Procedure for payment and reimbursement of medical expenses under ECHS

No.22A(10)/2010/US(WE)/D(Res)Nol-VIII

Government of India

Ministry of Defence

(Department of Ex-Servicemen Welfare)

New Delhi, the 14th February 2014

To

Managing Director

Central Organisation,

ECHS New Delhi-10

Subject: Procedure for payment and reimbursement of medial expenses under ECHS: Processing of bills by Bill Processing Agency (BPA)

Sir,

1. Further to Gol letter No. 24(8)/03/US(WE)/D(Res) dated 19 Dec

2003 and 22A(10)/10/US(WE)/D(Res) dated 23 Feb 2012 and 05 Nov 2012.

2. I am directed to convey the sanction of the Government to extend the On-Line bill processing by the Bill Processing Agency (BPA) to under mentioned Regional Centres w.e.f. 1st April 2014.

(a) Bangalore.

(b) Chennai.

(c) Coimbatore.

(d) Dehradun.

(e) Jabalpur.

(f) Jammu.

(g) Mumbai.

(h) Nagpur.

(i) Patna.

(j) Allahabad.

(k) Ahmedabad.

(I) Ambala.

(m)Bareilly.

(n) Delhi(II).

(o) Guwahati.

(p) Hisar.

(q) Ranchi.

(r) Visakhapatanam.

3. One dedicated broadband Internet circuit {2Mbps(1:1)} and one standard 2Mbps broadband connection for each of the Regional Centres processing bills on line is sanctioned.

4. Procedure for Bill payment as authorised vide Govt letter 22A(10)110/US(WE)/D(Res) dated 23 Feb 2012 and 05 Nov 2012 will be followed by all Regional Centres and Polyclinic. All other contents of Govt letter mentioned in this para remain unchanged.

5. This issues with the concurrence of Ministry of Defence (Finance) vide their U.O. No.33(07)/2011-FP dated 02-12-2013.

Yours faithfully,

Sd/-

(H.K. Mallick )

Under Secretary to the Govt of India

Source:http://www.desw.gov.in/sites/upload_files/desw/files/pdf/US-WE-14-Feb-2014.pdf

REFUND OF CONTRIBUTION MADE BY PRE 1996 RETIREES

REFUND OF CONTRIBUTION MADE BY PRE 1996 RETIREES

Appx A

(Ref to Para 3(a) of C&L Sec SN No

13/49717-C/AG/ECHS dt 21 Feb 14)

REFUND OF CONTRIBUTION MADE BY PRE 1996 RETIREES

1. Though pre 1996 retirees were exempted from making contribution for becoming members of ECHS vide Hon’ble Supreme Court Order on Writ Petition (Civil) No 210 of 1999 dt 22 Aug 2006, however there are no instrs from the Govt regarding refund of ECHS contribution in r/o pre Jan 1996 retirees who had already made the contribution prior to the Judgment of the Hon’ble Supreme Court. Contempt petition in this regards filed by Reid Defence Officers Association vide (C) No 16 of 2007 in WP (C) No 210/1999 was dismissed by the Hon’ble Supreme Court on 03 Nov 2008.

2. However, the case for refund of ECHS contribution for pre 1996 retirees who became ECHS member by paying ECHS contribution has been taken up with MoD since 20 May 2010 by Central Org ECHS. MoD had intimated that it has been decided to examine the case after Cabinet decision on the recovery of excess amount of NPA granted to retired Armed Forces doctors is available. Since the NPA issue has now been settled, Do ESW has again been requested for issuing favourable instructions.

Source:http://echs.gov.in/images/pdf/ops/ops100.pdf

List of Private Hospitals / Nursing Homes and Diagnostic Labs under ECHS

No.22B (01)/2011-WE/D(Res) 
Government of India 
Ministry of Defence 
Dept of Ex-Servicemen Welfare

OFFICE MEMORANDUM

New Delhi the 12 Dec., 2013

Subject :- EMPANELMENT OF HOSPITALS / NURSING HOMES AND DIAGNOSTIC CENTRES FOR ECHS

   1. I am directed to state that in terms of the provisions of Govt. of India, Ministry of Defence letter No. 22B 14(04)/2010/US (WE)/D(Res) dated 18 Feb 2011, it has now been decided by the Empowered Committee in its meeting held on 10 Sep 2013 under the chairmanship of Secretary (ESW) to empanel 43 Private Hospitals/Nursing Homes and Diagnostic Laboratories for different specialities and procedures as per the list attached in the Annexure :-

EX-SERVICEMEN CONTRIBUTORY HEALTH SCHEME ECHS FAQ’s – GENERAL

Q1. What is the Ex Service Men Contributory Health Scheme?
 
   Ans. ECHS was authorised by Government of India on 30 Dec 2002, and has been introduced from 01 April 2003. It is a publicly funded Medicare scheme for those who are ex-servicemen and pensioners & their eligible dependants, and will provide medical care through out-patient treatment at 227 Polyclinics all over India, and in-patient hospitalization & treatment through Military Hospitals and out-sourced Civil Hospitals & Diagnostic Centers at all these 227 locations, which will be empanelled for the purpose. Treatment/hospitalization in Service Hospitals will be available to ECHS members, subject to availability of speciality, medical staff and bed space.

Q2. Is ECHS only for army servicemen only?

   Ans. This medical facility is for Ex-servicemen only, who have served in Army/Navy/Air force/Indian Coast Guard/Special Frontier Force.

Irregularities in Medical Treatment

Press Information Bureau
Government of India

Irregularities in Medical Treatment

   In a special audit drive undertaken by all the Principal Controllers of Defence Accounts (PCsDA) to examine the bill processing procedures of Ex-servicemen Contributory Health Scheme (ECHS), PCDA, Western Command had raised observations relating to excess payment to ECHS empanelled hospitals amounting to Rs.15 crores. All the observations raised by the PCDA, Western Command were thoroughly analysed by Regional Centre, Chandigarh and it was noticed that most of the observations raised were due to incorrect interpretation of the policies. Wherever observations of the Controller of Defence Accounts were conceded to, the overpayments have been duly deducted from the concerned hospitals and suitable warnings issued to them.

Functioning of Ex-Servicemen Contributory Health Scheme (ECHS)

GOVERNMENT OF INDIA
MINISTRY OF DEFENCE
LOK SABHA

UNSTARRED QUESTION NO 574

ANSWERED ON 09.12.2013

FUNCTIONING OF ECHS

574 . Shri KIRTI (JHA) AZAD

Will the Minister of DEFENCE be pleased to state:-

   (a) whether any service of the Ex-Servicemen Contributory Health Scheme (ECHS) Polyclinics is being outsourced;

   (b) if so, the details thereof, service-wise;

Revised Interim Scales of Contractual Manpower for ECHS Clinics.

No. 22(72)/06/ D(Res)/US(WE) (Vol-IV)

Government of India

Ministry of Defence

Department of Ex-Servicemen Welfare

New Delhi the 12th November, 2013

To,
The Chief of Arimy Staff
The Chief of Navy Staff
The Chief of Air Staff

Subject:- Revised Interim Scales of Contractual Manpower for ECHS Clinics

Sir,

   In continuation of Govt. of India, Ministry of Defence letters No.22(1)/01/US(WE)/D(Res) dated 30th December, 2002 and No.22D(44)/2007/US(WE)/D(Res) dated 18th October, 2010, the undersigned is directed to convey the approval of the competent authority to the following revised interim Scales of Contractual Manpower for ECHS Clinics, to tide over the immediate functional difficulties being faced by ECHS clinics in providing quality medical care to ECHS beneficiaries:-

REIMBURSEMENT OF MED CLAIM FOR EMERGENCY TREATMENT IN NON EMPANELLED HOSPITAL.

Central Organisation ECHS
Adjutant General’s Branch
Integrated Headquarters
Maude Line
Delhi Cantt - 110 010

B/49773/AG/ECHS/Rates policy

15th oct 2013

Reginal Centre ECHS
MUMBAI

REIMBURSEMENT OF MED CLAIM FOR EMERGENCY TREATMENT IN NON EMPANELLED HOSPITAL

   1. A Clarification was sought from the Chief Medical Officer (SAG), CGHS Mumbai on the rates at which the claims are settled of CGHS beneficiaries. The CGHS authorities have clarified vide their letter No 3(xiv)3/13 Genl/1958/13 dt 30 Aug 13 that reimbursement at 25% higher rate that the 2002 CGHS rates is applicable to those who have taken treatment in private non empanelled hospital through CGHS in Mumbai.

CLARIFICATION ON ECHS MEMBERSHIP WHEN HUSBAND AND WIFE ARE DEFENCE PERSONNEL.

   CLARIFICATION ON ECHS MEMBERSHIP WHEN HUSBAND AND WIFE ARE DEFENCE PERSONNEL

   1. There were a No of issues which come into effect when both husband and wife are defence personnel or one of them is a defence person and other is a Central Govt. employee. The issues also included whether one or both parents can be made members of the ECHS.

   2. We had taken up the case with the MOD and clarifications have been issued vide MOD letter No 22(20)05/US(WE)/D(Res) dated 10 Feb 2006(copy attached). In brief it contains the following clarifications:-

Medical facilities for in-patient treatment and post-operative follow-up treatment to ECHS beneficiaries residing in districts not covered by ECHS.

No. 22D (09)12013/US (WE)/D (Res)
Government of India
Deptt of Ex-Servicemen Welfare
Ministry of Defence
New Delhi

Dated the 21st August, 2013

To
The Chief of the Army Staff
The Chief of the Naval Staff
The Chief of the Air Staff

Subject:- Medical facilities for in-patient treatment and post-operative follow-up treatment to ECHS beneficiaries residing in districts not covered by ECHS.

Sir.
   1, The undersigned is directed to invite attention to Govt. of India, Ministry of Defence letter No. 24(48)/03/US(WE)D(Res) dated 19th December, 2003 and to state that keeping in view, the difficulties being faced by the ECHS beneficiaries residing in districts not covered by ECHS it has now been decided to liberalise the ECHS Rules as follows to enable them to avail medical facilities for in-patient treatment and post- operative follow-up treatment:-

Medical Facilities to Gorkha Pensioners.

   The Government has extended the benefits of Ex-servicemen Contributory Health Scheme (ECHS) to Nepal Domiciled Gorkha (NDG) pensioner Ex-servicemen and their dependents. Medical facilities will be provided through 3 ECHS polyclinics at Kathmandu, Pokhara and Dharan. One mobile clinic will also be attached with each of the polyclinic. The polyclinics will provide outpatient treatment and patient requiring hospitalization will be referred to empanelled hospitals in Nepal. Cashless treatment will be provided by these hospitals as is the case in India. The manpower for ECHS Polyclinics and the mobile clinics will be engaged on contractual basis. NDG Ex- servicemen residing in India already have coverage of this scheme since its inception.

   This information was given by Minister of State for Defence Shri MM PallamRajuin a written reply to Shri Manicka Tagore in Lok Sabha today.

PIB