Tender Notice Dt - Department of Health , J&K

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TENDER DOCUMENTGOVERNMENT OF J&KRASHTRIYA SWASTHYA BIMA YOJANAA number of studies have revealed that risk owing to low level ofhealth security is endemic for informal sector workers. The vulnerability ofthe poor informal worker increases when they have to pay fully for theirmedical care with no subsidy or support. On the one hand, such a workerdoes not have the financial resources to bear the cost of medical treatment,on the other; the public owned health infrastructure leaves a lot to bedesired. Large numbers of people, especially those below poverty line,borrow money or sell assets to pay for the treatment in private hospitals.Thus, Health Insurance could be a way of overcoming financial handicaps,improving access to quality medical care and providing financial protectionagainst high medical expenses. The “Rashtriya Swasthya Bima Yojana”announced by the Central Government attempts to address such issues.Government of J&K is inviting tenders for 2 districts namelyJammu and Srinagar of State of J&K.For effective operation of the scheme, partnership is envisagedbetween the Insurance Company, public and the private sector hospitalsand the State agencies. State Government / Nodal Agency will assist theInsurance Company in networking with the Government / Private hospitals,fixing of treatment protocol and costs, treatment authorization, so that thecost of administering the scheme is kept at the lowest, while making full useof the resources available in the Government / Private health systems.Public hospitals, including ESI hospitals and such private hospitals fulfillingminimum qualifications in terms of availability of inpatient medical beds,laboratory, equipments, operation theatres, smart card reader etc. and atrack record in the treatment of the diseases can be enlisted for providingtreatment to the identified families under the scheme.The companies which are in agreement with scheme and its clauses,only need to participate in the bidding and any disagreement in this regardmay invite disqualification / rejection of bid at technical level. Hence all thecompanies are requested to go through the scheme carefully and submittheir agreement in specific format given in the bid.3
Table of ContentsPART I – INFORMATION TO THE BIDDER ABOUT THE SCHEME ..................... 5PART II – SUBMISSION OF BIDS / PROPOSALS .................................................... 31SECTION A – TECHNICAL PROPOSAL ................................................................... 33SECTION B – FINANCIAL PROPOSAL ..................................................................... 34SECTION C – SUMMARY OF PROPOSALS ............................................................ 35SECTION D –DECLARATION BY THE BIDDER ................................................... 36SECTION E – TEMPLATE FOR ANNEXURE .......................................................... 374
Page 1 and 2: GOVERNMENT OF J&KDEPARTMENT OF HEAL
Page 3: GOVERNMENT OF J&KDEPARTMENT OF HEAL
Page 7 and 8: 4. Unit of Enrolment:4.1. The unit
Page 9 and 10: part of insured family member till
Page 11 and 12: iii) Those facilities undertaking s
Page 13 and 14: ased on basic quality criteria as g
Page 15 and 16: Insurance Act 1938.2. Premium payme
Page 17 and 18: (d)(e)(f)pre-defined fee.An enrollm
Page 19 and 20: ) Beneficiary has balance in his/ h
Page 21 and 22: intermediary institutions for the p
Page 23 and 24: to as the “Call Centre Service”
Page 25 and 26: The parties shall refer such disput
Page 27 and 28: for the insurer to download.ii. Dis
Page 29 and 30: esponsibility of the Insurer to ens
Page 31 and 32: 36. Notification of Award And Signi
Page 33 and 34: details of the scheme as mentioned
Page 35 and 36: SECTION B - FINANCIAL PROPOSAL(KIND
Page 37 and 38: SECTION D -DECLARATION BY THE BIDDE
Page 39 and 40: Annexure - 3UNDERTAKING BY THE BIDD
Page 41 and 42: Annexure 5Format for Providing Addi
Page 43 and 44: O.T. Charges, Medicines and Drugs,
Page 45 and 46: 34 FP00300010 J32 Ethmoidectomy - E
Page 47 and 48: 123 FP00500048 Q43 Duplication of I
Page 49 and 50: 212 FP00500137 K51 Ileostomy 7 17,5
Page 51 and 52: 301 FP00600020 D27 Ovarectomy/Oophr
Page 53 and 54: 390 FP00900048 K25 Vagotomy with Py
Page 55 and 56:
477 FP01100044Closed Reduction and
Page 57 and 58:
12 PAEDIATRIC565 FP01200001 Q79 Abd
Page 59 and 60:
653 FP01400045 N28 Repair of Ureter
Page 61 and 62:
743 FP01800016 B53744 FP01800017 B5
Page 63 and 64:
War like operations (whether war be
Page 65 and 66:
Draft MoU Between Insurance Company
Page 67 and 68:
4. Insurer has on the basis of desi
Page 69 and 70:
5. The Hospital shall ensure that m
Page 71 and 72:
2.5 Within a period of 12 hours fro
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2. The hospital undertakes to uphol
Page 75 and 76:
All official correspondence, report
Page 77 and 78:
3. Notwithstanding anything to the
Page 79 and 80:
each of the terms of this Agreement
Page 81 and 82:
Annexure IHospital Services- Admiss
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Case 3: In case of in-sufficient fu
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Qualifying Criteria for Smart Card
Page 87 and 88:
Annexure 14List of Public Hospitals
Page 89 and 90:
2. Smart card:2.1. OverviewA smart
Page 91 and 92:
esponsible for each of these to the
Page 93 and 94:
• Licensed system software• Cer
Page 95 and 96:
chip personalization. It is mandato
Page 97 and 98:
Annexure 17Guidelines for the RSBY
Page 99 and 100:
1.3.1. Re-issuance of a card: This
Page 101 and 102:
2. District Server1.3.4.4.1. The ca
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Tender Notice Dt - Department of Health , J&K

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