PRIORITY FOR WAR DISABLED VETERANS AND BATTLE CAUSALITIES IN OPD OF ARMED FORCES HOSPITALS

Central Organisation ECHS
Adjutant General’s Branch
IHQ of MoD (Army)
Thimayya Marg,
Near Gopinath Circle
Delhi Cantt – 110 010

B/49701-PR/AG/ECHS/2019

15 Mar 2019

Air HQ PD (DAV)
PD (Navy)
All Comd HQ’s (A/ECHS)
All Regional Centres, ECHS

PRIORITY FOR WAR DISABLED VETERANS AND BATTLE
CASUALTIES IN OPD OF ARMED FORCES HOSPITALS

Copy of O/o the DGAFMS, MoD letter No 5515/Gen Comp/4E/ DGAFMS/DG-3A dated 08 Mar 2019 is enclosed herewith.

For your info and necessary action please.

Sd/-
(BS Sisodia)
Col
Dir(Ops & Coord)
for MD ECHS

Encls:- One page.

Copy to :-
All Secs (Less S&A)
S&A Sec – For uploading on our website.

Office of the DGAFMS
Ministry of Defence
Room No. 08, ‘M’ block
7 New Delhi-110001

5515/Gen Comp/4E/ DGAFMS/DG-3A

08 Mar 2019

DGMS (Army)
DGMS (Navy)
DGMS (Air)

PRIORITY FOR WAR DISABLED VETERANS AND BATTLE CAUSALITIES IN OPD OF ARMED FORCES HOSPITALS

War Disabled Veterans form a very distinguished class of veterans. A large number of War Disabled Veterans/ Battle causalities are arnputation cases, amputated due to injuries sustained in war and war like conditions and have restricted mobility. In view of this special disposition, they rightfully deserve certain privileges. AFMS has always remained committed in providing them priority in AFMS hospitals.

Henceforth, War Disabled Veterans/Battle Causalities (self only) may be offered Specialist consultation directly at the OPDs of Armed Forces hospitals on OPD days, without obtaining a referral from the ECHS Polyclinics. However, these veterans will continue to avail services of their dependant polyclinic for routine illnesses.

Necessary instructions may please be issued to all concerned.

This has the approval of the DGAFMS.

Sd/-
(VK Bhatti)
Col
Col AFMS (Health)

Source: ECHS Order

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Empanelled Hospital Claims- Ophthalmic procedures

Central Organisation,ECHS
Adjutant General’s Branch
Integrated Headquarters
Ministry Of Defence(army)
Maude Lines
Delhi Cantt – 110010

B/49773/AG/ECHS/Rates/Policy

18th May 2017

UTI-ITSL
15533/1, Above Farico Show Room
1st Floor, Old Madras Road
Halasuru, Bangalore,
Karnataka – 560008

EMPANELLED HOSPITAL CLAIMS : OPHTHALMIC PROCEDURES

1. It has been noted with concern while scrutinizing claims of an Eye Centre that ECHS had been billed more than the hospital rates. It was also observed that for ocular investigations the hospital was billing ECHS at twice the CGHS rates (stating that the CGHS rates are for one eye). It has been clarified the CGHS rates for Ophthalmology investigations are for both eyes unless specified”.

2. As per provisions of MoA and para 4(b)(x) of Gol MoD letter NO.24(8)/03/US(WE)/D(Res) dated 19 Dec 2003, the hospital cannot bill ECHS more than the hospital rates. It should be ensured by Regional Centre’s that the rate list of the hospital is taken whenever MoA is being renewed. The rate list attached with MoA should not have a rate more than CGHS rate/Hospital rate. wherever the hospital rate is below CGHS rate it should be reflected with an asterisk (*) on the rate list attached with MoA.

3. BPA to check the claims of such hospital (including settled claims) which have not been processed correctly and the excess amount paid post implementation of CGHS 2014 rates if any would be recoered from the pending claims of the hospitals.

4. The RCs are directed to ensure no additional charges/extra charges than CGHS/ECHS or actuals whichever is less to be paid to the hospital. It is also requested RCs to accordingly review the pending claims (i.e not settled claims) of the hospitals not restricted to ophthalmic claims and those with observations be returned to BPA for correct processing.

5. Please ask.

Sd/-
(IVS Gahlot)
Col
Dir (Med)
for MD ECHS

Source: [Document Click here to download]

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

B/49773/AG/ECHS/Rates/Policy

19 Dec 2014

REVISION OF CEILING RATES FOR INTRA OCULAR LENSES (IOL)
1. Refer this office letters:-
(a) B/49773/AG/ECHS/Rates/Policy dt 10 Jan 2011.
(b) B/49773/AG/ECHS/Rates/Policy dt 28 Oct 2014.
(c) B/49773/AG/ECHS/Rates/Policy dt 24 Nov 2014.

2. The following ceiling rates for IOL are hereby made at para 16 of Appx ‘C’ of above mentioned letter on the basis of CGHS OM No 536/2012/R & H/CGHS dt 21 Aug 14 and even no of dt 11 Nov 2014:-

(i) Hydrophobic Foldable IOL
(Multi-piece/Single piece Aspheric) Rs. 5,800/-
(ii) Hydrophilic Acrylic IOL Rs. 4,500/-
(iii) PMMA IOL (AC/PC) Rs. 500/-
(iv) Scleral Fixated IOL Rs. 3,500/-

3. Reimbursement for LASIK Surgery and INTACS Rings is not recommended.

4. Therapeutic and Bandage contact Lenses for Keratoconus of Corneal Ulcers can be considered on a case to case basis.

5. Further, reimbursement for IOL Implants will be limited to ceiling rates or’actual, whichever is less and will be reimbursable in addition to the package rates for cataract surgery procedure. The reimbursement at the above mentioned ceiling rates will be done as per the rates fixed for the various types of IOL mentioned above and the IOL actually used in the surgery. It is mandatory for the operating surgeon of all private empanelled hospital/ECHS beneficiaries to attach the empty IOL sticker, bearing the signature and stamp of the operating surgeon on it, along with the bill in support of type of IOL used, containing its batch number. In the event of the private empanelled hospital not giving the batch number and/or empty IOL sticker, then the beneficiary will be required to obtain the same from the hospital before the competent authority finally settles the claim for reimbursement.

6. Beneficiaries undergoing IOL Implantation: This office has been receiving numerous queries regarding the cost of IOL which is in addition to the cost, of surgery as mentioned in our earlier ECHS letter under ref. Once again it is clarified that the cost of lens (IOL) would be reimbursable in addition to package charges for treatment procedures. The same has also been clarified by CGHS at para 3 of their Office Memorandum No 5-11045/36/2012 dt 26 Nov 2014 In addition it is clarified that if a beneficiary had been implanted Hydrophilic IOL in one. eye earlier and now requires IOL in other eye, then in such a case Hydrophilic IOL would be permitted as per old rates of 2008. In all such cases prior permission by competent authority permitting use of Hydrophilic IOL based on advice of specialist would be required.

7. Para 16,17 & 18 of Appx ‘C’ of this office letter No 8/49773/AG/ECHS/Rates/Policy dt 10 Jan 2011, B/49773/AG/ECHS/Rates/Policy dt 28 Oct 2014 & even no of dt 24 Nov 2014 are hereby cancelled.

(Vijay Anand)
Col
Dir (Med)
for MD ECHS

Source: http://echs.gov.in/images/pdf/med/med120.pdf

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