The Odisha State Treatment Fund will provide financial assistance for treatment of poor patients suffering from life-threatening disorders and diseases. The financial assistance will be released to the medical institutions where the patient undergoes treatment.
Odisha State Treatment Fund - Introduction
The Department of Health and Family Welfare, Government of Odisha introduced a scheme named “Odisha State Treatment Fund” which aims to provide financial assistance to poor patients suffering from life-threatening disorders and diseases for treatment of their major ailments.
The fund is managed by an autonomous society known as “Odisha State Treatment Fund Society”. The society is registered under the Societies Registration Act, 1860.
The financial assistance will be released to the medical institutions in which treatment has been/is being given to the patients.
The eligible patients will be provided assistance for treatment in specific life-threatening diseases as mentioned at Annexure – D in the detailed guidelines.
Benefits
- OSTF will be a top-up to RSBY. The patient will be covered under RSBY at the first instance and where the amount of assistance required exceeds the limit of RSBY, the patient will be provided assistance under OSTF.
- The treatment cost approved shall be within the upper limit of Rs. 3.00 lakh (Rupees three lakh only).
- The sanction of District Headquarters Hospitals shall be limited to Rs. 30,000 per case. Where the quantum of assistance exceeds Rs. 30,000, the CDMO, with the approval of the Collector-cum-District Magistrate concerned, can sanction up to Rs. 50,000.
- For assistance over and above Rs. 3.00 lakh, approval of the Hon'ble Chief Minister of Odisha needs to be obtained.
Eligibility
- Applicable to persons below the poverty line, or persons with an annual family income not exceeding Rs. 40,000/- in rural areas and Rs. 60,000/- in urban areas. Either a BPL card, an AAY card, or an annual income certificate issued by the concerned Tahasildar will be accepted for determining eligibility.
- Rastriya Swasthya Bima Yojana (RSBY) card holders are also eligible under this scheme.
- An unknown accident victim, or patients duly referred from registered destitute homes, orphanages, mental asylums, or child care institutions, are also eligible for assistance under the scheme, subject to citing sufficient reason for recommending the patient.
- Assistance will be available only to patients undergoing treatment as in-patients in any of the government or empanelled private hospitals. However, this will not restrict cancer patients from receiving chemotherapy in government day-care centres without formal admission, nor patients who have undergone kidney transplantation at government hospitals from receiving post-operative care, including the supply of free medicines and investigations, up to six months from the date of discharge.
Exclusions
- Central Government, State Government, and PSU employees are not eligible.
- Assistance will not be available for reimbursing the expenditure incurred by the applicant. The date of application for seeking financial assistance should be during the course of treatment.
- Reimbursement of medical expenditure already incurred for treatment/operation shall not be permissible.
- Diseases of common nature and diseases for which treatment is available free of cost under other health programmes/schemes will not be covered.
- Assistance will normally not be provided where medical coverage under ESI, CGHS, or any other scheme is available, or where there is a provision for reimbursement of the cost of medicine.
- Any person shall be assisted once in a financial year. Repeat assistance for the same ailment shall not be allowed in any case. However, this will not bar receiving treatment assistance in a phased manner for diseases such as cancer, collagen disease, renal failure, etc.
Application Process
A. Procedure for seeking treatment assistance in Government Medical Colleges & Hospitals, Sishubhawan, Cuttack and AHRCC, Cuttack under “OSTF”
- The application in the prescribed format with all necessary documents attached to it shall be submitted by the applicant to the Nodal Officer of the concerned Department. The Nodal Officer will scrutinize the application and will forward the same to the HOD of the concerned Department.
- If the Committee approves the same, the treatment of the patient will be done free of cost at the hospital, strictly restricted to the amount sanctioned.
- The sanctioning power of the Committee shall be limited to Rs.1.00 lakh only. Where the quantum of assistance exceeds Rs.1.00 lakh, the Screening Committee will immediately sanction assistance up to Rs.1.00 lakh and, with the approval of the Revenue Divisional Commissioner concerned, can sanction the rest of the amount up to a maximum of Rs.2.00 lakh. In case of treatment assistance required beyond Rs.2.00 lakh, the same shall be forwarded by the Screening Committee with their views to the Executive Committee of OSTFC for consideration and approval.
- A separate bank account in State Bank of India, nearer to the medical college shall be opened by the medical college under the signature of the Dean & Principal, Superintendent and DDO concerned. Amount can be withdrawn with the signature of at least two of the account holders.
B. Procedure for seeking treatment assistance at District Hospitals / Capital Hospitals / RGH Under “OSTF”
- The patient will submit the application form in the prescribed format with all necessary documents attached, to the Nodal Officer.
- If the Committee approves the same, the treatment of the patient will be done free of cost at the hospital, strictly restricted to the amount sanctioned.
- The sanctioning power of the Committee shall be limited to Rs.30,000/- only for District Headquarters Hospital and Rs.1.00 lakh for Capital Hospital and RGH. Where the quantum of assistance exceeds Rs.30,000/-, the CDMO with the approval of the Collector‑cum‑District Magistrate concerned can sanction up to the maximum limit of Rs.50,000/-. For CMO, Capital Hospital, BBSR and RGH, Rourkela, if the treatment cost exceeds Rs.1.00 lakh, the same will be referred to DMET, Odisha for approval.
- Director / CMO / CDMO will sanction the treatment cost for which they are empowered and ensure continuance of treatment of patient pending approval of designated authority for the sanction of balance required amount.
- A separate bank account in State Bank of India, nearer to the DHH / Capital Hospital / RGH will be opened with the signature of CDMO / CMO, ADMO (Medical) of DHH / DDO and one of the Specialists to operate the fund. Amount can be withdrawn with the signature of at least two of the account holders.
C. Procedure for seeking financial assistance For treatment at private & other hospitals under “OSTF”
- The eligible patients will not be admitted into empanelled private hospitals as a first entry case. They must be referred from Govt. Medical College or by the CDMOs / CMOs as have been authorised by Govt. (Subject to modification from time to time)-Annexure- F.
- In emergency case (cardiac arrest, road accident etc.) the patient will get himself admitted to the empanelled private hospital without being referred. However, the authority of private hospital will intimate such admission to DMET within 24 hours. On being satisfied that the patient was suffering from a disease requiring immediate treatment, DMET will approve covering such patient under OSTF fold.
- The Private Hospitals on admission of the patients will provide the required treatment and claim the treatment cost from DMET, Odisha after discharge of the patient.
- Funds will be released in favour of Private Hospitals towards the treatment of eligible patients as per CGHS rate applicable to the city where the hospital is located or the actual cost of treatment whichever is less.
Downloads & Media
PDF
Guidelines
EXTERNAL LINK
List Of Empanelled Private Hospitals