BRIEF ON EX-SERVICEMEN CONTRIBUTORY HEALTH SCHEME (ECHS)

Preamble

1. This Brief is set out as given below, and is only a preliminary guideline for information of the environment/members joining the ECHS. This Brief provides progress on the ECHS as on 01 September 2003, and must be referred to in conjunction with “Frequently Asked Questions” issued by the Central Organisation ECHS in August 2003. A detailed booklet on the scheme will be prepared in due course, once procedures are formally approved by the GOI/MOD: -

(a) Part 1 . Medical Treatment entitlement to ex-servicemen (ESM) pensioners prior to 01 April 2003.

(b) Part 2 . Aim & Salient aspects of the ECHS, including Eligibility for Membership.

(c) Part 3 . Procedure for enrolment for ESM who were already retired on or before 31 March 2003, and procedure to be followed by post -01 April 2003 retirees.

(d) Part 4 . Rates of Contribution and method of remittance.

(e) Part 5 . Utilisation of ECHS medicare system.

(f) Part 6 . Action in case of Emergency.

(g) Part 7 . Status of AGIS (MBS) & AFGIS (MIS) & ECHS Road Map.

(h) Part 8 . Some Important Information.

(i) Part 9 . SMART Card and its use.

(j) Part 10 . Progress on ECHS & interim arrangements.

PART 1General

2. “Authorised” vis-à-vis “Entitled” Medical Treatment . While in service, all ranks of the Armed Forces are authorised to full & free medical treatment for themselves and for their declared dependants. However, on proceeding on retirement, as per Regulations for Medical Services of the Armed Forces (RMSAF), ex-servicemen (ESM) pensioners (including family pensioners) are only entitled to a medical allowance of Rs 100/- pm for purchase of medicines - which amount is included in their Pension Payment Order (PPO) - or in lieu, to avail free outpatient treatment in Service facilities and limited in-patient facilities by paying stipulated stoppages. Those in receipt of Medical Allowance are NOT permitted to utilise any outpatient facility/medicines from Service Hospitals/MI Rooms. Therefore, treatment to the extent possible was provided to them as an entitlement, and as a welfare measure, at Service Hospitals, Augmented Armed Forces Clinics

(AFC) and Medical Inspection (MI) Rooms, subject to availability of bedspace, facility and expertise. Such treatment does not cater for any of the major diseases, or cover support to dependants, other than spouse. Moreover, in stations where an MH/AFC/MI Room is not present, the pensioner has to make his own arrangements. An additional problem has been that with passage of time, Service Hospitals/AFCs & MI Rooms (particularly in metro cities) became overloaded with the progressive increase in demand of treatment by pensioners, and it has not been possible for the existing medical infrastructure to cope with either their aspirations or provide quality treatment.

3. Shortcomings of ESM Medicare . Retired Armed Forces pensioners, therefore, lacked an adequate post-retirement medicare scheme, as available to other Central Government employees. The other major shortcoming was that such entitlement did not cover treatment of major diseases, and Rs 100.00 pm hardly catered for the prohibitive costs of even common medicines. To provide some relief to pensioners, a privately funded Medical Benefit Scheme (MBS) under the Army Group Insurance Scheme was introduced in Apr 91, and a similar Medical Insurance Scheme) (MIS) under Air Force Group Insurance Scheme in 1993. These catered to specific high cost surgery/treatment, but for a limited number of diseases. Due to inadequacies of these, it was felt necessary to formulate a comprehensive health scheme to cater to the needs of ever increasing pensioners of the Armed Forces, and also to decrease the out patient load on Service Hospitals.

4. Creation of ECHS. As a consequence of above, and after detailed deliberations, a comprehensive paper on a health scheme for defence pensioners, was submitted to Government which finally took shape as the Ex-Servicemen Contributory Health Scheme (ECHS), duly sanctioned by the Government vide letter No 22 (I)/01/US (WE) /D (Res) dated 30 Dec 2002, to come into effect from 01 Apr 2003. The GOI/Min of Def letter ibid only laid down a broad policy framework, and was to be implemented through detailed administrative & financial procedures, to be approved separately by MOD. Of the 11 administrative & financial procedures submitted to Government by the Armed Forces, for running the ECHS, only three stand approved as on date.

PART 2Aim

5. To provide comprehensive & quality medical care (covering all possible diseases) to ESM pensioners and their dependents, to widows and family pensioners through out-patient (OPD) facilities at 227 all-India Polyclinics, and in-patient treatment through Service Hospitals (subject to restrictions)/empanelled Civil Hospitals/ Diagnostic Centres & specialist Consultants in all such stations.

Salient Aspects of ECHS

6. It covers complete spectrum of ESM pensioners settled in far-flung areas of the country through a network of Polyclinics in military and non-military stations. This will bring outpatient treatment & medicines closer to the location of pensioners, and they will no longer have to go only to service hospitals that are often located far away.

7. The Scheme is wholly financed by Govt of India from Public Funds through the Army budget, with only marginal contribution from retiring and retired service pensioners. All expenditures under this scheme are auditable. Since GOI/MOD has financed the scheme, the modalities for its implementation are being set out in a series of eleven administrative & financial procedures, based on the broad policy letter of 30 December 2002. Contributions from members do NOT run the scheme (as is commonly believed) and their money goes into a consolidated fund. There is no connection between Receipts from pensioners and Expenditure done from public accounts.

8. It will have a network of 227 polyclinics - 104 co-located at military stations with service hospitals (where existing), and 123 new Polyclinics at specified non-military stations. Location of these 227 Polyclinics, as well as their size/type, has been based on the density of ESM pensioners residing in a district. All India list of Polyclinic location is given at Appendix to this Brief.

9. ECHS will reduce the out patient load on service hospitals, since an exclusive Polyclinic facility for ESM pensioners will be located alongside the MH. Experienced and caring Polyclinic staff (medical and non-medical) will be recruited, on contractual/basis, through properly constituted Boards of Officers appointed by Station Commanders. 10. In addition to existing Service Hospitals, good & qualified Civil Hospitals/Diagnostic Centres and Consultants will also be empanelled by local Station Commanders, through empowered Station Board of Officers. These Hospitals/Diagnostic Centres will provide back up support for in-patient hospitalisation/treatment/investigations where Service Hospitals do not have bed space or facilities. Treatment will be easily accessible in emergencies, either through empanelled hospitals or non-empanelled facilities – however, rules apply as mentioned later in this Brief.

11. Dependent parents are included in the scheme subject to the condition that their income is less than Rs 1500/- per month. Likewise, dependant unemployed sons upto 25 years of age, and unmarried & unemployed daughters, are also included. Physically & mentally challenged children are covered for life, even after the death of parents.

Eligibility for Membership

12. All ESM pensioners of the Armed Forces who are in receipt of any form of pension/disability pension, and widows/family pensioners in receipt of pension, are eligible to become members of the scheme. A detailed policy letter is under issue clarifying eligibility pre-conditions for membership. Incidentally, there is NO restriction on age or medical condition of the pensioner at the time of application.

13. Besides the ESM pensioner himself/herself, the following members of his/her family are also covered by ECHS: -

(a) Spouse.

(b) Unemployed son, below 25 years.

(c) Unemployed or unmarried daughter and unemployed divorced/Widow daughter.

(d) Dependent parents whose income is less than Rs 1500/- pm.

(e) Mentally/Physically Challenged children for life. Certificate from a Specialist in a Service Hospital is mandatory in such cases.

Note: Wherever there is a doubt about eligibility, the case shall be referred to the Central Organisation through Regional Centres. Under NO circumstances will non-entitled members be enrolled. In all such cases, it is made clear to the applicant that his/her application is accepted provisionally.

14. Enrolling into the ECHS is voluntary/optional for those ESM pensioners, and for widows/family pensioners of deceased soldiers, who retired on or before 31 March 2003. Those who opt NOT to join the scheme will continue to draw Rs 100.00 pm medical allowance, and continue to avail the limited medical facilities provided under RMSAF, as hitherto fore. They shall NOT be permitted to use any ECHS facilities, in any case. This option of joining the ECHS has to be exercised latest by 31 March 2008 , on which date entry to the Scheme will terminate. The ECHS is, however, compulsory for all Services pensioners retiring w.e.f 01 Apr 2003, and their contribution shall be deducted at source by PCDA (Pensions), prior to retirement.

PART 3

Procedure for joining ECHS (pre 01 April 2003 pensioners)

15. STEP 1

(a) Pensioner/widow/family pensioner or his/her representative can collect computerised Application form from nearest Station HQs of Army/Navy/Air Force on payment of Rs 5.00. The forms have got detailed instructions as to how a pensioner or a widow, or family pensioner are to fill these up, and the list of documents to be attached. Pensioners who submitted forms in April – May 2003 are NOT required to submit computerized forms afresh.

(b) Forms are also available on internet websites, which are, (www.indianarmy.nic.in/arechs.htm) and (www.irfs-nausena.mil.in).

16. STEP 2

(a) Pensioner/widow/family pensioner to report personally to any of the designated 104 Station Headquarters (and specifically authorised Navy and Air Force collection centres) with completed Application, along with original and photocopy of undermentioned documents. (Family members are NOT required to accompany the pensioners for registration). The purpose of personal reporting is for safety of original documents and for answering any questions that the scrutinizing Station HQ staff may wish to ask the applicant: -

(i) PPO duly attested by Bank/Treasury/PDPO from which drawing pension. This is a mandatory requirement.

(ii) Discharge book – mandatory in all cases, except as given below: -

(aa) NOT required in case of Officers/PBOR with no dependants.

(ab) In case only spouse is dependant – AGIS/AFGIS card with joint photograph will suffice. AGIS/AFGIS Card is acceptable proof of identity for both husband and wife.

(ac) Naval Officers who are not issued discharge book.

(ad) AF officers who are not issued a discharge book.

(iii) Two passport size photographs each of pensioner & dependants – (Paste one copy each on Pages 8 and 9 of application form, and one copy each on affidavit). Also read instructions in affidavit. Photographs are NOT required to be stamped by the Notary – they should be signed over by the dependant, or by the applicant himself/herself if dependant is a minor.

(iv) Attach original copy of Military Receivable Order (MRO) as proof of deposit of contribution.

(v) Affidavit duly notarized in original only to be submitted with application form. Notary is required to sign at one place ONLY on the Affidavit.

(vi) ESM Identity Card, where available, will be produced in original only for verification by the checking officer. Identity Card issued by Kendriya/Rajya/Zila Sainik Boards is NOT acceptable.

Note :- The Station HQ staff will compare attested photocopy with the original document & return the originals immediately to the pensioner. They may also ask questions in case of any doubts. They will also assist pensioners in case of problems in filling in the form. Once finished they will handover a Receipt to the pensioner. Pensioners must retain original copy of Reciept carefully. Where there is any dispute regarding identity/inadequacy of documentary proof, the case will be referred to the Central Organisation. In such cases, Application will NOT be formally accepted, unless cleared by Central Organisation.

17. STEP 3

(a) Applicants to come in person to Station HQs when informed, for collection of ECHS membership SMART CARD. The Receipt provided by the Station Headquarters at the time of accepting the application form must be brought along for collection of SMART CARD.

(b) Card must be kept carefully, as no medical treatment will be possible without the membership card.

Note :- Personal reporting is required in order to prevent SMART Card(s) being handed over to a wrong person. Also the pensioner/

widow is required to sign in the Master Ledger at Station HQs, as proof of having received his/her Card(s).

18. STEP 4

(a) It is mandatory for members and dependents to report jointly or singly to nearest Polyclinic indicated in their Application, along with SMART CARD, for recording of fingerprint biometric data of the applicant and each member of his/her family. This should be done within 120 days of receiving the SMART CARD. (b) ECHS SMART CARD will not work at any ECHS Polyclinic unless activated.

(c) Use the polyclinic facilities. When visiting a Polyclinic subsequently, it is mandatory for the pensioner or his family member to carry the ECHS SMART CARD as proof of eligibility. Otherwise, the Polyclinic may not accept the individual for treatment.

Application Procedure for Soldiers Retiring wef 01 April 2003

19. (a) Separate procedure is being issued through Army/Navy/Air Forces Orders/Instructions. Such personnel are automatic members of the Scheme from date of retirement.

(b) Application Form (ECHS Med – 2003), currently under printing, to be submitted (as indicated in the General Instructions in the form) well in advance of retirement date. Submission of Application form and Affidavit is mandatory. Contribution will be automatically deducted by respective Principal Controller of Defence Account (CDA) (Pensioners) from terminal benefits and endorsed on PPO with remarks “ECHS Contribution”.

(c) The organisation will attempt to ensure that SMART CARD is issued 7-15 days prior to retirement through his/her unit, in respect of Officers, and from Regimental Centre/Records Office/Commodore Bureau of Sailors (CABS)/Air Force (AF) unit in case of personnel below officer rank (PBOR) of the three services.

PART 4

Contribution

20. Contribution can be made by Ex-Servicemen as a one-time payment or in three consecutive yearly installments. The contribution amount is mentioned in the application form and is per basic pension (ie, without commutation and without DA) of the ESM and is to be remitted through Military Recievable Order, to SBI/RBI/Government Treasury. This remittance procedure is NOT applicable to those persons retiring from 01 Apr 2003 onwards, and where PPOs have the endorsement “ECHS Contribution” thereon. For pensioners/widows/family pensioners, who opt to pay in one installment, the ECHS facility is available for lifetime. In case the payment is remitted in three installments, the validity of the ECHS Smart Card/medical treatment will only be valid for the period of payment. Pensioners paying by installments are responsible to inform the Station HQs or concerned Regional

Centre by post (enclosing original copy of MRO) that the second & third installments have been deposited as & when due. In case the next installment is not paid by due date, such SMART cards will not be accepted by Polyclinic Card Readers and the card will automatically become inactive. However, the ECHS Card will be renewed/reactivated when the next payment is deposited and proof provided. After the third & final installment is paid, the SMART Card will become active for lifetime of the pensioner and for eligibility period for dependents.

21. Rates are at par with rates of CGHS. The amount to be deposited by MRO is as follows:-

BASIC UNCOMMUTED PENSION RATE OF ONE TIME (excluding DA & Disability) SUBSCRIPTION

Upto Rs 1500/- Rs 1800/-

Between Rs 1501 and 3000/- Rs 4800/-

Between Rs 3001 and 5000/- Rs 8400/-

Between Rs 5001 and 7500/- Rs 12000/-

Above Rs 7500/- Rs 18000/-

Who is an ECHS Member? An ECHS member is one whose application has been fully scrutinized and verified, for his/her eligibility, his/her dependants, widow status, and eligibility of his/her parents. Only such persons who fully meet eligibility criteria will be issued with an electronic ECHS Membership SMART Card. They are the only ones who can claim to be members of the Scheme. (In the interim period, till issue of SMART CARD, Reciept may be used as proof of membership).

PART 5

Medical Facilities

22. Facilities in 104 military stations are being progressively upgraded. In 123 non-military stations, new polyclinics will be established progressively. 36 such augmented clinics Armed Forces Clinics (AFCs) and 10 Dental Clinics have already been established in military stations by Service Headquarters from their welfare funds. These will continue to provide support to pensioners, while new ECHS Polyclinics are being established/constructed.

23. Eligible members of the Scheme can go to the nearest ECHS Polyclinic/AFC along with their SMART CARDS to avail treatment (till issue of Smart Cards Reciept may be utilized). In the interim, till ECHS procedures are formalized, ECHS members may approach any Service Hospital to be provided medical cover, under the provisions of Army HQ letter No B/49769/AG/ECHS dated 14 July 2003 (amended on 12 August 2003).

24. Doctors at Polyclinics will provide required outpatient treatment and medicines free of cost. In case a prescribed medicine is not available in the Polyclinic Pharmacy, the OIC Polyclinic or Medical Officer will procure this through Local Purchase (LP) and provide it to the member. ECHS members

will NOT be required to purchase any medicine specified for him/her by an ECHS doctor/empanelled hospital. ECHS will NOT deal with any case of reimbursement for medicines purchased by a member/dependant, as this is not permissible under ECHS rules. In case any medicine is so purchased the cost will have to be borne by the member.

25. In case further treatment is required, the patient will be referred to the nearest Service Hospital if the treatment/bed availability exists there. At the Service Hospital, the ECHS member will be provided free treatment & medicines and ward facilities as per his entitlement, but will have to pay nominal hospital stoppages in cash, on being discharged from the hospital. The procedure for dealing with ECHS members or dependants will be the same as for serving Soldiers & their dependants.

26. In case treatment facility/bed space does not exist/is not available in a service hospital, the ECHS patient will be referred to the desired empanelled Hospital/Diagnostic Center/Consultant in the city/region as per choice of the pensioner. He/she alone will have the right to make the selection. A list of empanelled Hospitals/Diagnostic Centers and Consultants will be available in each Polyclinic for benefit of patients. In due course this information will also be provided on an ECHS website.

27. All that the patient is required to do is, to go to the selected Hospital/Diagnostic Centre, show his ECHS SMART CARD and referral form from the Polyclinic, and get treatment. Suitable Memorandum of Agreement (MOA) will have been drawn up with empanelled Civil Hospitals/Diagnostic Centres and Consultants to provide treatment only to those pensioners who are referred to them from the Polyclinic, and provide proof of membership/SMART Card. ECHS members are NOT permitted to go directly to any empanelled Hospitals/Diagnostic Centres/Consultant (except in emergency – see provisions in this Brief).

28. The ESM/dependent does not have to clear bills or make payment (except for dietary charges) either on admission or when discharged from the Hospital/Diagnostic Centre/Consultant, provided the cost is as per rate contract concluded with the empanelled facility. These Hospitals/Diagnostic Centres/Consultants will be paid directly by the concerned Station Headquarters under whose jurisdiction the clinic falls. ECHS is responsible for such payments incurred on treatment of the entitled members – but only if the laid down procedure is followed. If a member/dependant goes directly to a Hospital/Diagnostic Centre/Consultant, without first having shown himself to a Polyclinic Doctor and having got referred, then ECHS will not be held responsible for costs incurred and will not make payment to the empanelled facility.

29. There will be no burden of payment (except hospital stoppages in Service Hospitals, and dietary charges in empanelled Civil Hospitals) on the ECHS member, either for medicines or for any treatment - whether out-patient or in-patient - so long as laid down procedures are adhered to, and rate contract concluded with the facility is not exceeded.

PART 6

Treatment in Emergency

30. In an emergency, the ECHS pensioner/eligible family members, may report to the nearest hospital (preferably empanelled) and inform the dependant Polyclinic/Station HQ/Regional Centre of the emergency within 48 hrs of admission. In case of admission to an empanelled hospital, the bills will be cleared by ECHS directly. However, in case of emergency admission to a non-empanelled hospital, the member will first clear the bills, and thereafter put up claim for re-imbursement to the dependant ECHS Polyclinic, duly supported with original bills. The bills will be reimbursed if ECHS is satisfied as to the reasons of emergency and the cost of treatment availed is reasonable. The onus of proving the emergency lies with the member and ECHS may, or may not, clear bills in entirety in the event of doubt/misuse of emergency provisions.

PART 7

Status of AGIS (MBS) & AFGIS (MIS)

31. AGIS (MBS) will terminate on 31 Mar 2006, and its members will be refunded the full amount of subscription once they have acquired ECHS membership. For further details members should contact MD AGIS.

32. AFGIS (MIS) will terminate on 31 Mar 2004. AFGIS will issue separate instructions regarding refund to its members.

Road Map for Development of ECHS Polyclinics

33. Ex Servicemen Contributory Health Scheme (ECHS) is one amongst the many important initiatives take by the Government & the Armed Forces to alleviate the social-economic needs of retired pensioners of the three Services. These essential steps are just a small compensation to the brave soldiers who sacrifice their youth & life in the nations’ service.

34. The ECHS scheme is a major venture and this medicare concept is being attempted for the first time at an all India level. It is but natural that such a scheme will take time to emerge on ground, through newly constructed and equipped Polyclinic buildings. In fact construction of buildings, purchase of medical equipment/medicines, vehicles, generators, employment of medical/non-medical staff will take time. Therefore, there will be a minimum period required for stabilisation of ECHS. In the interim, provisions are being made to ensure to that ESM joining the scheme are able to use its benefits.

35. A road map has been charted out for progressive build up of ECHS assets within a span of five years as per GOI letter, ie, by 31 Mar 2008, which is also linked to the progressive release of funds by MOD. The Polyclinics where construction work is planned to commence in FY 2003 – 04, is at 62 Polyclinics in military stations and at 33 non-military stations.

36. There is no doubt that the ECHS is a very forward looking & comprehensive medicare scheme, which will go a long way in providing

succour to the numerous ex-servicemen pensioners who retire each year. It caters for all types of diseases & conditions that can afflict aged persons, as also covers problems related to the younger age dependants.

37. This scheme is definitely in the interest of ex-service pensioners and, through the means of this Brief and through media, it is hoped that ESM will seize the opportunity to enroll well before the cut off date.

PART 8

Important Information

38. Some important information for pensioners/widows is summarised:-

(a) To become an ECHS Member an initial contribution as per laid down rates in mandatory. Thereafter, no payment is to be made for any medicines or treatment provided under the scheme.

(b) There is no restriction on the type of disease to be treated, or medicine to be provided, to an ECHS Member within the ECHS rules.

(c) An ECHS member can opt for a single ECHS Smart Card for him/herself and all dependants, or one for him/herself and a maximum of two add-on cards for his/her dependants. As the scheme stabilizes we may permit a separate card for each dependant.

(d) All cards will mandatorily carry fingerprints of the member and his/her entitled dependants.

(e) It is mandatory to produce the ECHS Smart Card for every visit to a Polyclinic. Without the Card, the computer at the Polyclinic will not activate the patients’ record/data, and member/dependant will be denied treatment, except in emergency. In case a card is lost, immediately inform the issuing Station HQ/Regional Centre.

(f) Referral to empanelled Civil Hospital / Diagnostic Centre/ Consultant, or Service Hospital, can only be made by Polyclinic Doctor(s). ECHS Members are NOT permitted to go directly to any of above.

(g) Patients who are referred by the Polyclinic doctor(s) to a Service Hospital or to an empanelled facility, must carry their membership Smart Card & the Polyclinics Referral Card. Without these they will NOT be entertained by the Service Hospital or the empanelled facility.

(h) No payment to be made by members for treatment (within rate contract concluded with Hospitals/Diagnostic Centres), or for medicines - that will be done by ECHS. (Hospital Stoppages/Dietary charges will be paid by the patient). Since members are not required to buy medicines or pay for treatment, requests for re-imbursement will not be entertained. Medicines so bought will be at own cost.

(j) In an emergency, an ECHS patient may be rushed directly to the nearest Service hospital or to an empanelled hospital (if nearby). However, if empanelled hospital is not located nearby, or it is inconvenient due to the nature of emergency, the member may

proceed to a non-empanelled hospital for treatment. He/she must, in any case, inform the dependant Polyclinic / Station HQs / Regional Centre, of the admission within 48 hours.

(k) An ECHS member who has a SMART Card can avail of treatment at an ECHS Polyclinic anywhere in India. He can also go to any empanelled Civil Hospital/Diagnostic Centre, provided he has an authorised Referral slip from an ECHS Polyclinic.

(l) Intercity transportation will invariably be at the members’ cost, except where he/she is moved on medical advice. Detailed policy will be issued in due course of time. For movement within town/city limits, ECHS ambulances may be used to convey very sick and immobile patients from an ECHS Polyclinic to the Civil Hospital/Diagnostic Centre at the discretion of OIC Polyclinic or the Polyclinic doctors.

(m) Service Hospitals are automatically empanelled under the ECHS. Therefore, free treatment/medicines will be provided to ECHS members/entitled dependants, subject to availability of bed space, treatment facility and qualified doctors. Nominal stoppages will have to be paid in cash, before discharge.

(f) First priority for treatment in Service Hospitals is reserved for serving personnel and their authorised dependants. Hence ECHS members may be denied admission in Service Hospitals, if bed space is NOT available. Also, certain types of treatment (Cancer, Heart, hip/knee replacements, Renal etc) are not available in all Service Hospitals – admission may be denied in those hospitals.

PART 9

ECHS SMART Card & its utilization

40. To efficiently manage the health needs of an ESM population of approx 20 lakhs, with an average of 5 dependants per member, the ECHS would have to track and cater for a strength of over 1 crore members. This can only be done through an electronic system, for which the SMSRT Card was found to be the best solution. The main purposes of the SMART Card are:-

(a) Identification and prevention of fraud . The card will carry personalized details of the pensioner and eligible dependants. The information shall be in the form of digitized photos and fingerprints.

(b) Medical History Details . Details of medical history will be carried on the card so that, in the event of emergency, the data is available. For example, the card will indicate if patient is Diabetic, or Asthmatic, or allergic to a particular drug. This will prevent contra medication.

(c) Medical Expenditure . Amount of expenditure incurred on each member/dependant, details of reference, hospitalisation and such like details, will be available for use by ECHS management.

41. It had been planned to commence issue of Cards from September 2003 onwards. However, that shall NOT be possible, since the project is enormous, and it has not been possible to short list a suitable vendor as on 31 August. It may take another few months for cards to commence issue to members. We do not wish to hurry matters in view of complexity of the task, it being a prestigious project being undertaken for the first time in the country.

Interim Arrangements in lieu of SMART Card

42. In the interim, till such time issue of cards commences, a pensioner who has paid his/her contribution shall be permitted to use the Reciept provided to him by the Station Headquarters or by Regional Centre, as authority for availing treatment under the ECHS, for himself/herself and for his/her authorised dependants. Orders to this effect have been passed to all Service Hospitals, and similar instructions will be passed to empanelled hospitals, if necessary. However, with the Reciept the member shall mandatorily have to carry/produce some other authentic document/ identification of his/her or dependants identity.

PART 10

Progress on ECHS

43. Based on the broad policy letter issued by the GOI/MOD on 30 Dec 2002, Central Organisation ECHS had forwarded to the MOD (between April 2003 – August 2003) a total of 11 administrative and financial procedures to implement the scheme. Of these, the following procedures have been approved by GOI/MOD so far:-

(a) Engineering Design of Polyclinics.

(b) Procurement of Medical Equipment for Polyclinics.

(c) Empanelment of 431 CGHS approved Hospitals, in 27 cities, as an immediate measure for referral/treatment of ECHS patients.

44. Eight more procedures are yet to be approved as on 01 September 2003. Of these, the two most important ones are – Empanelment/employment of Polyclinic Doctors, Technical and non-medical staff; and Payment Procedures to empanelled Hospitals, staff and for other ECHS functions. In the event that these two procedures are approved, it will permit the ECHS Central Organisation to refer patients through Polyclinic staff to empanelled hospitals and pay for the treatment.

45. In the interim period, when ECHS Polyclinic buildings are under construction (as per phased plan) in military stations, a separate building(s) will be earmarked for the Polyclinic from where ECHS doctors will function. In non-military stations, buildings will be hired. Authorised Medical equipment shall be provided to Polyclinics in phases – in the interim period, existing resources of the Armed Forces shall be utilized.

Arrangements for Medical Treatment till Approval of MOD Procedures

46. Since GOI/MOD procedures may take time in being approved, owing to detailed vetting and financial clearance, ECHS members and their authorised dependants (less parents) requiring critical medical care, should report to the Service Hospital nearest to them, with their RECIEPT and some identification. Routine treatment shall be provided as hitherto fore. For specialized treatment/referral, each Service Hospital has been provided with a sample form in which the clinical management of the patient and likely cost of treatment is to be indicated by the Hospital, and forwarded through medical channels to DGAFMS. On receipt of medical recommendations, financial concurrence shall be accorded by ECHS. Payment will be made to the concerned hospital for the approved treatment.

47. The above procedure has been invoked for the interim period vide Army Headquarters AG’s Branch letter No B/49769/AG/ECHS dated 14 July 2003, as amended vide letter of same number dated 04 September 2003, and is applicable to all three Services.

Tele: 2736 Pashchim Kaman Mukhyalaya

Headquarters Western

CommandChandimandir –

134107

46153/5/ECHS 16 Aug 04

List ‘A’

PH & HP81 Sub Area91 Sub Area

___________________(Station Headquarters)

CHANGE OF ADDRESS

A photo copy of Central Organisation letter No B/49726/AG/ECHS/ii DT 27 Jul 2004 regarding their change of address encl for your and necessary action.

(S Dhillon)MajOffg SO (ECHS)For COS

Enclose : (One only)

Tele: 25684946 Central OrganisationASCON: 6832 Ex-servicemen Contributory

Health Scheme (ECHS)

Maude Lines

Delhi Cantt – 110010

B/49726/AG/ECHS/II 27 Jul 2004

HQ WESTERN COMMAND (A)(All Concerned)

CHANGE OF ADDRESS

1. The office of Central Organisation, Ex-servicemen Contributory Health Scheme (ECHS) has shifted from Room No 278 A , South Block, Army HQs to its temporary premises at Maude Lines, Delhi Cantt – 110010 wef 12 May 2004. The HQs is expected to be located at this address upto 31 march 2007. You are kindly requested to correspond with this office on the following address:-

Central Organisation, ECHSMaude LinesDelhi Cantt – 110010

2. The tele Nos of various apps are as under:-

Ser No Appts Office Tele Nos(a) MD (Maj Gen) 6830 (ASCON), 25684846 (CIV)

(b) Dy MD (Brig) 6831 (ASCON), 25684847 (CIV)

(c) Dir (Ops & Coord)-(Col) 6832 (ASCON), 25684946 (CIV)

(d) Dir (Med) - (Col) 6833 (ASCON), 25684945 (CIV)

(e) Dir (P & FC) -Gp Capt 6834 (ASCON)

3. This is for your info please.

Sd –x-x-x-x-x-x(O S Yadav)

ColDir (Ops &

Coord)For Managing

Director

Appendix

LIST OF 227 ECHS POLYCLINICS PLANNED UPTIL 31 MARCH 2008State Polyclinic/Station

Andaman & Nicobar Port Blair

Andhra PradeshChittoor, East Godavari, Guntur, Hyderabad, Krishna, Ongole, Rangareddy, Vishakhapatnam, West Godavari

Arunachal PradeshAssam Jorhat, Gauhati, MasimpurBihar Bhojpur, Chappra, Danapur, Darbangha, Gaya, Muzaffarpur, SinghbumChandigarh (UT) ChandigarhChattisgarhDelhi NCR Delhi, Faridabad, Gurgaon, Hindon, NOIDA

Goa PanjimGujarat Ahmedabad, Jamnagar, Vadodra

HaryanaAmbala, Bhiwani, Chandimandir, Fatehabad, Hissar, Jhajjar, Jind, Kaithal, Karnal, Kurukshetra, Narnaul, Panipat, Rewari, Rohtak, Sirsa, Sonipat, Yamunanagar

Himachal Pradesh Bilaspur, Chamba, Dharamsala, Hamirpur, Mandi, Una, Shimla, SolanJammu & Kashmir Baramulla, Doda, Jammu, Janglot, Leh, Poonch, Rajauri, Samba, Srinagar, Udhampur

Jharkhand Ranchi

KarnatakaBangalore (U) Urban, Bangalore (R) Rural, Belgaum, Bijapur, Dharwad, Karwar, Madikeri, Mangalore, Mysore

Kerala Allepy, Kannanur. Kochi, Kottayam, Kozhikode, Malappuram, Palakkad, Pathanmitha, Quilon, Trissur, Trivandrum

Maharashtra

Akola, Alibagh, Amravati, Aurangabad, Buldana, Jalgaon, Kohlapur, Latur, Mumbai, Mumbai (U) Upnagar, Nagpur, Deolali, Osmanabad, Pune, Ratnagiri, Sangli, Satara, Sholapur, Sindhudurg, Thane

Manipur ImphalMeghalya ShillongMizoram AizwalMadhya Pradesh Bhind, Bhopal, Gwalior, Mhow, Jabalpur, Morena, Rewa, SagarNagaland Mokokchung, Kohima Orissa Balasore, Behrampur, Cuttack

PunjabAmritsar, Bhatinda, Faridkot, Fatehgarh, Firozpur, Gurdaspur, Hoshiarpur, Jalandhar, Kapurthala, Ludhiana, Mansa, Moga, Muktsar, Pathankot, Ropar, Sangrur

RajasthanAjmer, Alwar, Barmer, Bharatpur, Bikaner, Churu, Jaipur, Jaisalmer, Jhunjhunu, Jodhpur, Kota, Nagaur, Pali, Sikar, Sawai Madhopur, Sriganganagar, Udaipur

Sikkim Gangtok

Tamilnadu

Chennai, Coimbatore, Dharampuri, Dindigul, Guddalore, Kanyakumari, Kanchipuram, Madurai, Nagapattinam, Salem, Thanjavur, Theni, Thiruvannamalai, Thiruvalur, Tiruchi, Tirunaveli, Tuticorin, Vellore, Villupuram, Virudhnagar, Wellington

Tripura Agartala

Uttar Pradesh

Agra, Allahabad, Aligarh, Azamgarh, Badaun, Ballia, Bareilly, Bulandshahr, Deoria, Etah, Etawah, Faizabad, Fatehgarh, Fatehpur, Firozabad, Ghazipur, Gorakhpur, Jalaun, Jhansi, Kanpur, Kanpur (D) Dehat, Lucknow, Mainpuri, Mathura, Meerut, Muzaffarnagar, Pratapgarh, Rai Bareilly, Saharanpur, Shahajanpur, Sultanpur, Varanasi

Uttaranchal Almora, Chamoli, Dehradun, Lansdowne, Nainital, Pauri Garhwal, Pithoragarh, Raiwala West Bengal 24 Parganas, Bengdubi, Burdwan, Darjeeling, Howrah, Kolkatta, Krishnanagar, Midnapore

NOTE : This list may be updated in future & number of Polyclinics increased. New Clinic locations may be added, based on fresh Ex-servicemen pensioner census inputs.

ECHS Contribution (.) copy of Indarmy (ECHS Central Org) Sig

A-333342/AG/ECHS of Nov 05 (05) is reproduced below (.) Quote (.) with

immediate effect the ECHS contribution will correspondingly go up on merger

of 50% dearness allowance / dearness relief with Basic Pension of ESM(.)

example if basic pension of ESM is Rs 5200/- comma the ECHS contribution

will be Rs. 12,000/- (.) Now basic pension plus 50% of merged DA with

pension works out to 7,800/- thus ECHS contribution by ESM will be Rs.

18,000/- (.) the new rates of ECHS contribution are to be implemented

forthwith (.) confirm action (.) Unquote (.) for info and necessary action