The Central Organisation, ECHS, issued a circular dated August 13, 2025, introducing major changes to the policy on prior sanction for treatment at non-empanelled hospitals. This reform is designed to reduce delays in approvals and expand access to advanced medical care for Ex-Servicemen and their dependents.
Background: Old Policy Framework
Under the earlier system, the Director of the Regional Centre (Dir RC), ECHS, was the primary authority for granting approvals to seek treatment at non-empanelled hospitals, with the exception of certain specialized medical cases.
In these high-end or complex medical situations, the responsibility shifted to the Managing Director (MD) ECHS, often causing longer processing times and inconvenience for beneficiaries. The cases requiring MD ECHS approval included:
- Major cardiac surgery or interventional cardiology
- Oncology cases
- Organ transplant cases
- Joint replacement surgeries
- Major neurosurgical or neurology cases
- Bariatric surgery
This dual-approval framework, while ensuring oversight, was criticized for procedural delays and lack of timely access to essential treatments.
Key Changes in the New Policy
After consultation with the competent authority, the ECHS has restructured the approval process to make it more efficient and beneficiary-friendly.
1. Expanded Role of Director, Regional Centre (Dir RC), ECHS
- The Dir RC is now empowered to sanction all CGHS-listed treatments and implants even in the earlier restricted categories.
- This includes major cardiac surgeries, oncology procedures, and joint replacements, among others.
- The reform is expected to drastically reduce approval timelines and minimize inconvenience for patients and families.
2. Continued Role of Managing Director (MD) ECHS
The MD ECHS will retain sanctioning authority in sensitive or highly specialized treatments, including:
- Liver, heart, and lung transplants
- Bariatric surgery
- Infertility treatments
- Therapies for neurodevelopmental disorders such as Autism Spectrum Disorder (ASD), ADHD, and specific learning disabilities, including occupational therapy, speech therapy, and ABA-based behavioral therapy
- Any other newly listed procedure notified by the Central Organisation’s technical committee from time to time
Implications for Beneficiaries
- Faster Access: Delegating broader powers to Dir RC ensures quicker decisions and reduced dependency on central approval.
- Specialized Oversight: By retaining MD approval for rare or complex procedures, the policy maintains necessary checks for resource-intensive treatments.
- Beneficiary-Centric Reform: The restructuring reflects ECHS’s effort to balance efficiency with accountability, providing timely medical care without unnecessary administrative hurdles.
Conclusion
The revised ECHS prior sanction policy (August 2025) marks a significant step towards streamlining healthcare delivery for veterans and their dependents. By decentralizing approval powers for most CGHS-listed procedures while keeping specialized oversight at the central level, the policy strikes a balance between efficiency, transparency, and quality of care.
