ECHS – Change In Referral System

F.No.18(54)/2018/WE/D(Res-1)
Government of India
Department of Ex Servicemen Welfare
D(WE)

New Delhi, dated 02 August. 2018

To
Managing Director
Ex-servicemen Contributory Health Scheme,
Maude Line,
Delhi Cantt

Subject: Change in System of Referral- No referral to be in the Name of any Private Empanelled Medical Facility.

Sir,
The undersigned is direct to state that as per the Ministry of Health & Family Welfare OM No.Z15025/105/2017/DIR/CGHS/EHS dated 09.11.2017 the CGHS doctor / Government Specialist shall not refer the beneficiary to any particular empanelled hospital by name but shall specify the treatment procedure and mention “referred to any CGHS empanelled centre”

2. ECHS has to follow the CGHS Norms. However, it is seen that doctors at CHS Polyclinics are issuing referrals by name to specific Pvt. Empanelled Medical Facilities.

3. In view of the above, it has been decided by the competent authority that henceforth no ECHS doctor will issue referrals by name to any Pvt. Empanelled Medical Facility. The ECHS doctors shall mention on the prescription the treatment procedure/tests required by the ECHS beneficiary and then write as follows:

“Referred to any ECHS Empanelled Medical Facility located within the Area of Responsibility of Regional Centre, (Name of City).”

4. CO, ECHS and RC, ECHS will ensure that the list of Pvt. Empanelled Medical Facilities along with the medical treatment procedures/tests for which they have been empanelled is prominently displayed on the website of ECHS, Regional Centre wise. OIC, of every Polyclinic, will be responsible for ensuring that hard copies of this list downloaded from ECHS website is kept in the Polyclinic in sufficient numbers and given to the ECHS beneficiary whenever demanded. If any change lakes place in this list, it shall be the responsibility of Director RC, ECHS concerned ensure display of the corrected/amended list on the website of ECHS without any delay.

5. Whenever an ECHS beneficiary approaches a Pvt. Empanelled Medical Facility with such a referral from ECHS Polyclinic and the Pvt. Empanelled Medical Facility is not empanelled by Ministry of Defence (MoD) for the required treatment procedure / tests, it shall be the responsibility of the Pvt. Empanelled Medical Facility to inform the beneficiary that it is not empanelled for the required treatment procedure / tests. If any Pvt. Empanelled Medical Facility is found providing treatment procedure / conducting tests to such an ECHS beneficiary for which it is not empanelled, then apart from not reimbursing the expenses incurred by the Medical Facility on such treatment, action will be taken against the said ECHS Empanelled Pvt Medical Facility under the rules / as per the provisions of Memorandum of Agreement (MoA).

6. No ECHS Polyclinic Officer/Official/Doctor should indulge in any action force canvassing for/against any ECHS empanelled Pvt. Medical Facility.

7. The above orders shall come into force with immediate effect.

 

Reference:  https://www.gconnect.in/orders-in-brief/cghs/echs-change-in-referral-system-in-line-with-cghs-norms.html?utm_source=feedblitz&utm_medium=FeedBlitzEmail&utm_content=408382&utm_campaign=Twelve-hourly_2018-08-13_00%3a15

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ECHS Facilities to Ex-Servicemen

The Government has sanctioned 426 Polyclinics for Ex- Servicemen Contributory Health Scheme (ECHS). 227 Polyclinics were sanctioned in the year 2002, all of which are functional. Due to increasing ESM population an additional 199 Polyclinics including 17 Mobile Clinics were sanctioned in October 2010, out of which 43 Polyclinics are operational, thus at present 270 Polyclinics are functioning. In addition the Government has sanctioned 15 new Regional Centers to strengthen the ECHS Services, out of which 6 Regional Centers are already functional. As on 1st March, 2012, there are 39,46,898 beneficiaries which include 12,34,069 ex-servicemen and 27,12,829 dependents.
The ECHS beneficiaries can avail treatment at state Government hospitals/Clinics. The cost of treatment at Government hospitals is reimbursed at the approved rates and 80% advance of the estimated cost of the treatment at Government hospitals/Clinics is admissible to the ECHS beneficiaries.
At present 1383 Private hospitals/Dental Clinics/Diagnostics Centers and Eye clinics throughout the country are empanelled with ECHS, where the ECHS beneficiaries can avail cashless treatment. In emergency cases, reimbursement is made at approved rates, even for treatment in non-empanelled hospitals.
This information was given by Minister of State for Defence Dr MM Pallam Raju in written reply to Shri Virender Kashyap and Shri Kuldeep Bishnoi in Lok Sabha on 26 Mar 2012.
Source: http://pib.nic.in

Issue of Medicines to ECHS Beneficiaries

1. Representations have been received from ECHS members that tablets of drugs issued to them are often of strengths either larger or lesser than that prescribed. Hence getting the correct dose has to be done after breaking the tablet, on many occasions, into pieces or by taking multiple tablets.

2. It may be appreciated that ensuring correct dosages after fragmenting the tablet, specially by ECHS members who are old and frail, becomes a difficult task. On some occasions, it has resulted in either over dosage or less than the prescribed strength which could have been avoided.

3. In view of the above, you are requested to issue necessary instructions to all concerned so that drugs which are usually prescribed in different strengths, specially for chronic diseases, be provisioned to ECHS beneficiaries in the commonly prescribed strengths.

(G Ghose)
Col
Dir (Med)
For MD

Authority: Central Org ECHS, Army HQ letter No: B/49762/AG/ECHS/Policy dt 20 Feb 2007

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