Reimbursement for Hearing Aids enhanced under CGHS and Medical Attendance Rules

The Department of Health and family welfare has issued order to the effect that rates payable for purchase of hearing aids under CS(MA) Rules, 1944 and CGHS has been increased.  The procedure for purchase of hearing aids by eligible central government employees under CGHS and CS (MA) Rules, 1944 has also been revised.

The following is the text of the said order dated 21.03.2012

No: S..14025/10/2002/MS
Government of India
Ministry of Health & Family Welfare
Department of Health & Family Welfare

Nirman Bhawan, New Delhi 110 108
Dated the 21st March, 2012.

OFFICE MEMORANDUM

Subject: Revision of rates and guidelines for reimbursement of expenses on purchase of Hearing Aids under CS(MA) Rules, 1944 and CGHS- regarding.

With reference to the above mentioned subject the undersigned is directed to refer to the Office memoranda of even No. dated 17.11.2006 and 28.10.2002 and OM Nos.S.14025/36/93/MS dated 26.03.94 and 17.08.1999 and to state that on the basis of recommendations of an Expert Committee, it has been decided to revise he rates and guidelines for hearing aids to be reimbursed under CS (MA) Rules, 1944 and CGHS.

2. The revised ceiling rates fixed for various types of Hearing Aids (for one ear) are as under:

The cost of hearing aid shall include all Taxes including VAT and shall carry ’3′  year Warranty.

The cost of Analogue BTE / Digital BTE / ITC / CIC type hearing aid shall also include the cost of ear mould.

3. Beneficiaries covered under CS(MA) Rules, 1944 / CGHS shall be eligible to obtain hearing aid after the same has been recommended by a Government E.N.T. Specialist on the basis of audiometric and audiological assessment. ENT Specialist shall specify the type of hearing aid most suited for the beneficiary.

4. The permission to procure hearing aid shall be granted by Chief Medical Officer in-charge of CGHS Wellness Centre in case of CGHS pensioner beneficiaries and by the Head of Department /Office in case of serving employees and CGHS beneficiaries of Autonomous Bodies on the basis of recommendation of a Government Specialist and an undertaking that the beneficiary has not been reimbursed the cost of bearing aid in the preceding Five years.

5. Reimbursement claim shall be submitted to CGHS through CMO i/c of concerned dispensary by CGHS Pensioner beneficiary in the prescribed medical reimbursement claim form along with a photo copy of CGHS card, original bill of the Hearing aid and original copy of the permission letter. In case of other beneficiaries, the medical claim shall be submitted to the concerned Ministry/ Department / Office. Reimbursement shall be limited to the ceiling rate or actual cost of the hearing aid, whichever is less.

6. Record of permissions granted for procurement of hearing aids shall be maintained by CGHS in respect of pensioner CGHS beneficiaries and by concerned Ministry / Department Office in respect of other beneficiaries.

7. Replacement of hearing aid may be permitted after 5 years on the basis of condemnation certificate issued by a technical expert and on approval of a Government ENT Surgeon. Maintenance and repair will be the responsibility of the beneficiary.

8. These orders shall supercede all the earlier orders issued on the subject.

9. The revised rates and guidelines shall come into force from the date of issue and shall be valid for a period of two years or till further revision, whichever is earlier.

10. This issues with the concurrence of Integrated Finance Division vide Dy.No. 5894 dated 19.03.2012 of the office of AS&FA, Min. of Health &Family Welfare.

sd/-
(V.P. Singh)
Deputy Secretary to the Government of India