No. 22D(19)/2020-D(WE/Res-I)
Government of India
Ministry of Defence
D/o Ex-Servicemen Welfare

221, B-Wing, Sena Bhawan, New Delhi.
Dated: 17 August, 2021

To,

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

Subject:- Reimbursement of cost of Medicine: Special Sanction in view of the Covid-19 till 31st October 2021 – regarding.

Sir,

Refer to MoD/DoESW Letter No. 22D(19)/ 2020- D(WE/D(Res-I) dated 24.04.2021.

2. An onetime sanction for purchase of medicines and claim reimbursement of cost of medicine was issued till 31st July, 2021, vide letter referred above. In view of current situation of COVID-19 pandemic and restricted movements in containment zones, to promote social distancing and avoiding unnecessary exposure to ECHS beneficiaries to COVID-19 as well as minimizing footfall at ECHS Polyclinics and to protect from probable third wave of Covid-19, the ECHS beneficiaries having life style/chronic ailments/diseases on long treatment may purchase medicines till 31st October, 2021 based on the prescription held (prescribed by doctor of ECHS Polyclinic/Service Hospital/Empanelled hospital/Sehat OPD) irrespective of NA or otherwise on reimbursement basis. It is also clarified that the ECHS Polyclinics are functional and ECHS beneficiaries also have the option to collect medicines through ECHS Polyclinics as per normal practice, instead of purchasing from the market, after taking a prior appointment from the respective OIC, ECHS Polyclinic.

3. One-time sanction is hereby accorded to reimburse the above expenditure under individual reimbursement of medical claims. The reimbursement will be done as per guidelines issued by CO, ECHS vide letter No. B/49761/AG/ECHS/ Medicines Policy dated 18th May, 2020 and even No. dated 21st July, 2020.

4. This will be applicable beyond 31st July, 2021 to till 31st October, 2021.

5.This issue with the concurrence of MoD(Finance/Pension) vide ID Note No. 32(09) /2020/Fin/Pen, dated 17.08.2021.

Yours faithfully,
sd/-
(Dr. P.P. Sharma)
OSD (WE & IC)
Tel/Fax- 2301 5772

Reimbursement of Cost of Medicines under ECHS Extended till 31-10-2021 – ECHS Orders 2021 PDF Download

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Tele : 011-25684847
ASCON : 36832
Fax : 011-25684946
Email : diropsechs-mod@nic.in

Central Organisation
Ex-Servicemen Contributory
Health Scheme (ECHS)
Adjutant General’s Branch
Integrated HQ of MoD
Thimayya Marg,
Near Gopinath Circle
Delhi Cantt – 110010

B/49701-PR/AG /ECHS/2020

31 Jul 2020

IHQ of MoD (Navy)/Dir ECHS (N)
Air HQ (VB)/DPS
HQ Southern Command (A/ECHS)
HQ Eastern Command (A/ECHS)
HQ Western Command (A/ECHS)
HQ Central Command (A/ECHS)
HQ Northern Command (A/ECHS)
HQ South Western Command (A/ECHS)
HQ Andaman & Nicobar Command (A/ECHS)
All Regional Centres ECHS
DIAV

GRANT OF ECHS FACILITIES TO WORLD WAR II VETERANS
ECOS, SSCOS AND PRE-MATURE RETIREES

1. Refer to this office letter No B/49701-PR/AG/ECHS/2019 dt 09 Oct 2019.
2. Verification of cards in respect of Pre-mature category (PMR) has been stopped pending clarification from MoD regarding length of service required for eligibility of this category.
3. It has come to light that at certain places, verification of cards in respect of SSCOs, ECOs & WW-Il category are also being held up alongwith PMR category. It is intimated that the verification of cards in respect of SSCOs, ECOs & WW-Il category to be continued and temporary slip in this regard to be issued to concerned veterans as it is not linked with PMR case.

Also check: Unmarried disabled sons eligible for ECHS facilities even after attaining 25 years

(BS Sisodia)
(Ops & Coord)
for MD ECHS

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Central Organisation, ECHS
Adjutant General’s Branch
Integrated HQ of MoD (Army)
Thimayya Marg,
Near Gopinath Circle
Delhi Cantt – 110010

B/49711-MoD/AG/ECHS/DBT

29 Jul 2019

IHQ of MoD (Air Force)
IHQ of MoD (Navy)
HQ South Comd (A/ECHS)
HQ East Comd(A/ECHS)
HQ Wesst Comd(A/ECHS)
HQ Central Comd(A/ECHS)
Northern Comd(A/ECHS)
South West Comd (A/ECHS)
All Regional Centres

DELAY IN HANDING OVER OF ECHS SMART CARD TO ECHS BENEFICIARIES

Please refer to Central Organisation, ECHS letter No B/49711-IT/AG/ECHS dated 13 Sep 2018. (Copy enclosed).

The procedure of dispatching the 64 Kb ECHS Cards by the Card making company and their distribution by respective station HQ’s was given vide a/m letter. As on 17 Jul 2019, the card making company has printed and dispatched 8,33,468 cards to various station HQ’s through respective Regional Centres. It is seen that only 4,11,948 cards have been physically handed over by the station HQ’s to the beneficiaries. This shows that the rate of distribution by most of the station HQ’s is very low. This has led to dissatisfaction amongst the ESM.

In view of the above, it is requested that suitable instruction be passed to Station HQ’s under your justification to handover cards on priority and clear the backlog.

Sd/-
(Rakesh Kakar)
Col (Retd)
Jt Dir (Stats & Automation)
for MD ECHS

Source: ECHS

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More than 40,000 individual to be benefitted

07 MAR 2019

The Cabinet Meeting Chaired by Prime Minister Narendra Modi today approved the grant of Ex-Servicemen Contributory Health Scheme (ECHS) facilities to World War-II Veterans, Emergency Commissioned Officers (ECOs), Short Service Commissioned Officers (SSCOs) and pre-mature retirees.

As a result, over 43,000 individuals not covered so far under ECHS will be able to avail the benefits of cashless medical treatment under ECHS facilities through a network of over 425 ECHS polyclinics, over 2500 empanelled private hospitals and all Government hospitals throughout the country, subject to certain conditions.

As a special dispensation, war-widows will be exempt from one-time contribution to join ECHS.

Launched by NDA Government in April 2003, ECHS provides quality medicare to 54 lakh ex-servicemen pensioners, their dependents and a few other categories.

Measures for welfare of Ex-Servicemen:

Today’s decision is yet another landmark step in the pro-active policies of the Government since its very first days for welfare of our valiant ex-servicemen, who rendered valuable service to the country.

Implementation of ‘One Rank One Pension’ for ex-servicemen, a demand which had been pending for over four decades, has resulted in over 20 lakh ex-servicemen receiving more thanRs. 35,000 Crore under the scheme. Other welfare measures by the Government for ex-servicemen include increase in pension by 40%, disability pension for pre-mature retirees, applicability of battle causality compensation at Line of Actual Control, Line of Control and International Border, financial assistance to soldiers on their supreme sacrifice through newly created Army Battle Causalities Welfare Fund, enhancement of ex-gratia ad-hoc allowance, Special Pension to Ex-sailors and skill development training in 36 job roles to over 30,000 retiring soldiers so far.

PIB

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DG (DC & W)
Adjutant General’s Branch
Integrated HQ of MoD (Army)
South Block
New Delhi – 110 011

B/49717-C(VIG)/AG/ECHS

12 Jul 2018

VETERAN PATIENT CARE AND ASSISTANCE (VPCA) TEAMS -A VIGILANCE MECHANISM IN ECHS

Gen

1. Ex Servicemen Contributory Health Scheme (ECHS) is a welfare oriented scheme providing effective healthcare to Ex Servicemen and their dependents. Since in 2003, the scheme has expanded exponentially and has nearly 52 lakh beneficiaries today throughout the length and breadth of the country.

2. There is a need to institute a vigilance framework with a nominated nodal officer at each echelon of the scheme to introduce checks and balances in the system to ensure its efficient and effective functioning . The vigilance frame work so instituted will pay attention to the following aspects with a mechanism to detect, analyse and take corrective and preferably pre-emptive :-

(a) Ensure ECHS benefits are not availed by unauthorized persons.

(b) Check unethical practices I exploitation of ESMs by empanelled facilities.

(c) Monitor referral to empanelled facilities and carry out checks to negate unauthorized treatments/or claims.

Handling of ECHS Issues/Subject/Tasks

3. Tech issues relating to billing, claims and MoA with empanelled hospitals are dealt by Regional Centres of ECHS. All adm issues of Polyclinics are handled by Stn HQ.

4. Regional Centres (RC) ECHS. Comments/ assistance/inv/vigilance on following issues are carried out through RCs:-

(a) MoA with empanelled hospitals therefore complaints regarding empanelled hospitals/Harassment in empanelled hospitals.

(b) Claims/Billing issues of empanelled hospitals.

(c) Indl reimbursement claims received by RC from Polyclinics.

5. Stn HQs. Stn HQs handle the following issues:-

(a) Adm of Polyclinics.

(b) Card making of beneficiaries.

(c) Contractual employment.

(d) Medicine availability through SEMO.

(e) C of I / detailed inv in empanelled hosp or service hosp.

Vigilance Cells

6. A feedback on the satisfactory functioning of Pilot Project at three stations has been obtained. It is now planned to institute the vigilance framework in 14 other major ECHS stations, to include Ambala, Bareilly, Channai, Hyderabad, Jaipur, Jabalpur, Jammu,Kochi, Kolkata, Lucknow, Meerut, Patna, Pune and Ranchi.

7. Composition of Vigilance Cell. The ECHS Vigilance Cell will function under the Stn Cdr and will incorporate a contractual Doctor/serving AMC officer for On-Spot verification of cases of alleged medical negligence/ violation of MoA. It will be composed as under:-

(a) OIC Team. Medical Offr (when accompanying) CMP JCO/NCO.

(b) CMP Team. Two CMP pers (JCO/NCO) in a light vehicle/MC.

(c) Medical Team. One Medical Offr (serving/contractual from ECHS) to be co-opted for all investigations related to hospitals/having examination of medical aspects. Serving offr may be also co-opted under arngs of Stn Cdr.

8. Tasks of Vigilance Cell. While not exhaustive, some of the tasks will be:-

(a) At Polyclinics.

(i) Investigate irregularities I fraudulence by contractual staff.

(ii) Physical verification of ESM and dependents (card and self attested proforma)

(iii) Review adm functioning of Polyclinics when so detailed by Stn I Sub Area I Area HQs on specific instructions

(iv) Surprise physical check of Medicines I Dispensary.

(v) Surprise physical verification of ESM/dependents.

(vi) Check use of ambulance/equipment with Polyclinic.

(vii) Avlb of complaint/Grievance Book and redressal/Comments.

(b) At Regional Centres.

(i) Check BPA verifiers at Regional Centres and any wrong practices by Hospital reps.

(ii) Check process of receipt of bills.

(iii) Ensure process of First in First Out (FIFO) in billing/ as specified by Central Org.

(iv) Monitor hospital representatives visiting for empanelment process.

(v) Security procedure of Regional Centre premises.

(c) At Hospitals/Diagnostic Centres/Labs.

(i) Periodic/Surprise Checks of Empanelled Facilities and patients admitted.

(ii) Physical verification of patients at non-empanelled facilities when so directed.

(iii) Investigate individual cases of fraudulence by beneficiaries .

(iv) Carry out preliminary investigation wrt complaints received at Regional Centre, if so directed by Director Regional Centre. These will be fwd to Stn Cdr being the nodal agency for check.

(v) Assist in medical audits if ordered by Regional Centres / Higher Headquarters .

Investigations and Reporting

9. Investigations. All complaints/reports are to be forwarded to Stn HQ in confidence irrespective of the subject being dealt by any agency. The Stn Cdr will brief the team and allocate the task to them in confidence. No prior info will be made available to vigilance cell members for surprise checks to avoid confidentiality being compromised. Routine and planned checks can be pre-decided.

10. Reporting. Reports will be of two types, viz/Incident/Info Report and Monthly Report. Reports of Vigilance Cell will be forwarded through Stn HQ SO (ECHS) to Area/Sub Area HQ (Dir ECHS/Dir Veteran) to Command HQ (SO ECHS) to Central Org ECHS (Dir C & L). All cases of misuse, fraud and harassment will be reported.

(a) Incident/Info Report. This report will be initiated by the Stn HQ to imdt higher HQ in chain of command within seven days of investigation being completed, with copy to all echelons of Comd till Comd HQ and Central Organisation ECHS (Dir C & L) for prompt action. Report should be passed immediately on telephone depending on gravity of input, to all concerned and followed up by return report so that corrective measures are not delayed. The format is as per Appendix A (in cases where delinquency in respect of serving pers come to notice, it will also be info to HQ Comd (DV) and DV Dte/AG’s Br by Comd (SO ECHS) and Central Organisation ECHS respectively.)

(b) Monthly Report. A monthly report on surprise checks carried out during the month by the Vigilance Team will be forwarded to Central Org ECHS as per format on Appendix B by 20th of next month by the Comd HQ (SO ECHS).

11. Report. The report by the Vigilance Team for various est will be rendered as per u/m formats:-

(a) Empanelled Hospital – Appendix C.

(b) Regional Centre – Appendix D.

(c) Polyclinic – Appendix E.

12. Check list. A suggested check list for the Vigilance Team is at Appendix F.

13. The Stn Cdr will compile the activities of the vigilance team and render a ground report after three months to Central Org ECHS through comd channel with recommendations/inputs to refine the vigilance mechanism.

(Yogendra Dimri)
Lt Gen
DG (DC&W)

Source: echs.gov.in

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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:

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

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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]

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Ex-Servicemen Contributory Health Scheme

There have been no specific complaints regarding misuse of funds. However, there are some complaints about lack of funds allocated to the ECHS.

The budget allocated at Budget Estimate stage was less than projected estimate and additional funds were allocated at Revised Estimate (RE) stage.

The shortfall of medicines is not directly related to lack of funds and it is attributed to procedure involved in procurement of medicines. Some private hospitals have withdrawn their services from ECHS due to various reasons including low rates, delay in clearance of bills etc.

The steps taken by the Government to improve health care under ECHS include sanction of additional manpower to ECHS polyclinics, revision of remuneration, bringing all 28 Regional Centres under online billing mode for timely processing and payment of medical bills of empanelled facilities, upgrading ECHS Card, empanelment of more medical facilities etc.

This information was given by Minister of State for Defence Rao Inderjit Singh in a written reply to Shri B.V. Naik in Lok Sabha today.

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Ex-servicemen Contributory Health Scheme (ECHS) was launched with effect from 01 April 2003. Growth of ECHS Membership. Year wise enrolment of ECHS members in beneficiary base over the years is as under:-

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Adjutant General’s Branch
Integrated Headquarters of
Ministry of Defence (Army)
Maude Lines

 New Delhi – 110010

B/49761/AG/ECHS/Policy

29 Aug 2013

ISSUE OF MEDICAL EQPT PRESCRIBED FOR ECHS MEMBERS:

AMENDMENT TO POLICY
1, Refer following of Central Org ECHS letters:-
(a) B/49773/AG/ECHS dated 05 Apr 2004.
(b) B/49770/AG/ECHS/HA dated 30 Aug 2006.
(c) B/49761/AG/ECHS/Policy dated 01 Apr 2013.

2. As per letter as 1 (a) above the following Med Eqpts are authorized for issue to ECHS members:-
(a) Hearing Aids.
(b) Artificial Limbs / Appliances.
(c) Glucometers and Nebulisers.
(d) CIPAP / BIPAP Machines.
(e) Spectacles.

3. The competent Financial Authority for purchase of all a/m Med Eqpts is the Station Cdr as per letter as para 1 (a). For all Regional Centres where medical claims are being processed ‘on line’ w.e.f 01 Apr 2013, CFA has been redesignated as per letter at para 1 (c). All such claims will be processed physically by Polyclinics and Regional Centres and not “On line” as was being done hither-to-fore.

4. Para 6(a) of this office letter No. B/49770/AG/ECHS/HA dated 30 Aug 2006 is amended as under for Body worn/Pocket type/Analogue BTE hearing aids.

For – “Recommendation for Hearing Aids will be acceptable ONLY from a Service ENT Specialist”

Read – “Recommendation for Hearing Aids will be acceptable from Service ENT Specialist / ENT Specialist of Govt Hospitals.”

Sd/-xxxxx
(Vijay Anand)
Col
Dir (Med)
for MD

Source: http://echs.gov.in
[http://echs.gov.in/images/pdf/Policy%20HA.pdf]

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