B.C.S. (Exe.),
Special Secretary to the
Government of West Bengal

To: The C.E.O./ Medical Superintendent,
…………………………………
…………………………………

Sub: Request to furnish treatment related papers at the time of seeking permission from the West Bengal Health Scheme Authority.

Sir,

With due respect, I am directed to draw your kind attention to the fact that obtaining permission from the West Bengal Health Scheme Authority is mandatory on the part of the H.C.O.s empanelled under the West Bengal Health Scheme, 2008 for performing certain procedures, e.g. implantation of dual chamber pacemaker, PTCA with more than two stents or more than one drug eluting stents, human organ transplantation, etc. or in case of conservative treatment where the cost of treatment exceeds Rs. 2.5 Lac vide Clause-8.16, 8.17 and 8.18 of the agreement signed between the H.C.O.s and West Bengal Health Scheme Authority. However, it is frequently observed that permission is sought for by the empanelled H.C.O.s without furnishing relevant papers related to the treatment. Such cases are placed before the West Bengal Health Scheme Authority and the Authority seeks for furnishing treatment related papers required for arriving at any decision. This is causing serious delay in the treatment process.

Accordingly, I am directed to request you to furnish the following papers at the time of seeking permission from West Bengal Health Scheme Authority:-

1. For seeking permission for treatment with the cost exceeding Rs. 2.5 Lac:-

(a) Up-to-date detailed bill of the treatment.

(b) Discharge summary/ death summary/ prognosis report (where the treatment is still going on).

(c) Detailed clinical note of the treating doctor regarding the treatment. It is to be separately furnished if sufficient details are not given in the discharge summary/ death summary.

2. For seeking permission for performing some specific procedures:-

(a) Cost estimate of the treatment advised to be done.

(b) Detailed clinical note of the treating doctor regarding the treatment. It must contain justification for the treatment as required vide Para-5 of Finance Department Memo No. 11253-F (MED), dated 16-12-2011 read with Finance Department Memo No. 7578-F (MED), dated 04-09-2012.

Yours faithfully,

Sd/- Shri Samiran Pal
Special Secretary to the
Government of West Bengal

No. 71-F(MED) dated 09.10.2013, Source

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