Form B - Application For Reimbursement/direct Payment Of Medical Expenses (Except Drugs Provided By The Hospital Authority) In Accordance With Csb Circular No. 2/2013 Page 8
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8. Any reimbursement and / or direct payment of medical expenses is granted to the applicant on
condition that any overpayment to him / her are recoverable in full as a debt with interest (as
appropriate) and all costs and expenses incurred in recovering such debt and interest from him
/ her. In consideration of the Government granting to him / her the reimbursement and / or
direct payment of medical expenses, he or she charges in favour of the Government all salaries,
pensions, gratuities, allowances, benefits (including reimbursement for expenses already
incurred) and any other monies payable or due to him / her or his / her estate from the
Government (collectively, “Salaries and Pensions”) and accrued benefits derived from
voluntary contributions under any provident fund scheme (“Accrued Benefits”) as security for
payment or repayment of all sums (including interest, costs and expenses incurred in recovery,
if any) payable or due to the Government arising from or incidental to the reimbursement and /
or direct payment of medical expenses (collectively, “Indebtedness”). The Government shall
deduct at such times at its own absolute discretion as it deems fit from his / her Salaries and
Pensions in all circumstances including, but not limited to, where he or she becomes insolvent
until the Indebtedness is fully recovered.
Until the Indebtedness is fully recovered the
Government is a secured creditor and has a charge on his / her Salaries and Pensions and
Accrued Benefits for repayment of the Indebtedness. In applying for and on receipt of the
reimbursement of medical expenses and / or upon direct payment being made by the
Government, as the case may be, the applicant accepts in full the terms and conditions above.
9. (a) The information provided will be used for processing of application for reimbursement /
direct payment of medical expenses by the Department of Health in accordance with Civil
Service Regulations and / or Civil Service Bureau Circulars. It may be transferred to
other Government bureaux and departments and related persons and organisations
(including Hospital Authority) for the administration and provision of civil service
medical benefits and related purposes.
(b) It will not be possible to process the application if the applicant fails to provide all the
information required.
Please ensure that the information provided is accurate.
Obtaining benefits for oneself or another by furnishing false information may constitute a
criminal offence.
(c) Data subjects may request for access to or correction of personal data provided on this
form in accordance with the provisions of the Personal Data (Privacy) Ordinance. Such
requests may be made in writing to the Director of Health (Attn.: Medical Reimbursement
Section, Finance and Supplies Division).
10. For enquiries, please contact the Departmental Secretary, who should approach the Medical
Reimbursement Section, Finance and Supplies Division of the Department of Health (at 3107
3415 or 3107 3417; or by email at
sco_mr@dh.gov.hk
for enquiries) about the processing of
applications and related payment and accounting arrangements. If Departmental Secretaries
have other enquiries, they may contact the Conditions of Service Division of the Civil Service
Bureau. Pensioners who require application forms may contact the Pensioner Services Unit
of this bureau by phone (at 2810 3850) or by email (csbpen@csb.gov.hk).
Civil Service Bureau
March 2013
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