Hemant Gupta, J. - (1.) THE challenge in the present writ petition is to an order passed by the Central Administrative Tribunal, Chandigarh Bench, Chandigarh (for short the Tribunal) on 03.08.2010 whereby an original application filed by the petitioner for reimbursement of actual expenses incurred by the petitioner on his treatment was declined. The petitioner was working as Senior Tax Assistant in the year 2006 when he suffered a heart attack. He was admitted in a private hospital namely Oxford Hospital, Jalandhar on 04.03.2006 and underwent Coronary Angiography with Stenting on 18.03.2006. He was discharged on 21.03.2006 and joined his duties on 25.04.2006. He incurred expenditure of Rs. 2,94,463/ - and claimed reimbursement of the said amount but only a sum of Rs. 1,72,428/ - was reimbursed.
(2.) AGGRIEVED against the non reimbursement of the remaining amount, he invoked the jurisdiction of the Tribunal under Section 19 of the Administrative Tribunals Act, 1985, which was dismissed on 03.08.2010. It was found that the petitioner is entitled to medical reimbursement in full or on the basis of package rates for having taken treatment at private hospital in view of the judgment of Bombay Bench of the Tribunal reported as (1995) 31 Administrative Tribunal Cases Page 1 titled as 'N.B. Rao v. Union of India' as well as later judgment of the Hon'ble Supreme Court reported as : 1998 (4) SCC 117 titled as 'State of Punjab v. Ram Lubhaya Bagga. Learned counsel for the petitioner points out that the medical reimbursement to the Central Government employees is governed by Central Civil Services (Medical Attendance) Rules, 1944 (for short 'the Rules'). In respect of treatment from the private hospitals, instructions have been issued vide O.M. No. S -14025/55/92 -MS dated 19.08.1993, O.M. No. S -14023/43/94 -MS, dated 31.10.1994 as amended by O.M. No. 14025/43/94 - MS dated 22.04.1998. The instructions permit reimbursement of medical expenses at the rates meant for the Central Government employees under Central Government Health Scheme (CGHS). The instructions contemplates reimbursement of medical expenses for specialized treatment like Heart, Kidney, Coronary etc. at par with Central CGHS beneficiaries as only in these case a package deal arrangement with private hospitals for CGHS beneficiaries exist at present. The relevant circulars issued by Government of India reproduced as under: - "(16) (A) Recognized private hospitals and approved rates for Coronary Bypass Surgery. The approval of the Government is conveyed for reimbursement of medical expenses under Central Services (Medical Attendance) Rules, 1944, for specialized treatments like Heart, Kidney, Coronary, etc., at par with CGHS beneficiaries as only in these cases a package deal arrangement with private hospitals for CGHS beneficiaries exist at present. The rates of Coronary Bypass Surgery for all recognized private hospitals will be as under xx xx xx 2. xx xx xx xx
(3.) A list of private hospitals recognized for Coronary Angiography and bypass surgery on a referral basis is given in the Annexure. 6. The admission in these hospitals will be regulated on the package deal basis. The package will include professional charges like surgeon's fee, anaesthetist's fee, etc., hospital stoppage charges for the total period of stay from admission till discharge, medication and food.";