ECHS Extends AYUSH Treatment through Pvt Hospitals for Exservicemen

Treatment under AYUSH . Govt has authorised treatment under AYUSH (Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy) for all ECHS beneficiaries. In the authorization, treatment in Govt AYUSH hospitals is permitted on reimbursement basis at full rates, including the cost of prescribed medicines. Permission has to be taken from Oi/c of the Polyclinic or Director, Regional Centre or CO ECHS, for a particular disease. However, only one system of treatment is allowed at any one time and the choice has to be made by veteran prior to consultation/treatment.

(Auth: – Central Organisation letter B/49769/AG/ECHS/Med/Policy dated 04 Sep 2018).

Tele: 011-25682870 Mil: 36833

                                                                         Central Organisation,
                                                                        ECHS Integrated HQ of MoD (Army)
                                                                         Adjutant General’s Branch 
                                                                         Maude Line, Delhi Cantt- 10                                                                                  

B/49769/AG/ECHS/Med/Policy                                                  04 Sep 2018

IHQ of MoD (Navy)
Dir ECHS(N)
Air HQ (VB)/DAV
HQ Southern Comd(A/ECHS)
HQ Eastern Comd (A/ECHS)
HQ Western Comd (A/ECHS)
HQ Central Comd (A/ECHS)
HQ Northern Comd (A/ECHS)
HQ South Western Comd (A/ECHS)
HQ Andaman & Nicobar Comd (A/ECHS)
AMA ECHS, Embassy of India, Nepal
All Regional Centres 

POLICY AMENDMENTSTOPERMIT ECHS BENEFICIARIESTO AVAIL MEDICAL FACILITIES UNDER ALTERNATIVE SYSTEM OF MEDICINES AYUSH

1. PleaseReferthe following:

(a) Government of India, MoDletterNo 24(8)/03US(WE)/D(Res) dated 19 Dec 2003.
(b) Government of India, MoD (DoESW) letter No 22B(06)/2017/WE/D (Res-1) dated 08Aug 2018 (copy enclosed) (Encl 1). 

2. Medical facility under AYUSH (Ayurveda, Yoga& Naturopathy, Unani, Siddha and Homeopathy) can now be availed as under :

(a). ECHS beneficiaries can avail medical facility under AYUSH (Ayurveda, Yoga& Naturopathy, Unani, Siddha and Homeopathy) system of medicines through Government AYUSH Hospital & Colleges / National Institute of AYUSH (list annexed- Annexure A), all Government dispensaries/District hospitals/ Sub district hospitals/PHC /CHC /Municipality hospitals that are funded by Central/State Government/Local Government and are having facility for consultation/treatment/procedures/ investigations /medicines of AYUSH system of medicines effective from 08 Aug 2018 as per GOL MoD (DoESW) letter 22B(06)/2017/ WE/D (Res-1) dated 08 Aug 2018. OPD as well as IPD treatment is allowed.

(b). Prior permission from either of parent Polyclinic/Regional Centre or ECHS Central tenhoice of Org (Director Med) as per the own choice of ECHS beneficiary has to be taken bat in C mandatorily before taking treatment in Government AYUSH facility. Format of prior which will application & permission is at Encl 2, which will be filled in duplicate, one with individual care with for attaching with claim & second as record with PC/RC/CO ECHS. 

(c) Reimbursement can be claimed as per ‘actual cost’ incurred subject to the condition that they have to initially pay for their treatment and claim reimbursement for consultation/treatment/procedures /investigations/ medicines etc.

3. The details of guidelines to be followed are given as below: –

2- (a) Thepermission would generally be granted except in thefollowing conditions:

(i) If beneficiary is already undergoing treatment under Allopathic system, he/she will not be granted permission to take treatment concurrently under AYUSH system. However, beneficiary may shift to another system of medicine after stopping treatment in one system, for which permission would be granted. The choice of selecting one system of medicine to avail treatment as per their choice is entirely of the beneficiary. Permission to obtain treatment under two or more system of medicine concurrently would not be granted.

(ii) Patients seeking permissionfor treatment infacilities otherthanthoseGovernment AYUSH hospitals/facilities as specified in the GL will not be granted. 

(iii) Permissionfortreatment for non-therapeutic purpose/procedure will not be granted.

(b) The beneficiaries will submit the Medical reimbursement claims in the prescribed format with all relevant supporting vouchers/documents in original toParent ECHS Polyclinic. The parent polyclinic after verifying the prior permission letter for obtaining treatment and ensuring that all relevant documents are enclosed will issue a dated acknowledgement to the claimant. The ECHS Polyclinic would upload the claim online to Bill Processing Agency (BPA) UTI-ITSL after proper scrutiny and finally for approval of CFA. Validity of the permission letter would be for 03 months only. On expiry of 03 months, permission will need to be taken again. 

(c) If beneficiary chooses to get treatment in a hospital/Government facility of AYUSH in acity away from his place of residence permission/ approval may be given but TA/DA would have to be borne by the beneficiary. 

(d) Submission of Billsby Claimants. It is furtherclarified that bills shall besubmittedto parent ECHS Polyclinic with all the supporting vouchers and relevant documents as listed below: (i) A copy of ECHS card. 

(ii) Prior Permission letter (format as per Encl 2) 
(iii) E-mail address/telephone /Mobile No. for information 
(iv) Bank account details wherepayment tobereceived. 
(v) Individualbills with summary 
(vi) Dischargesummary if admitted. 
(e) Processingof Bills 
(i) Bills would be processed as per actual rates. 

(ii) Prior permission/ approval from ECHS Polyclinics/ Regional Centres/ Central Organisation (Medical Branch) ECHS is mandatory to obtain treatment from any Central/ State Government bodies to be eligible to claim reimbursement of expenditure incurred for consultation/ treatment/procedures /investigation/medicines underAYUSHSystemof medicines. 683 -3- 

(iii) Claims are to be preferred within 3 months period from the date of obtaining treatment or discharge from hospitals, whichever is later. (iv) Cost of all medicines are reimbursable in full, except preparations classified as food, tonics, vitamins eg Cap Revital etc , disinfectants, toiletries etc. Medicines prescribed in OPD of Government AYUSH facilities would be reimbursable. (v) The actual Cost of medicines would be reimbursable as per MRP after proper scrutiny and verification of the prescription and bills by UTI-ITSL (BPA). 

(vi) Cost of treatment taken at private hospitals/facilities of AYUSH wouldnot be reimbursed. (vii) UTI-ITSL shall thoroughly scrutinize the claim documents for ease of uploading, Govt Hosp window will be created with option of ‘AYUSH’ window. 

(viii) UTI-ITSLshallseek clarification if any within a maximum period of seven days of receipt of the bills. (viii) After claim is scrutinized and processed by (BPA) UTI-ITSL, payment would be made directly to the individual claimant’s account after CFA approval. 

4. For Your Info And necessary action please. 

(IVS Gahlot) 
Col Dir (Med) 
for MD ECHS 

Encls: 15Pages 

Copy to: US(WE) PS to JS ESW PPSto Secy (ESW) CGDA, NewDelhi – for info UTI-ITSL Surabhi Arcade1stFloor, 5- 1-664, Bank Street Hyderabad-500001 O/oDGAFMS DGMS(Army) DGMS (Air) DGMS(Navy) DGDS Internal All Sec – for info please.

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