ECHS: PRIOR SANCTION FOR TREATMENT IN NON EMP HOSPITAL

ECHS: PRIOR SANCTION FOR TREATMENT IN NON EMP HOSPITAL

Tele: 25682870
Mil: 36833

Central Organisation, ECHS
Adjutant General’s Branch
Integrated Headquarters
Ministry of Defence (Army)
Maude Lines
Delhi Cantt-110010

B/49770/AG/ECHS

05 Oct 18

All Regional Centres

PRIOR SANCTION FOR TREATMENT IN NON EMP HOSP

1 Ref Para 18(a) of SOP on treatment Management in ECHS.

2. All prior sanctions for treatment in Non Empanelled Hospitals will be accorded by Dir RC except in the following cases:-

(a) Major cardiac surgery/ interventional cardiology.
(b) Oncology
(c) Organ transplant cases.
(d) Joint Replacement cases.
(e) Major Neurosurgical / Neurology cases.
(f) Bariatric surgery cases.
3. Format of prior sanction by Dir RC ECHS will be same as is being followed by CO ECHS.

4 Bills will be reimbursed at CGHS Rates only. No representation will be accepted for full reimbursement in such cases.

5. No TA is admissible in such cases.

6. Cases already received and dispatched by 10 Oct 18 will be processed by Central Org ECHS Org ECHS.

sd/-
(Ravi Pal Kapoor)
Lt Col
Jt Dir (Med)
for MD ECHS

Source: https://echs.gov.in

ECHS: Scrutiny of OPD/ IPD Claims at RC Level

ECHS: Scrutiny of OPD/ IPD Claims at RC Level

Central Organisation ECHS
Adjutant General's Branch
Integrated HQ of MoD (Army)
Maude Lines

Delhi Cantt- 110 010
B/ 49779-Outsourcing/ AG/ ECHS/ Policy
12 Jul 2018

All Regional Centres
...................................
...................................

SCRUTINY OF OPD/IPD CLAIMS AT RC LEVEL

1. Further to our letter No B/ 49779-Outsourcing/ AG/ ECHS/ Policy dated 10 Nov 2017, pursuant to the instructions received from DoESW vide letter No. 18(80) / 2017/WE/ D(Res-1) dated 12 Jul 2018 and proposal to formalize second tier check vide case file No B/ 49779- Outsourcing/ AG/ ECHS initiated on 06 Jul 2018.

2. It is directed that the process for online bill processing at RC level to be carried out as under:-

(a) Bills Amounting to Less than Rs 30,000/ -. For bills amounting to less than Rs. 30,000/ -, 2% bills per day shall be checked by the JD (HS). The bills selected will be those having highest financial value. Additional bill scan be checked as per discretion.

(b) Bills in the Range of Rs 30,000/ -to Rs 59,999/ -. For bills in the range of Rs 30,000/ - to 59,999/ -, 3% bills per day shall be checked by the JD (HS). The bills selected will be those having highest financial value. Additional bills can be checked as per discretion.

(c) Bills in the Range of Rs 60,000/ -to Rs 99,999/ -. For bills in the range of Rs 60,000/ - to 99,999/ -, 5% bills per day shall be checked by the JD (HS). The bills selected will be those having highest financial value. Additional bills can be checked as per discretion.

(d) Bills More than Rs1 Lakh. 100% Bills for amount more than Rs. 1 Lakh to be checked by JD(HS) at RC.

3. The process to be put in effect immediately and respective functionaries in the Online Bill Processing chain to ensure that the above is complied.

4. The modification incorporated in the system of the online bill processing application will be such that a basket of 100 claims is presented to the JD(HS), those 100 claims will be picked up in FIFO manner out of the claims processed by BPA. There will be separate baskets for OPD, IPD and individual re-imbursement claims. The 100 claims in each basket will be strictly presented in FIFO manner. The presentation of these baskets to JD(HS) and its subsequent manner of processing for all baskets (OPD, IPD and individual re-imbursement) is described below:- ,

(a) Claims less than Rs. 30,000/ -. These will be listed on top of the page and JD(HS) would have to compulsorily check 2% of such claims (number to be rounded off to the next round figure). These claims would be the one's with the highest recommended amount. The multi select option for the balance claim in this category would be available orally after atleast 2% claims have been checked. JD(HS) can check additional claims also as per his discretion.

(b) Claims between Rs. 30.000/ - to Rs. 59,999/-. A counter for the claims falling in this region would be created by BPA to reflect 3% of such claims ,(number to be rounded off to the next round figure) which would have to be compulsorily checked by the JD(HS). These claims would be the one's with the highest recommended amount. The JD(HS) would have the option to check any additional claim also should he choose to do so. The multi select option for the balance claim in this category would be available only after atleast 3% claims have been checked.

(c) Claims between Rs. 60,000/ - to Rs. 99,999 / -. A counter for the claims falling in this region would , be created by BPA to reflect 5% of such claims (number to be rounded off to the next round figure) which would have to be compulsorily checked by the JD(HS). These claims would be the one's with the highest recommended amount. The JD(HS) would have the option to check any additional claim also should he choose to do so. The multi select option for the balance claim in this category would be available only after atleast 5% claims have been checked.

(d) Claims above Rs. 1 Lakh/-. All claims above Rs. 1 Lakh will have to be compulsorily checked by JD(HS). No multi select option will be enable? in this window.

5. Next set of 100 claims in the concerned basket will be presented to the JD(HS) only after the claims in the respective basket has been completely cleared.

6.In addition, it is highlighted that in accordance with Para 2(d) of MoD letter No. 22(A)(10/ 10/ US(WE)(Res) dated 23 Feb 2012, "CFA will examine the bill and BPA's worksheet prior to according sanction,,." Hence, all CFAs must ensure that no violation to the above guidelines take place and 'the provisions brought out above are not compromise did any manner.

7. Please ensure speedy clearance of bills so that large tendencies can be reduced. Financial integrity of checks, will not be compromised.

8. These instructions are issued with approval of MD ECHS.1

(DM Anand)
Col
Dir (Stats & Automation)
for MD ECHS

Source: ECHS

PCDA Circular 586 : Fixed Medical Allowance to the Armed Forces Pensioners

PCDA Circular 586 : Fixed Medical Allowance to the Armed Forces Pensioners

Office of the Principal CDA(Pensions)

Circular No. 586

Draupadi Ghat, Allahabad- 211014
Dated: 25th September, 2017

To,
The Chief Accountant, RBI, Deptt. Of Govt. Bank Accounts, Central office C-7, Second Floor, Bandre- Kurla Complex, P B No. 8143, Bandre East Mumbai 400051
All CMDs, Public Sector Banks including IDBI Bank
Nodal Officers, ICICl/ HDFC/ AXIS/ IDBI Banks
Managers, All CPPCs
Military and Air Attache, Indian Embassy, Kathmandu, Nepal
The PCDA (WC), Chandigarh
The CDA (PD), Meerut
The CDA, Chennai
The Director of Treasuries, All States
The Pay and Accounts Officer, Delhi Administration, RK Puram and Tis Hazari, New Delhi
The Pay and Accounts Office, Govt of Maharashtra, Mumbai
The Post Master Kathua (J&K)
The Post Master Camp Bell Bay
The Pr. Pay and Accounts Officer, Andaman and Nicobar Administration, Port Blair


Subject: Grant of Fixed Medical Allowance (FMA) to the Armed Forces Pensioners/ Family Pensioners in such cases where date of retirement is prior to 01.04.2003 and who had opted not to avail medical facilities at OPD of Armed Forces Hospitals/ MI Rooms and are not members of ECHS.

Reference: 1). This office Circular No. 544 dated 04.06.2015, Circular No. 451 dated 21.02.2011 and Circular No. 208 dated 27.07.1998
2). GOI, MoD letter No. 1(10)/2009-D(Pen/Policy) dated 29th August 2017.

Copy of GOI, MoD letter No. 1(10)/2009-D(Pen/Policy) dated 29th August, 2017 on the above subject, which is self-explanatory, is forwarded herewith as annexure to this circular for further necessary action at your end.

2. In terms of Para-1 of GOI, MOD letter dated 29th August 2017, the fixed medical allowance has been enhanced from Rs.500/- pm to Rs. 1000/- pm with effect from 01.07.2017. Ex-Servicemen who retired after 01.04.2003 have to become member of ECHS compulsorily and are not eligible to draw Fixed Medical Allowance. However, Pre-01.04.2003 retirees have the option of either joining the Scheme or draw Fixed Medical Allowance as per the extant rates.

3.The other conditions for grant of Fixed Medical Allowance as brought out in this Office Circular No. 208 dated 27.07.1998 quoted under reference shall continue to be in force. PDAs are requested to please review the cases and revise the Fixed Medical Allowance in all the affected cases accordingly.
4. This circular has been uploaded on this office website www.pcdapension.nic.in for dissemination to all alongwith Defence pensioners and Pension Disbursing Agencies.
No. Grants/Tech /0164/III

Dated: 25th September, 2017

S/d,
(Nasim Ullah)
Asst. Controller (P)

ECHS: IMPLEMENTATION INSTRS: PROCEDURE FOR AUTHORISED LOCAL CHEMIST

ECHS: IMPLEMENTATION INSTRS: PROCEDURE FOR AUTHORISED LOCAL CHEMIST

Central Organisation ECHS
Adjutant General's Branch
Integrated HQ of MoD (Army)
Maude Lines
Delhi Cantt-110010

B/49762/AG/ECHS/Medicine Policy

27 Aug 17

IHQ of MoD (Navy)/Dir ECHS (N)
Air HQ (VB)/DPS
HQ Southern Command (AIECHS)
HQ Eastern Command (AIECHS)
HQ Western Command (AIECHS)
HQ Central Command (AIECHS)
HQ Northem Command (AIECHS)
HQ South Western Command (A/ECHS)
HQ Andaman & Nicobar Command (AIECHS)
AMA ECHS, Embassy of India, Nepal
All Regional Centres

IMPLEMENTATION INSTRS: PROCEDURE FOR AUTHORISED LOCAL CHEMIST

1. Refer:-
(a) GOI/MOD letter No 220(01)/2016/ WEID(Res-l) dated 22 Aug 17 (copy att as Encl 1).
(b) GOI letter No 24(3)lO3/US(WE)ID(Res)(i) dated 08 Sep 03 amended vide 25(01)/2014/US(WE)/D(Res) dated 04 Aug 14.

2. In all stations with ECHS polyclinics local medical stores/ chemists will be empanelled for supply of Not Available, emergent, life saving and essential drugs on as required basis. The empanelment of local medical stores/chemists will be done by a Board of Officers constituted by the Station Commander which will comprise the following
Chairman - SO ECHS/Col Rank officer detailed by Station Commander.
- Lt Col (Non Medical) detailed by Station Commander
- Jt Dir Hospital Services of Regional Centre concerned/ Medical Officer detailed by Station Commander
- Rep of LAO/ CDA

3. Actions by the Board.

(a) The Board of Officers will invite Tenders through advertisement in the local press and e-procurement portal from local medical stores/chemists for empanelment with ECHS Polyclinic. The tender enquiry will be based on same format as CGHS tender for Authorised Local Chemist with conditions suitably modified to suit local military requirements (CGHS tender format att as Encl 2).

(b) The Board will check the Technical parameters as per Tender Enquiry and will consider the price bids of only the technically qualified vendors. The Board will arrive at L 1 Vendor based on maximum overall amount of discount on MRP for all the drugs to be supplied with a minimum OR of 15%. Bids offering less than 15% overall Discount will be rejected. The tenderers will quote an overall discount figure irrespective of the quantity or number of individual drugs.

(c) The Board will consider parallel rate contract with L2 and L3 vendors and include their names in recommendation if those vendors agree to the L1 rates in writing.

(d) The Board of Officers will submit a recommended list of local medical stores/chemists to the Station Commander for approval.

4 Actions by Station Cdrs

(a) Constitute a Board of Officers for empanelment of local medical stores/chemists including CGHS authorised chemists. Due care is to be exercised in choice of Medical officer to avoid any conflict of interest. MOs/Spl posted to Ml-l of SEMO concerned to be avoided and MOI RMO of non medical units may preferably be detailed as JDl-lS of RC may be occupied in similar bds for other stns under AOR.

(b) Approval of recommended list of local medical stores/chemists submitted by the Board of Officers.

(c) All CGHS Authorised Chemists in the same city will be considered as deemed empanelled i.e need not participate in TE if the rates planned to be quoted are same as given for CGHS. They will give their contract discount documents for CGHS to the board, but will sign the contract with Stn Cdr provided the discount offered by them to CGHS is not less than that offered by L1 vendor of the TE. They have option to participate in the empanelment process and offer fresh quotes discounts at the TE Stage.

(d) The Contract will be signed with the approved local medical stores/chemists by Stn HQrs for a period of two years. The terms and conditions of Contract will be based on CGI-lS formats.

(e) The Officer in charge Polyclinic will after due verification authenticate the receipt of drugs/consumables and forward the consolidated bills by the 5th of the following month to the Stn HQrs.

(f) Stn Cdr will process the same for releasing payment with sanction of appropriate CFA.

(g) Payment: The payments on account of procurement of drugs and consumables from empanelled local chemists will be made from the cash assignments placed at the disposal of Station Commanders under Major Head 2076 Minor Head 107 Head 363/01. The payments will be effected by cheque/ electronic payment.

(h) Delegated financial powers as per Para 1 of Appendix to GOI letter No 24(3)IO3IlJS(WE)/D(Res)(i) dated 08 Sep 03 amended vide 25(01)12014/US(WE)ID(Res) dated 04 Aug 14 will be exercised by CFA. The delegated powers are enumerated in table below:

CFA (Station Commander)	Financial Limit (without consultation)	Fin Limits with IFA consultation
Lt Col/ Col	Upto 1,00,000	-
Brig	Upto 2,00,000	-
Maj Gen(Sub Area Commander/ COS Area HQ)	Upto 3,00,000	-
Dy MD ECHS	-	Upto 5,00,000
MD ECHS	-	Upto 10,00,000
JS ESW	-	Upto 25,00,000
Secy ESW	-	Upto 25,00,000

(j) The monetary ceilings for expenditure irrespective of their Military or Non Military status are as follows:-
Type A & B Polyclinic : Rs 2.5 Lakh per month
Type C Polyclinic : Rs 1.5 Lakh per month
Type D Polyclinic : Rs 01 Lakh per month
Prior approval of MD ECHS will be required for any expenditure above this limit.

(k) The expenditure on account of local purchase of drugs and consumables from empanelled local medical stores/chemists will be monitored separately under the relevant revenue head.

(l) The records of polyclinic will be checked by a Boards of Officers detailed by the Station Commander.

5. Actions by Polyclinic : When an emergent/life saving/essentlal drug prescribed by the Medical Officer in the ECHS Polyclinic is not available as confirmed from the stock by the medical store of polyclinic and requirement of the same is essential for a patient, following procedure will be followed:-

(a) The Officer in charge Polyclinic will raise a demand to the empanelled local medical store/chemist. The demand will be supported by prescription(s) signed by the Medical Officer managing the case.

(b) On receipt of the demand the empanelled local medical store/chemist will supply the required drug to the Polyclinic within 24 hrs.

(c) The Bills for the drugs supplied will be forwarded by the empanelled local medical store/chemists monthly to the Officer in charge Polyclinic along with a copy of the demand raised by the Polyclinic.

(d) The Officer in charge Polyclinic will, after due verification, authenticate the receipt of drugs/consumables and forward the consolidated bills by the 5th of the following month to the Stn HQs.

(e) The Officer in charge Polyclinic will also certify on the consolidated bill that drugs demanded are emergent/life saving/essential drugs and are Not Available in the polyclinic medical stores neither a substitute! equivalent drug was available.

(f) Stn Cdr will process the same for releasing payment with sanction of appropriate CFA.

(g) The list of drugs and consumables indented from local chemists alongwith quantity indented
will be included in the next Emergent/ Normal polyclinic indent to SEMO.

(h) Monthly list of such drugs will be forwarded to SEMO for initiating procurement action by SEMO while forwarding the next demand.

(j) The Polyclinics will maintain a separate account for all purchases of this nature. All daily transactions will be maintained and particulars of patients who are issued the essential medicines will be recorded. The records will be checked by a Boards of Officers detailed by the Station Commander, and will be audited by Local Audit Officer (LAO) every quarter.

6. Funds required will be placed at the disposal of Station Commanders by Central Organisation ECHS. Due control shall be exercised by MOs/ Spll OiC Polyclinics and Stn Cdrs to ensure that the monthly limit is available to maximum patients and is not exhausted in procuring medicines for a few patients. Existing provisions for reimbursement of costlier medicines for the diseases specified in Para 6 of GOl/MOD letter No 24(8)IO3IUS(WE)ID(Res) dt 19 Dec 03 for a period of 23/30 days may also be explored to benefit maximum number of veterans.

7. Special Instructions to MOs/Spls of Polyclinics and Empanelled Hospitals.

(a) The demand for NA medicines will be supported by prescription signed by the Medical Officer! Spl of ECHS polyclinic managing the case. In all such cases. the Medical Officer / Spl will ensure that there ar e no other substitutes available in the Polyclinic medical store in lieu of the drug required. Branded drug will be prescribed with due medical justification only. Demands will not be signed by Para Medical/Dental Staff under only circumstances.

(b) As specified in MCI Ethics Rules, pharmacy of a polyclinic is not an open pharmacy but is meant as self dispensing of medicines prescribed by Medical Officers/ Doctors of polyclinic only. All other prescriptions issued by other consultants shall be rewritten by polyclinic doctor keeping in mind availability. patient’s condition and other drugs prescribed.

(c) Prescription of branded medicine by empanelled hospitals will have to be justified by treating Doctor and should be avoided as per National Policy. The AFV should also not insist on particular brand name of medicine if an equivalent is available in Polyclinic or supplied by Empanelled Local Chemists.

(IVS Gahlot)
Md
Dir (Med)
for MD ECHS

Source: ECHS

ECHS: Enhancement of contractual remuneration of Doctors/Officers engaged on contract basis

ECHS: Enhancement of contractual remuneration of Doctors/Officers engaged on contract basis

22D(19)/2017/WE/D(Res)
Govt of India
Department of Ex-Servicemen Welfare

Sena Bhawan,
New Delhi, the 16th August, 2017

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

ORDER

Sir,
I am directed to convey the sanction of the Competent authority to the following amendments in Para 2 of GoI letter No. 22d(50)/2007/US(WE)/D(Res) dated 27th Nov 2015 as amended vide Ministry of Defence letter No. 22D(50)/2007/US(WE)/d(Res) dated 06.04.2016 regarding contractual remuneration of employees engaged on contract basis in ECHS.

2. Sl. No. 1 to 4 of para 2 to read as follows:-
3. The revised order will be effective from the date of issue of this letter.
4. The issue with the concurrence Ministry of Defence (Finance) vide their U.O. No. 33 (05)/2009/Fin/Pen. Dated 09.08.2017.

Yours Faithfully,
sd/-
(A.K. Karn)
Under Secretary to the Govt. of India

Ex-Servicemen Contributory Health Scheme

Ex-Servicemen Contributory Health Scheme

Some empanelled hospitals have stopped providing services in the recent past citing reasons of delayed payments, excessive deductions and low CGHS rates. 384 empanelled facilities have not renewed Memorandum of Agreement with ECHS till date. 69 empanelled facilities have rejoined after establishment of online billing system by ECHS.

Actions like issuance of show cause notice, issuance of ‘stop referral’ pending investigations have been carried out against such defaulting hospitals. The hospitals have refunded the amount in most of the cases. Details of action taken against the hospitals are as under:

(i)	Disempanelled	-	01
(ii)	Stop Referral	-	25
(iii)	Panel Deductions	-	02
(iv)	Warnings	-	04

This information was given by Minister of State for Defence Dr. Subhash Bhamre in a written reply to Shri Rajeshbhai Chudasama in Lok Sabha today.

PIB

Ex-Servicemen Contributory Health Scheme: Aim, Objective

Ex-Servicemen Contributory Health Scheme: Aim, Objective

GOVERNMENT OF INDIA
MINISTRY OF DEFENCE
LOK SABHA

STARRED QUESTION NO: 56
ANSWERED ON: 18.11.2016

Ex-Servicemen Contributory Health Scheme

MD. BADARIDDOZA KHAN
Will the Minister of
DEFENCE be pleased to state:-


(a) the details of aims and objectives of the Ex-Servicemen Contributory Health Scheme (ECHS);

(b) whether ECHS has fulfilled its mandated aims and objectives;

(c) if so, the details thereof and if not, the reasons therefor;

(d) whether shortcomings / deficiencies in the implementation of ECHS have come to the notice of the Government; and

(e) if so, he details thereof and the corrective measures taken by the Government thereon?


ANSWER
MINISTER OF DEFENCE (SHRI MANOHAR PARRIKAR)

(a) The aim and objective of the scheme is to provide quality healthcare to the Ex-Servicemen (ESM) pensioner and their dependents.

(b) & (c): Yes, Madam. Ex-Servicemen Contributory Health Scheme (ECHS) was launched on 1st April 2003. Its growth has been phenomenal. It had a beneficiary base of only about 3.5 lakh in 2003 and its beneficiary base has expanded to approximately 50 lakh. Having started with 13 Regional Centres and 227 Polyclinics, the Scheme expanded in October 2010 with 15 more Regional Centres and 199 Polyclinics, taking the total to 28 Regional Centres and 426 Polyclinics. Presently all Regional Centres and 421 Polyclinics are operational across the country. Further, ECHS has a large number of empanelled medical facilities.

(d) The shortcomings / deficiencies in the functioning of the empanelled hospitals, supply of medicines, budgetary and manpower matters, have come to the notice of the Government.

(e) Corrective steps taken / being taken to overcome the shortcomings / deficiencies include outsourcing of pharmacy, authorization of local chemists, enhancement of financial power of Officer in-charge of ECHS polyclinic to obviate the shortage of medicines, processing of medical bills of all 28 Regional Centres on-line as per rules, appropriate use of ECHS funds by the service hospitals, adherence to the terms and conditions of Memorandum of Agreement by the empanelled hospitals, recruitment of the manpower in ECHS polyclinics, de-duplication of ECHS smart cards etc.


Source: Loksabha.nic.in [Click to view/download]