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Governor is now pleased to enhance the ceiling of cashless limit of each IPD treatment in private empanelled hospital to Rs. 2,00,000/- only from the existing ceiling of Rs. 1,50,000/-
Governor is pleased to appoint West Bengal Clinical Establishment Regulatory Commission (WBCERC), as the arbitrator hereafter under WBHS for resolving disputes regarding West Bengal Health Scheme.
Inclusion of State Govt. pensioner/ family pensioner and retired member of AIS of the State Cadre who are parent of government employee, as dependent beneficiary under their in-service son/daughter in WBHS.
Dialysis is a procedure to remove waste products and excess fluid from the blood when the kidneys stop working properly. This procedure is done frequently as a life saving measures for the patient suffering from renal failure (CKD-V stage).
Discontinuation of Form-H and introduction of comprehensive Form-D4 & preparation of claims in progressive manner by the private hospitals under WBHS.
Governor is now pleased to revise the existing rate list for Tata Medical Center, Rajarhat only, for treatment of the beneficiaries under West Bengal Health Scheme.
New matrix of Approving Authority for all employees and pensioners of PW Department as well as Directorates and sub-ordinate Offices will be as follows:-
Revision of financial power for sanctioning of reimbursement claims for medical treatment and attendance under West Bengal Health Scheme.
Acceptability of online purchase for medicine and mandatory submission of Cash Memo/ Tax Invoice from GST registered pharmaceutical shops in case of offline purchase of medicine.
Yes, up to 60% or 80% (depending on the nos. of available beds of treating hospital) of cost for admissible medicines prescribed in Trade/ Brand name for indoor treatment is reimbursable.
Governor is now pleased to extend the last date for incorporation of the Aadhaar No. for the employees/ pensioners along with their beneficiaries above the age of five years up to 31.03.2023.
An amount of Rs. 8500/- for parent and Rs. 5000/- for other members of the family has been fixed as the maximum ceiling of gross income/ earning for becoming the dependent beneficiary under the Scheme.
If patient has a history of cardiac surgery like of Bypass Surgery, AICD, Valve Replacement or Implantation of Stent through Angioplasty or Implantation of Pacemaker, will get lifelong reimbursement of the cost.
Governor is now pleased to enhance the ceiling of cashless limit of each IPD treatment in private empanelled hospital up to Rs. 1,50,000/- only from the existing ceiling of Rs. 1,00,000/-.
Governor is pleased to introduce the online processing of medical advance claim through WBHS Portal with the following guidelines, new set of Forms and Pro-forma Estimate from the Hospital for processing and settlement of the claim:
Revision of guidelines for seeking permission by the state empanelled private hospitals from West Bengal Health Scheme Authority for providing treatment under West Bengal Health Scheme.
Considering the gravity of the disease/illness named ‘Covid-19’ the West Bengal Health Scheme Authority (WBHSA) has agreed to include the same as 17th (seventeenth) disease/ illness in the OPD List of WBHS.
Last date of incorporation of Aadhar Number of existing beneficiaries above the age five years is 30.06.2022 failing of which they may face inconvenience to avail uninterrupted benefit under this scheme.
All Head of the offices under Govt. of West Bengal have the financial power for sanctioning the reimbursement cost of medical attendance and treatment under West Bengal Health Scheme (WBHS).
Introduction of online functionality for seeking prior permission of availing treatment in Enlisted Hospitals outside the State through West Bengal Health Scheme Portal.
Training on processing & disbursement of reimbursement claim under West Bengal Health Scheme on ONLINE platform through WBHS and WBIFMS Portal.
Governor is pleased to prescribe the entitlement of accommodation for indoor treatment in different Hospitals including the Government Hospitals and Tata Medical Centre, Rajarhat to the beneficiaries under WBHS after ROPA-2019
Governor is pleased to implement ONLINE functionality for discontinuation of Medical Allowance/ Relief from the Salary/Pension of the enrolled employee and pensioner with the following directives:
The facility shall be restricted only for the treatment of one or more diseases/ illness mentioned in the Enrolment Certificate out of the above mentioned critical diseases/ illness.
Introduction of online functionality for Opt-out and Termination of enrolment from West Bengal Health Scheme through WBHS Portal.
Online processing of reimbursement claims through WBHS Portal and making payments thereof under WBIFMS in integrated web mode was under active consideration for some time past. And, in order to make the ONLINE processing of these claim more comprehensively, the existing claim Forms also modified.
Teachers including Librarians and Graduate Laboratory Instructors of the College of Medicine and JNM Hospital, Kalyani and Officers of the West Bengal University of Health Sciences, Salt Lake and the family members.
For permanent Teachers/ Officers and their dependent family members of Bidhan Chandra Krishi Viswavidyalaya (BCKV) and Uttar Banga Krishi Viswavidyalaya (UBKV) and College of Agriculture under both Universities.
Governor is pleased to introduce the two new TR forms with number TR-68C and TR-31A for drawal of fund related to claims for Reimbursement/ Advance/ Advance Adjustment under WBHS in respect of Government employees/ pensioners and Teachers /Officers of GIA Colleges & Universities.
For processing of claim of West Bengal Health Scheme (WBHS) through WBHS Portal, mapping of Payment Head of Account from the end selective users (Head of Office himself/ herself or Approver of User Administration) of a Head of Office, is mandatory.
Extension of age limit of new born baby for availing benefits of West Bengal Health Scheme with the enrolment certificate of parents.
Governor is pleased to issue a fresh guidelines for reimbursement towards the cost of any IPD treatment including COVID-19 cases in the following manner for the benefit of members enrolled under West Bengal Health Scheme.
With the inclusion of Pay Clinic of Government Hospitals and Tata Medical Centre, Rajarhat under WBHS and due to implementation of ROPA 2019, and as such it has been felt necessary to redefine the type of accommodation which the employees and pensioner may avail at the time of indoor treatment.
Relaxation of proviso of Financial Power for Sanctioning Cost of Treatment for payment against Cashless Admissibility Reimbursement Certificate (CARC).
To apply for the same to any office up to sub-divisional level of the department concerned nearest to the residence of the pensioner or to the office of the Sub-divisional Officer of the Sub-Division where pensioner resides.
Medical benefits to the serving Teachers including Librarians and Graduate Laboratory Instructors of Government-aided Colleges and serving Teachers and Officers of State aided Universities.
Existing, retired State Government employees pensioners, Family Pensioners, AIS and retired AIS officers who have not enrolled their names under the WBHS may be allowed to enrol up to 31.03.2019.
Condonation of delay beyond one year for both Indoor and OPD cases, proposal is to be submitted through the administrative department before the WBHS Authority under Finance Department.
Introduction of online seeking/ grant of permission and preparation/ submission of online Bill by Health Care Organizations (HCOs) in West Bengal Health Portal.
Governor is pleased to relax the income limit for parents, son, minor brother, unmarried/ widowed/ divorced daughters, unmarried/ widowed/ divorced sisters of the Government employee/ pensioner for medical treatment of Critical diseases.
Governor is pleased to extend the last date of online application for enrolment under the cashless medical treatment scheme upto 30th September, 2018.
Re-enrolment process under the West Bengal Health for All Employees and Pensioners Cashless Medical Treatment Scheme, 2014 should be completed within 31.03.2018.
Governor is pleased to extend the last date of online application for enrolment and validity of existing card from 1st October, 2017 to 31st March, 2018.
Governor is pleased to provide medical benefits to the Serving Teachers incl. Librarians and Graduate Laboratory Instructors of Govt-aided Colleges and State-aided Universities.
Governor is pleased to decide that all existing staff members of work charged establishments under State Government establishments will be included under West Bengal Health Scheme.
Group- C employees as appointed under the West Bengal Services (Appointment, Probation and Absorption of Group C Employees) Rules, 2013 will also be eligible for Health Scheme.
Governor is further pleased to extend the last date of online application for enrolment under Cashless Medical Treatment Scheme from 1st April, 2017 to 30th September, 2017.
Governor is pleased to discontinue empanelment of Apollo Gleneagles Hospital under West Bengal Health For All Employees and Pensioners Cashless Medical Treatment Scheme, 2014.
Introduction of Government Employee/ Pensioners login in West Bengal Health Portal and uploading all beneficiaries’ photo, signature and blood group at the time of Online Enrolment.
Guidelines regarding submission of documents by the Health Care Organisations for new/renewal of Memorandum of Agreement under West Bengal Cashless Medical Treatment Scheme, 2014.
Memorandum of Agreement between the Private Health Care Organisations and State Government for empanelment to provide treatment facilities & diagnostic facilities.
Financial Power as delegated by No. 483-F dated 26.05.2016 for sanctioning cost of medical attendance and treatment cannot further be re-delegated.
Governor has been pleased to revise the Financial Power for sanctioning cost of medical attendance and treatment to various designated officers.
Authority may condone the cases related to delay in preferring of indoor treatment claim beyond 3 months but within 1 year from the date of discharge on reasonable ground.
After 31.03.2017 neither Sanction Order nor bills will be processed without system generated Certificate of Enrolment duly verified from the respective DDO.
Governor is further pleased to extend the last date of enrolment under Cashless Medical Treatment Scheme from 1st April, 2016 to 31st March, 2017.
Guidelines regarding signature in Certificate of Enrolment and Form – H & D4 and other documents under West Bengal Health For All Employees and Pensioners Cashless Medical Treatment Scheme, 2014.
Whether Government Employee/ Pensioner and their eligible dependent members of the family can avail reimbursement facility with the ‘Certificate of Enrolment’ generated from Health Scheme Portal?
Procedure for settlement of Cashless treatment bills amounting more than Rupees One lakh under West Bengal Health For All Employees and Pensioners Cashless Medical Treatment Scheme, 2014.
Last date of enrolment in cashless medical treatment scheme is extended upto 31.03.2016. Validity of existing health card as per WBHS-2008 also be extended upto 31st March, 2016.
Modification of TR form 68B which will be used for the purpose of drawal of fund related to the claim under Cashless Medical Treatment Scheme, 2014, from the Treasuries/ PAO’s.
Last date of enrolment under West Bengal Health for All Employees and Pensioners Cashless Medical Treatment Scheme, 2014 is hereby extended from 31st March to 30th September, 2015.
Opening of two New Scheme Heads for Payment to Health Care Organisations for Cashless Medical Facility under West Bengal Health for All Employees and Pensioners Cashless Medical Treatment Scheme, 2014.
Send the receipted bill along with copies of all prescriptions, reports, bills to Medical Cell of Finance Department instead of sending the same to the respective Government department, as a temporary measure.
Implementation of West Bengal Health for All Employees and Pensioners Cashless Medical Treatment Scheme, 2014 with respect to processing of Bills from HCOs located at Kolkata/ Districts to respective Govt. Department/ District Offices.
Receipted bill along with copies of all prescriptions, reports, bills etc. will now be required to be sent to the respective Government department of the employee/ pensioner as per his declaration.
To avail the benefit of the Cashless Medical Treatment under the Scheme, a Government Employee or Government Pensioner shall have to enroll afresh at WBHS Monitoring System. This link will be operational from 15.09.2014.
Clause 14 of the Agreement already in existence between HCOs and the Finance Department for providing medical attendance and treatment to the beneficiaries under the WBHS 2008 be treated as substituted with this.
Cashless medical treatment up to Rupees one lakh will be provided to the beneficiaries for undergoing treatment in private empanelled hospitals within the state including NCR.
This scheme shall apply to all State Government employees, State Government pensioners including family pensioners and the beneficiaries who have opted for existing scheme in lieu of medical allowance.
Financial Power of various designated Officers for sanctioning cost of medical attendance and treatment is increased making amendment to the clause 13 (3) of the West Bengal Health Scheme, 2008.
Governor is pleased to reconstitute West Bengal Health Scheme Authority consequent upon joining two numbers of Medical Officers on re-employment to the Medical Cell of Finance Department.
All WBA & AS cadre officers are requested to take prior permission before receiving treatment, in any recognized speciality hospitals outside West Bengal.
The State Government with the objective of promoting the welfare of State Government Employees and improve their health and housing benefits has decided to introduce the following measures:
The existing, retired State Govt employees, pensioners, family pensioners, AIS and retired AIS officers who have not enrolled their names under West Bengal Health Scheme, 2008 may be allowed to enrol their names up to 31.03.2015.
Government Employees and Pensioners enrolled under West Bengal Health Scheme, 2008 may avail themselves of Cashless benefit up to Rs. 1.00 Lakh during their indoor treatment in the empanelled hospitals under WBHS-2008.
Governor is pleased to decide that henceforth there is no need to provide intimation to the Head of Office/ PSA before undergoing Medical Treatment.
Consequent upon the depth of the disease of Renal failure West Bengal Health Scheme Authority has amicably considered the treatment of Continuous Ambulatory Peritoneal Dialysis (CAPD), also called Home Dialysis, to be started at Home.
Governor is pleased to reconstitute West Bengal Health Scheme Authority with the following composition:
Governor is pleased to recognize Eskag Senjeevani & Eye Mirosurgery & Laser Centre for the purpose of availing benefits of medical attendance and treatment under the West Bengal Health Scheme 2008.
As per recommendations of West Bengal Health Scheme Authority, in case of OPD treatment, intimation to the Head of Office/ PSA is not mandatory.
Permission from the West Bengal Health Scheme Authority is mandatory for performing certain procedures where the cost of treatment exceeds Rs. 2.5 Lac.
Dr. Kapur’s The Healing Touch Eye Centre, D-8, Vikas Puri, New Delhi-110018 is recognized for the purpose of availing benefit of medical attendance and treatment under the West Bengal Health Scheme, 2008.
West Bengal Health Scheme allows to draw medical advance for outdoor treatments relating to B-thallasaemia, Hepatitis C and Carcinoma including Multiple Mycloma.
Prior permission of the West Bengal Health Scheme Authority will not be required for purchase of Digital Hearing Aid subject to the condition that the maximum reimbursable amount is limited to the rate mentioned under WBHS code No. 03003003.
For receiving treatment at Tata Memorial Hospital, Mumbai, prior permission of the West Bengal Health Scheme Authority and referral from recognized Health Care Organization will no longer be necessary.
Advance purchase of medicine for maximum period upto six months may be allowed when medicine are prescribed for indefinite period by outside hospitals.
Alphabetical list of empanelled private hospitals/ diagnostic centres under West Bengal Health Scheme, 2008, with address and contact persons for the West Bengal Govt. Employees.
Governor is pleased to recognize the following private Health Care Organisations under the West Bengal Health Scheme 2008: SHARANYA, Glocal Hospital Dubrajpur, (Unit of Glocal Health Care System Pvt. Ltd.), North Bengal Oncology Centre Pvt. Ltd.
Secretaries shall dispose of at their level the matters of approval for Medical Advance and Medical Reimbursement cases for the State Government employees upto an amount of Rs. 2.00 lakh in each case.
For treatment in non-empanelled Health Care Organisations, cost of medicines in generic names may be reimbursed in full. Trade name shall not be considered by any means.
West Bengal Health Scheme, 2008 is applicable to the West Bengal State Government employees working in the National Capital Region and pensioners/ family pensioners of the State Government and their beneficiaries residing there.
Guidelines to be adopted for change of sanctioning authority in connection with medical benefits under the W.B.H.S. 2008 for the State Government Pensioners/ Family Pensioners.
Not more than two packages should normally be performed or planned. Permission of the West Bengal Health Scheme Authority is necessary for more than two packages.
Pensioners/ family pensioners are also allowed to claim reimbursement of medical expenses both from the Insurance Company as well as the West Bengal Health Scheme, 2008.
The existing and retired employees not enrolling their names under West Bengal Health Scheme by 31.03.2013 shall not be eligible to get the benefits of the Scheme in future.
(a) AIIMS, New Delhi, (b) PGIMER, Chandigarh, (c) Tata Memorial Hospital, Mumbai, (d) NIMHANS, Bangalore, (e) Christian Medical College, Vellore, (f) Apollo Hospitals, Chennai, (g) Sankara Netralaya, Chennai (h) L.V. Prasad Eye Hospital, Hyderabad, (i) Asian Institute of Gastroenterology, Hyderabad, (j) Metro Hospital & Cancer Institute, New Delhi.
Here is the latest updated list of Class – II Hospitals/ Specialty Hospital which are under West Bengal Health For All Employees And Pensioners Cashless Medical Treatment Scheme 2014.
Due to late submission of option for enrollment under the Scheme Enrollment Certificate could not be issued by the authorities within the stipulated period.
Here is the latest updated list of Class – I Hospitals/ Specialty Hospital which are under West Bengal Health For All Employees And Pensioners Cashless Medical Treatment Scheme 2014.
WBHS beneficiaries often face a lot of problems e.g. Improper Medical facilities from empanelled hospitals nursing homes, difficulties while reimbursement of medical bill for final settlement.
Now, the cost of medical treatment in non-empanelled private Health Care Organisation is also reimbursable under certain conditions. Request for clarifications of some points laid down in the said Scheme after its amendments are being received by this department from various corners.
The expenditure incurred by, and to be reimbursed to on account of medical attendance and treatment under the WBHS, 2008 may be drawn in T.R. Form. 68 and 68A.
Cost up to 80% of the West Bengal Health Scheme approved rates may be reimbursed for the indoor medical treatment, if availed in a non-empanelled private hospital.
Cost of train journey for medical attendance and treatment in speciality hospitals outside the State with one attendant, both ways, may be reimbursed.
Retired members of AIS shall have to pay Rs. 40,000/- (Rupees Forty Thousand) only as one-time contribution for enrollment of names under the Health Scheme.
Governor is pleased to extend the benefits of the WBHS to retired members of AIS on payment of one-time contribution of Rs. 40,000/- only.
Here is the latest updated list of Class – III Hospitals/ Specialty Hospital which are under West Bengal Health For All Employees And Pensioners Cashless Medical Treatment Scheme 2014.
Here is the latest updated list of Class – I, Class – II and Class – III Diagnostics Centres which are under West Bengal Health For All Employees And Pensioners Cashless Medical Treatment Scheme 2014.
The existing and retired Govt. employees who have not yet enrolled their names under the health scheme may be allowed to enroll their names within 31.03.12.
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