Reimburse cost of surgery to retd employee: HC to centre
MUMBAI: The Bombay high court on Friday directed the central government to fully reimburse the medical expense of a pensioner who underwent heart transplant in a private hospital in 2019 as hospitals empanelled under Central Government Health Scheme (CGHS) could not provide him the required treatment. The court has granted four weeks to the central government to reimburse the full expenses.
CGHS empanelled hospitals provide healthcare services to central government employees, pensioners and their dependents at affordable rates.
The pensioner, Anirudh Prataprai Nansi, voluntarily stepped down from central government services in 2008. In 2009, Nansi was diagnosed with Cardiomyopathy which aggravated in 2019 when the functioning of his heart's left ventricle significantly deteriorated to 15%, restricting smooth blood flow. Doctors advised Nansi for immediate heart transplant but as CGHS-empanelled government hospitals did not have the necessary license, approvals and expertise,he sought treatment at the privately owned Sir H. N. Reliance Foundation Hospital. Prior to the surgery, he notified CGHS authorities regarding the estimated cost.
After multiple follow ups, CGHS authorities responded to Nansi's reimbursement request in March 2021, stating that they could only provide an amount of ₹69,000 out of the total expense of ₹22 lakh, as per CGHS's Mumbai rate list.
Nansi approached the Bombay high court in 2021. The court appointed committee heard the case in November 2021 and opined that the full expense could not be reimbursed as it did not match CGHS rates. The committee noted that since the heart transplantation was a planned surgery and not an emergency, the reimbursement should be done as per CGHS rules and guidelines.
Nansi again approached the high court in 2022, citing violation of his fundamental right to life and pleading that the full expense be reimbursed to him as government hospitals lacked the required facilities.
On Friday, the division bench of justices G S Kulkarni and Advait Sethna observed that Nansi cannot be deprived of full reimbursement when he had to undergo treatment at a private hospital as the surgery had to be done immediately. In such cases of necessary treatment, the central government is obliged to grant reimbursement on a case to case basis, the court said.
'Not granting full reimbursement is not only violative of the fundamental rights but strikes at the very root, purpose and essence of these basic human rights as guaranteed by the Constitution, i.e., Right to Life under Article 21. Any employee, merely because he has retired, ought not be differently treated when it comes to genuine and realistic health expenditure,' the bench said.
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Hindustan Times
18 hours ago
- Hindustan Times
Reimburse cost of surgery to retd employee: HC to centre
MUMBAI: The Bombay high court on Friday directed the central government to fully reimburse the medical expense of a pensioner who underwent heart transplant in a private hospital in 2019 as hospitals empanelled under Central Government Health Scheme (CGHS) could not provide him the required treatment. The court has granted four weeks to the central government to reimburse the full expenses. CGHS empanelled hospitals provide healthcare services to central government employees, pensioners and their dependents at affordable rates. The pensioner, Anirudh Prataprai Nansi, voluntarily stepped down from central government services in 2008. In 2009, Nansi was diagnosed with Cardiomyopathy which aggravated in 2019 when the functioning of his heart's left ventricle significantly deteriorated to 15%, restricting smooth blood flow. Doctors advised Nansi for immediate heart transplant but as CGHS-empanelled government hospitals did not have the necessary license, approvals and expertise,he sought treatment at the privately owned Sir H. N. Reliance Foundation Hospital. Prior to the surgery, he notified CGHS authorities regarding the estimated cost. After multiple follow ups, CGHS authorities responded to Nansi's reimbursement request in March 2021, stating that they could only provide an amount of ₹69,000 out of the total expense of ₹22 lakh, as per CGHS's Mumbai rate list. Nansi approached the Bombay high court in 2021. The court appointed committee heard the case in November 2021 and opined that the full expense could not be reimbursed as it did not match CGHS rates. The committee noted that since the heart transplantation was a planned surgery and not an emergency, the reimbursement should be done as per CGHS rules and guidelines. Nansi again approached the high court in 2022, citing violation of his fundamental right to life and pleading that the full expense be reimbursed to him as government hospitals lacked the required facilities. On Friday, the division bench of justices G S Kulkarni and Advait Sethna observed that Nansi cannot be deprived of full reimbursement when he had to undergo treatment at a private hospital as the surgery had to be done immediately. In such cases of necessary treatment, the central government is obliged to grant reimbursement on a case to case basis, the court said. 'Not granting full reimbursement is not only violative of the fundamental rights but strikes at the very root, purpose and essence of these basic human rights as guaranteed by the Constitution, i.e., Right to Life under Article 21. Any employee, merely because he has retired, ought not be differently treated when it comes to genuine and realistic health expenditure,' the bench said.
Time of India
a day ago
- Time of India
IMA seeks clarity on emergency scheme for road accident victims in Haryana
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a day ago
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‘Welfare State Should Prioritise Prohibition': Madras HC Orders Closure Of Liquor Shop Near School
Last Updated: The petitioner alleged that the shop caused a public nuisance, particularly endangering schoolchildren who frequently use the road to reach nearby educational institutions The Madurai bench of the Madras High Court (HC) recently directed the closure of a TASMAC liquor shop located at Trichy Road, Dindigul, emphasising that the State, as a welfare government, must strive toward prohibition and not profit at the cost of public health. The order was passed by a division bench comprising Justice SM Subramaniam and Justice Dr AD Maria Clete in response to a writ petition filed by one K Kannan, who sought the closure of TASMAC shop No.3110. The petitioner alleged that the shop caused a public nuisance, particularly endangering schoolchildren who frequently use the road to reach nearby educational institutions. Raising concerns over its location, the petitioner pointed out that the shop stood in proximity to two schools, a church, and a government hospital. Though the TASMAC authorities argued that the shop was compliant with the prescribed distance of 50 metres under the Tamil Nadu Liquor Retail Vending Rules, 2003, the court found this argument insufficient. The bench noted that mere adherence to technical distance norms cannot override legitimate public health and safety concerns. 'The TASMAC shop would undoubtedly cause public nuisance to the road users, children attending the School and persons going to Church etc.," court noted. The bench referred to Article 47 of the Constitution, which mandates the State to improve public health and endeavor to prohibit intoxicating drinks except for medicinal purposes. 'It is a constitutional philosophy and the Directive principles insist that a welfare Government should strive wholeheartedly to enforce prohibition, rather than establish more TASMAC shops which adversely affect public health," court emphasised. It added, 'When the right to health is a fundamental right, the State must ensure that the prohibition is slowly implemented in a phased manner to reduce harm to the public health". Accordingly, finding merit in the petitioner's concerns and concluding that no prejudice would be caused by shutting down the shop, the high court directed the respondents—including the TASMAC Managing Director and Dindigul District Collector—to close the shop within two weeks from the receipt of the order. The matter is now listed for reporting compliance on June 18.
