Subject: - PROCEDURE FOR PAYMENT AND REIMBURSEMENT OF MEDICAL EXPENSES UNDER ECHS

Sir,

The procedure for payment and reimbursement of medical expenses under ECHS has been outlined in Ministry of Defence letter No. 24(8)/03/US(WE)/D(Res) dated 19th December 2003. Para 4(b) of the letter ibid says that the rates of payment to empanelled hospitals/diagnostic centers will be governed by the package rates as laid down for CGHS.

2. The Ministry of Health & Family Welfare have reduced the package rates of empanelled hospitals and diagnostic centres for various treatments/diagnostic procedures in December 2006 for Delhi area and June/July 2007 for the rest of the country covered under CGHS. Accordingly the Central Organisation, ECHS also revised the rates for ECHS in consonance with CGHS rates w.e.f. 08th December 2006 for Delhi region and 01st December 2007 for rest of the country.

3. CO, ECHS has been representing, since October, 2007, that consequent upon reduction in rates referred to in Para 2 above, most of the reputed hospitals all over the country have either disassociated themselves from ECHS or are accepting patients of selected specialties like Cardiology and Ophthalmology only. This has resulted in non-availability of appropriate treatment to ECHS patients, which is causing widespread inconvenience and discontentment amongst ex-servicemen. The Chairman of the Chiefs of Staff Committee and Adjutant General have also expressed their concern in the matter and requested to allow ECHS to follow pre-November 2006 CGHS rates.

4. After careful consideration the Government have decided that reimbursement of medical expenses under ECHS to the empanelled hospitals/diagnostic centres would continue at pre-revised CGHS rates as an interim measure.

5. In the meantime a committee of senior officers of the Ministry will go into the whole gamut of issues and prepare future course of action in the matter. Orders for constituting the committee are being issued separately.

6. Cases already settled at revised CGHS rates shall not be reopened.

7. This issues with concurrence of Defence (Finance) vide their UO No. 150/PD/08 dated 22.02.2008