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EX-SERVICEMEN CONTRIBUTORY HEALTH SCHEME

EX-SERVICEMEN CONTRIBUTORY HEALTH SCHEME. ECHS UPDATE MON 23 NOV 08. PRESENTATION. AIM SCHEME STATUS EXPANSION REVIEW REPORT TO MOD ECHS INFORMATION CONCLUSION. EX-SERVICEMEN CONTRIBUTORY HEALTH SCHEME. AIM TO APPRISE NAVY FOUNDATION ON ECHS. Govt sanctioned - 30 Dec 02

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EX-SERVICEMEN CONTRIBUTORY HEALTH SCHEME

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  1. EX-SERVICEMEN CONTRIBUTORY HEALTH SCHEME ECHS UPDATEMON 23 NOV 08

  2. PRESENTATION • AIM • SCHEME • STATUS • EXPANSION • REVIEW REPORT TO MOD • ECHS INFORMATION • CONCLUSION

  3. EX-SERVICEMEN CONTRIBUTORY HEALTH SCHEME AIMTO APPRISE NAVY FOUNDATION ON ECHS

  4. Govt sanctioned - 30 Dec 02 Launched - 01 Apr 03 ESM pensioners - 20 Lakhs(Approx.) Polyclinics - 227 Regional Centres - 13 Central Organisation - 01(Delhi) Budget Capital - 122 Cr one time Revenue - 355 Cr per annum (Increased to 600 Cr CFY) Fully Utilise Mil Hosp ; Empanel Pvt Hosp SCHEME

  5. PRESENT STATUS • MEMBERS - 8.5 LAKHS • POLYCLINICS FUNCTIONAL - ALL 227 • MIL - 106 • NON MIL - 121 • CLINICS CONSTRUCTED - 78 • CONSTRUCTION IN PROGRESS - 20 • MIL HOSP PROVIDING MEDICARE -129 • PVT. HOSP EMPANELLED - 1124 • POLYCLINICS MEDICARE - 89%

  6. PRESENT STATUS • MIL HOSP MEDICARE - 5% • PVT. HOSP MEDICARE - 6% • CAPITAL EXPENDITURE - 52 CR • REVENUE EXP TILL DATE - 1085 CR • REIMB APPROVAL BY COMMANDS/ STN HQS • EXTENDED TO CG & DSC – TO NEPAL ALSO SOON • SUPREME COURT DISMISSED PRE 96 REFUND CASE

  7. CURRENT ISSUES • MEMBERSHIP FOR NON MEMBERS • EMPANEL MORE PRIVATE HOSPITALS • EXPANSION NETWORK PROPOSAL WITH MOD • REVIEW RECOMMENDATION SUBMITTED TO MoD • DRUGS/ CONSUMABLES-ISSUE BEING MODIFIED • PHYSIO EQUIP WILL BE PROCURED SOON • NERUL POLYCLINIC UNDER NAVY MANAGEMENT

  8. REVIEW COMMITTEE RECOMMENDATIONS • ADDL MANPOWER FOR POLYCLINICS • POLYCLINIC STAFF PAY HIKE • ENHANCEMENT OF FIN POWERS • REFERRAL PROCEDURE SIMPLIFIED • MED OFF ALSO AS OI/C POLYCLINIC • HEREAFTER EVERY TWO YRS

  9. PENSIONERS NON ECHS MEMBERS • MEDICARE IN MIL HOSP AND NO FURTHER REFERRAL • NO MEDICARE IN POLYCLINICS/ PVT EMP HOSP • NO REIMBURSEMENTS THROUGH ECHS/ KSB/ INBA

  10. EXPANSION NETWORK • NEW ECHS POLYCLINICS - 197 • MOBILE POLYCLINICS (‘E’ Mil) - 16 • UPGRADE - 13 • CONVERSION - 10 • REGIONAL CENTRES - 14 • BUDGET • Capital (One Time) - 130 Cr • Revenue (Per Annum) - 45 Cr * COSC Recommended & Case is with MOD for Approval

  11. CGDA REP - SHRI SANJEEV MITTAL, IFA MOD REP - SHRI MM SINGH, DY SECY (RES-I) MOD (FIN) REP - SHRI KS PANCHPAL, AFA (AG/PD) ECHS CENTRAL - BRIG SATISH MALIK, DY MD ECHS ORGN REPS -WG CDR SK AGARWAL (ACCTS BR) -LT COL AK NAIK (MED) * INTERACTED WITH POLYCLINICS/ REG CENTRES/ COMMANDS/ STN HQ/ ECHS MEMBERS ECHS REVIEW COMMITTEE

  12. CHALLENGES MEMBERSHIP TO 100% AFV PENSIONERS EMPANEL MORE PRIVATE HOSPITALS IMLEMENTATION – EXPANSION NETWORK (ADDL 197 POLYCLINICS) REVIEW COMMITTEE REPORT BOTTOM LINE * ACHIEVE 100% ECHS MEMBERS SATISFACTION LIKE SERVING PERSONNEL MEDICARE

  13. AREAS OF CONCERN • INCREASING PVT HOSP BILLS • REFERRAL PROCEDURE • SMART CARD VALIDITY • MISUSE OF MEDICARE • AUGMENTATION OF AFMS • AUGMENTATION OF STAFF / PAY/DRUGS • MORE PVT HOSP EMP

  14. NAVY FOUNDATION POINTS • FORMATION OF ECHS COMMISSION/ LIBERALISED SCHEME (KERALA CHARTER) • NOT RECOMMENDED BY REVIEW COMMITTEE • REFUND OF EXCESS AMOUNT • TO BE CLAIMED FROM CDAs BY MEMBERS • REFUND OF AMOUNT PRE-96 RETIREES • SUPREME COURT DISMISSED APPEAL

  15. ECHS SMART CARD ESSENTIAL FOR AVAILING MEDICARE • PENSIONER • DEPENDENTS

  16. ECHS – SAAT SANDESH • CASHLESS/ GOVT FUNDED SCHEME • FREE MEDICARE AT 227 POLYCLINICS • FREE MEDICARE AT 1124 PVT EMP HOSP • FREE MEDICARE AT 129 MIL HOSP • REIMB NON EMP HOSP IN EMERGENCY • COMPREHENSIVE MEDICARE • NON-ECHS MEMBERS TO JOIN EARLIEST

  17. HEALTH INSURANCE

  18. DISADVANTAGES OF INSURANCE SCHEMES • INSURANCE COVERAGE AVAILABLE UP TO SUM INSURED • PRE-EXISTING ILLNESSES EXCLUDED • COVER FROM AGE OF 5 to75 ONLY AND NOT FOR LIFE TIME • BASED ON REIMBURSEMENT BASIS • OPD/CONSULTATION NOT COVERED • WAR OR WAR LIKE AILMENTS NOT COVERED • PREMIUM PAYMENT SAUBSTANTIAL • COVER NOT EXTENDED TO DEPENDENTS

  19. ECHS INFORMATION • ECHS WEBSITE : www.indianarmy.nic.in. • E-MAIL ID : echs_navy@yahoo.com • CENT ORG TELE NO. 011-25684846 • ECHS OFFICE (NAVY) TELE NO. 011-24101319 • ECHS INFO BROCHURE MAY 2008 • NEWS LETTER JUN 2008 • NON ECHS MEMBERS ADVISED TO JOIN • SUGGESTIONS / GRIEVANCES • FORWARD TO POLYCLINICS/STATION HEADQUARTERS

  20. CONCLUSION COMPREHENSIVE MEDICARE TO ECHS MEMBERS

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