NUST MEDICAL POLICY 2015
1.
The document will be called “NUST MEDICAL POLICY 2015” and
Title.
will come into force with effect from 1 November 2015.
2.
Scope.
It will be applicable to NUST employees, serving at Main Office and
its institutions, to the extent explained in the succeeding paras.
3.
Definitions. For the purpose of this policy, the pertinent terms are explained as
under:a.
Family.
Includes spouse, sons, daughters and parents of the
employee provided that:(1)
Sons will be taken as part of the family till the age of 18 years or till
get married, whichever is earlier.
(2)
Daughters will be taken as part of the family till they get married.
(3)
Parents will be taken as part of the family if both of them are not in
any service or business and their entitlement will be ascertained as
under:(a)
If the employee has other siblings, the parents will be
assumed to be dependent on his / her elder brothers,
primarily.
(b)
On the employee, if being the only son / daughter.
(c)
On the employee, even in the presence of elder brothers, if
parents are residing with and dependent on him / her.
(d)
If more than one child is serving as employees, the
parents will be assumed to be dependent on one employee
only, with higher pay scale.
b.
Medical Authority.
Means “Director Medical Sciences” or any
officer authorized by the competent authority as his representative at
Main Office NUST and its institutions.
4.
Execution. The extent and methodology for the provision of medical services
are explained as under:-
a.
Emergency Medical Services. All NUST employees, their families and
students will be entitled to free emergency treatment at H-12 campus / MI
Room at its institutions.
b.
Faculty & Officers (EBPS 17 & Above) on Contract on Lump Sum Pay
Package and their Families Less Parents
(1)
For their Indoor / Outdoor health care needs, they will be offered
“Health Insurance Package” on 60:40 premium sharing basis
between the employee and NUST except during the probation
period when they will not be entitled to it. The package may be
offered to fresh faculty members / officers as and when and to the
extent as deemed appropriate.
(2)
For the members opting for the package, premium deduction and
the processing of reimbursement cases will be undertaken by
Finance Directorate.
(3)
For the Faculty members and Officers who decline the package
offer, NUST will bear no responsibility what so ever towards their /
their families’ health care needs which will be managed at their own
except as specified in para 4a ante.
c.
Officers (BPS 17 & Above) on Regular Basis & NG Staff
(1)
The employees will be entitled to medical allowance as per NUST
rules.
(2)
The employees and their families will be entitled to Outdoor (other
than hospitalization) medical services in the manner specified
below:(a)
H-12 Medical Centre / MI room at institutions will act as filter
clinics to attend to the emergencies and routine sick report
and patients will be provided with consultation and
emergency treatment for a maximum of 5 days in a case.
(b)
Except emergencies, which may report at any time,
employees seeking medical assistance will report to the
Medical Centre at dedicated sick report time along with sick
report, to be initiated by an officer of that office. The sick
report will be endorsed by Medical Officer (MO) with the
diagnosis / disposal of the patient as under:(i)
Medicine & Duty
-
M&D
(ii)
Medicine & Rest
-
M&R
(iii)
M&R will be restricted to a maximum of 03 days,
beyond which hospitalization should be considered.
Bed rest without the need of hospitalization will be
counted towards medical / sick leave, on the
recommendation of Medical Authority.
(c)
Except emergencies, which may report at any time, the
employees’ families will report to the Medical Centre / MI
Rooms at sick report stipulated time with their updated family
treatment card. The specimen of the card will be prepared by
NUST Medical Centre which will undergo bulk printing while
based on the available data; the cards will be prepared by
the respective Directorates / Institutions.
(d)
Cases requiring opinion of specialists will be referred as
under:(i)
For the Directorates / Institutions at H-12 Campus, by
MOs of NUST Medical Centre
(ii)
For other Institutions, by MO of respective MI Room
(iii)
In principle, the cases will be referred to Government
/ Armed Forces hospitals or any other hospital,
deemed appropriate by the medical authority if the
required expertise and capabilities do not exist in
Government / Armed Forces hospitals.
(e)
The expenditure on the treatment and investigations advised
by specialist without hospitalization will initially be borne by
the employee with filing of reimbursement claim
subsequently (on specified form) with supporting medical
documents.
(f)
Medicines advised by specialist after first visit of the patient
or any new medicine advised subsequently, as part of long
term treatment, will be purchased by the employee, initially
for a maximum duration of one week and subject to its
tolerance by the patient, the same may be purchased for a
maximum duration of two weeks at a time, till changed
by the specialist. Reimbursement cases will be considered
accordingly.
(g)
Except in emergency which will be ascertained by Medical
Authority, expenditure incurred on the treatment /
investigations in hospitals / clinics other than Government /
Armed Forces hospitals will not be reimbursed. If a
justification for getting treatment / undertaking investigations
from a hospital other than Government / Armed Forces
hospitals exists, the non-existence of the consultative /
treatment / diagnostic capabilities will be required to be
certified by the Medical Superintendent of the Government /
administrator / concerned consultant of the Armed Forces
hospital and verified by Medical Authority.
(h)
Cases requiring day care operative procedures and
sophisticated
investigations
Echocardiography,
like
Angiography,
CT
all
scan,
other
MRI,
scanning
procedures, Hysterosalpingography, all biopsies etc. will
seek prior written approval of Medical Authority along
with
complete
medical
documents
and
financial
effects.
(j)
To cater for the outdoor reimbursement provisions, they will
be entitled to an outdoor consultation / treatment /
procedure / investigations expenditure ceiling on
reimbursement basis, as under:-
(k)
(i)
BPS 1 – 5 / equivalent -
Rs 4,000 / family member
(ii)
BPS 6 – 10 / equivalent -
Rs 5,000 / family member
(iii)
BPS 11 – 16 / equivalent - Rs 6,000 / family member
(iv)
BPS 17 – 18 / equivalent - Rs 7,000 / family member
(v)
BPS 19 / equivalent -
Rs 9,000 / family member
(vi)
BPS 20 / equivalent -
Rs 12,000 / family member
Day Care Procedures like cataract, minor surgical and
gynaecological procedures, endoscopies, scanning etc. are
disposed of in hospitals within a couple of hours and
therefore hospitalization is not justified in such cases. All
such procedures, in principle, will be accounted for against
Outdoor medical expenditure ceiling unless considered
otherwise by Medical Authority.
(l)
No medical expenditure ceiling will be entitled to NG staff
employed on contract, during the probation period.
(3)
For Indoor (hospitalization associated) health care needs of the
employees and their families, the following will apply:(a)
Except in emergency, hospitalization / operative or any other
procedure will strictly be on the discretion / approval of
NUST Medical Authority and the opinion of any specialist will
not be a binding on NUST.
(b)
Except
for
hospitalization
emergencies,
/
surgical
all
cases
intervention
/
requiring
sophisticated
investigations like CT and other scans, MRI, Angiography
etc, will require prior approval of Medical Authority. For
NUST H-12 Campus Main Office / Directorates / Institutions,
these will be processed with Director Medical Sciences
through NUST Medical Centre while for the other Institutions;
it will be sought through respective Medical Officer.
However, such cases pertaining to Institutions other than H12 Campus requiring medical expenditure over Rs 15,000/(Rupees Fifteen Thousand Only) will also be processed with
Director
Medical
Sciences
for
prior
approval.
In
emergencies, where prior approval could not be sought,
case will be regularized by seeking ex-post-facto sanction.
(c)
Hospitalization associated health care delivery will, in
principle, is through Government / Armed Forces hospitals,
where applicable. Hospitalization may be undertaken in
other hospitals with prior approval of Medical Authority, if the
required expertise and capabilities do not exist in
Government / Armed Forces hospitals. The non-existence of
the required consultative / treatment / diagnostic capabilities
will be required to be certified by the Medical Superintendent
of the Government / administrator / concerned consultant of
the Armed Forces hospital and verified by NUST Medical
Authority.
(d)
The expenditure during hospitalization will initially be borne
by the employee with filing of reimbursement claim
subsequently (on specified form) with supporting medical
documents.
(e)
For the purpose of reimbursement, as a rule, the rates of
Armed Forces / Government hospitals for room rents /
investigations / procedures / operations will be taken as
reference. Any expenditure incurred over and above to
those, when treatment undertaken in other hospitals in
emergency and that too vetted by NUST Medical Authority,
will be borne by the employee.
(f)
Unless necessitated by the condition of the patient for
placing him / her at another place, in principle, the
employees will be entitled to the following hospital
accommodation:-
(g)
(i)
BPS 1-16 / equivalent -
General ward
(ii)
BPS 17-19 / equivalent -
Semi-private room
(iii)
BPS 20 / equivalent -
Private room
No hospitalization associated services will be entitled to NG
staff employed on contract, during the probation period.
(4)
For the dental treatment, the employees and their families will be
entitled to consultation and treatment of common gum diseases
and extraction of carious / impacted tooth. All fillings / root canal
treatment / orthodontic / prosthodontic / cosmetic procedures /
crowning / bridging / scaling / dentures / elective maxillo-facial
surgery etc. will not be covered towards entitlement. NG staff
employed on contract will not be entitled to dental treatment, during
the probation period.
d.
Serving Armed Forces Officers /JCOs/Soldiers.
All serving Armed
Forces officers / JCOs / soldiers and their families will be entitled to free
emergency services at NUST Medical Center / MI Room of
institutions.
However, they will get long term treatment for themselves and their
families from respective Armed Forces hospitals.
e.
Retired Armed Forces Officers.
All retired Armed Forces officers
employed on contract and their families will be entitled to free emergency
services at NUST Medical Center / MI Room of institutions. However, they
will get long term treatment for themselves and their families from
respective Armed Forces Hospitals. If they want extended coverage,
may join Health Insurance Policy as explained in para 4 b ante.
f.
Retired Armed Forces JCOs / Soldiers.
(1)
They will be entitled to medical allowance as per NUST rules.
(2)
The employees employed on contract and their families will be
entitled to free emergency services at NUST Medical Center / MI
Room of institutions. However, they will get long term treatment for
themselves and their families from respective Armed Forces
Hospitals.
(3)
Cases requiring opinion of specialists / hospitalization will be
referred by Medical officer of NUST Medical Centre / MI Room of
institutions to respective Armed Forces hospitals.
g.
Students.
(1)
Each student will subscribe Rs 100/- pm as “Medical Treatment
Subscription”.
(2)
Will be entitled to free emergency treatment at H-12 Medical Centre
/ MI Rooms at institutions for common ailments, to the extent of
consultation and available medicines.
(3)
Will not be entitled to any medical / surgical / dental / cosmetic
treatment / procedure / investigation not forming part of an
emergency.
(4)
In case of emergencies occurring at NUST campuses, for which
management is beyond the capabilities of NUST Medical Centre /
MI Rooms, they will be referred to Government / Armed Forces
hospitals, in principle, for consultation / treatment / admission /
investigations / operative
procedure
as
deemed
appropriate.
In the best interest of the patient and subject to the decision of
NUST Medical Authority, such emergencies may also be referred to
other hospitals at the station. The authorization of medical
expenditure, incurred in such cases will rest entirely with the
competent authority at NUST.
(5)
They will be entitled to admission to a general ward, unless nature
of emergency demands placing the patient at another place.
(6)
Will not be entitled to the treatment / investigations of any cold
medical / surgical condition that either existed before joining or
appeared during stay at NUST except for that presenting as an
emergency.
(7)
Will be entitled to the reimbursement of medical expenditure
incurred on the treatment / investigations, advised by NUST
Medical Officers / specialists at various hospitals where they were
referred
in
emergency
by
NUST
Medical
Officers.
The
reimbursement claim will be entertained only with the supporting
documents.
(8)
Will not be entitled to reimbursement of medical expenditure
incurred on the treatment of emergencies occurring out-campus like
on leave / weekend etc.
5.
Financial Powers.
a.
For the regularization of medical expenditure, the following financial power
will be exercised:-
b.
(1)
Head of Institutions -
Rs
15,000/-
(2)
Director Medical Sciences -
Rs 150,000/-
(3)
Pro-Rector (P&R) -
Rs 300,000/-
(4)
Rector -
As deemed appropriate
Medical expenditure incurred in emergency and approved by an office
beyond its financial power, will be regularized by seeking ex-post-facto
approval from the appropriate higher office in chain.
6.
Exclusions.
Any modality of medical treatment / investigation / procedure
other than proven and recommended by allopathic system of health care delivery, will
not be covered towards the entitlement. Besides that, the following aspects and the like
will also be part of exclusion network for the purpose of entitlement:a.
Cosmetics, termed as medicines.
b.
Food supplements and fancy Vitamin preparations.
c.
Baby milk formulae.
d.
Scientifically un-proved products / procedures.
e.
Elective tubal ligation / vasectomy.
f.
Un-conventional procedures for fertilization like artificial insemination / test
tube baby.
g.
Active immunization other than covered by EPI.
h.
Elective health care screenings / routine medical checkup.
j.
Procedures like liposuction.
k.
Provision of equipment & appliances like glucometer, spectacle
frames, wheel chair, stretcher, air mattress, contact lens, IOL etc.
l.
Laser and cross linkage treatment for refractive error.
m.
Herbal / Ayurvedic / Unani and all other medications other than Allopathic
school of thought.
7.
Medical Examination on Employment
a.
All prospective employees will be required to undergo medical fitness
screening at the time of induction, the process starting with NUST Medical
Centre / MI Rooms receiving the employment letter from HR Directorate
b.
Medical fitness will consist of thorough clinical examination and a set of
investigations as under:(1)
Blood Complete Picture
(2)
Urine Routine Examination
(3)
Blood Sugar Fasting
(4)
Blood Lipid Profile
(5)
Hepatitis B screening
(6)
Hepatitis C screening
(7)
X-Ray Chest
(8)
Ultrasound Abdomen / Pelvis
(9)
ECG
(10)
Echocardiogram
(11)
Any other investigation, deemed appropriate by NUST Medical
Authority
c.
In the light of the advised investigations and the clinical examination
conducted, a medical fitness / unfitness certificate will be issued by
Medical Centre / MI Rooms.
d.
For the Officers (BPS 17 & Above) on regular basis & NG Staff having
their and their families’ health care liabilities on NUST, the prospective
employees must be in Medical Category AYE (Absolutely normal clinical
examination and investigations). However, the Faculty & Officers (EBPS
17 & Above) on Contract on Lump Sum Pay Package, with their health
care needs covered vide para 4 b ante, may be acceptable with even low
medical category, unless considered incapacitated to discharge their
proposed duties.
e.
Medical fitness / unfitness certificate will only be issued subject to the
completion of formalities explained vide para 6 b ante and no back dated
document to this effect will be issued.
f.
The cost of investigations will be borne by the prospective employee.
g.
The investigations undertaken at the following hospitals / laboratories only
will be acceptable to NUST:-
8.
(1)
Any Armed Forces hospital
(2)
Shifa International hospital, Islamabad
(3)
Agha Khan University hospital laboratory
(4)
Shaukat Khanum hospital laboratory
Weeding Out Employees on Medical Grounds
a.
The cases of employees, who become incapacitated medically / surgically,
to discharge their duties effectively, will be processed by the concerned
Directorate / institution, with Medical Sciences Directorate along with the
supporting documents. Such cases will be brought before a medical board
to consider their fitness for retention in service or otherwise. The
composition of the board will be as under:(1)
Director Medical Sciences -
President
(2)
Officer in-charge NUST Medical Centre -
Member
(3)
Deputy Director Human Resource -
Member
(4)
Medical Officer of concerned institution -
Member
(5)
SO NUST affairs / Deputy Director Administration
of concerned Directorate / Institution -
b.
Member
The case will be evaluated comprehensively by the board through opinion
of the concerned specialist of Armed Forces / Government hospitals and
relevant investigations. A summary and opinion by the board will be
framed and its recommendations will be furnished to the concerned
Directorate / institution for the final disposal
c.
Medical board will convene quarterly or as deemed appropriate. All
Directorates / institutions will process their cases, to be brought before the
medical board, latest by 30 November, 28 February, 31 May and 31
August for the 1st, 2nd, 3rd and 4th quarter, respectively.
d.
The appeal of an employee against the decision of the medical board will
be heard by an Appeal Medical Board, with the following composition:-
9.
(1)
Pro-Rector (P&R) -
President
(2)
Director Medical Sciences -
Member
(3)
Director Human Resource -
Member
(4)
Director / Head of the concerned Institution -
Member
This document supersedes all previous documents on the subject.