Medical reimbursement for government employees is admissible only if the treatment is obtained from hospitals empanelled and recognized by the government, regardless of whether the hospital is otherwise registered.

ORDER

Heard Sri Nadella Venkateswara Rao, learned counsel for the petitioner and learned Assistant Government Pleader for Services (Home) appearing for the respondents and perused the material available on record.

2. Learned counsel for the petitioner submits that the petitioner retired from service as a Sub-Inspector of Police on 30.06.2016. Subsequently, due to ill health, the petitioner was admitted to respondent No.5 hospital on 29.09.2021. Upon diagnosis, the petitioner came to know that he was suffering from “Fournier Gangrene - S/P Fasciotomy & Debridement and the petitioner underwent treatment and was discharged from the hospital on 03.10.2021. The petitioner incurred medical expenses amounting to Rs.1,73,527.20/- at respondent No.5 hospital for the said treatment. Thereafter, the petitioner submitted an application dated 22.03.2022 to the respondent No.3, seeking reimbursement of the said medical expenses. However, respondent No.4 issued a Memo bearing Rc.No.D1/645/CYB/2022 dated 19.04.2022, rejecting the claim of the petitioner and the same is illegal and arbitrary.

3. Learned counsel for the petitioner further submits that respondent No.5 is a hospital duly registered with the Medical and Health Department, and therefore the respondents cannot deny the petitioner’s claim for medical reimbursement and requested this Court to set aside the Memo bearing Rc.No.D1/645/CYB/2022 dated 19.04.2022 issued by respondent No.4 and consequently direct the respondents to release the amount incurred by the petitioner towards his medical treatment, based on the application submitted by the petitioner dated 22.03.2022.

4. On the other hand, learned Assistant Government Pleader for Services (Home), basing on the counter affidavit filed by the respondents, submits that after submission of the medical bills by the petitioner, the respondents verified the records and the list of recognized hospitals available on the website of the Directorate of Medical Education, Telangana State. Upon such verification, it was found that respondent No.5 i.e., M/s. Vicare hospital is an unrecognized private hospital, which is not included in the list of recognized or referred hospital list issued by the Government from time to time. It is further contended that the medical reimbursement claims are governed by the Andhra Pradesh Integrated Medical Attendance Rules, 1972 , as issued under G.O.Ms.No.74, Medical Health and Family Welfare Department dated 15.03.2005, G.O.Ms.No.32, Medical, Health and Family Welfare Department dated 03.11.2014, issued by the Government of Telangana and G.O.Ms.No.55 Medical, Health and Family Welfare Department dated 27.06.2015. As per the said Government Orders, medical reimbursement shall be provided only for the treatment taken in hospitals included in the empanel/recognized hospital list.

5. Learned Assistant Government Pleader for Services (Home) further submits that in the instant case, the petitioner obtained treatment at respondent No.5 hospital, which is merely a registered hospital but not a recognized hospital under the medical reimbursement scheme. Therefore, the respondents have rightly returned the medical bills submitted by the petitioner, and the petitioner is not entitled to claim medical reimbursement and requested this Court to dismiss the writ petition.

6. After hearing both sides and on a perusal of the material available on record, this Court is of the considered view that the petitioner was admitted to respondent No.5 – M/s. Vicare Hospital on 29.09.2021 and underwent treatment for “Fournier Gangrene - S/P Fasciotomy & Debridement”. Thereafter, the petitioner was discharged from th