Please refer to following:
It is observed that there is increasing tendency of ECHS beneficiaries resorting to treatment at Non Emp Hosp at their own will without prior sanction which is against the laid down ECHS guidelines and interest of ECHS beneficiaries at large. Non empanelled hospitals have tendency of inflating the bills. The blls are reimbursed for genuine emergencies only but at Non NABH CGHS rates only.
If beneficiary is planning treatment at non empanelled hospital for any planned treatment then prior sanction from concerned Regional Centre is mandatory. There are few categories of ailments for which permission from CO ECHS is required and some cases may involve unlisted implants, procedure or investigation requiring SEMO's permission.
Treatment at non empanelled hosp, without prior approval in case of non-emergency, should invariably be avoided by beneficiaries. OlC and MOs at PC may please be advised to spread this awareness amongst beneficiaries.
- Para 16 & 18 (a) of sOP on Treatment Management dated 28 Sep 2018.
- CO ECHS Letter No. B/49770/AG/ECHS dated 05 Oct 2018.
- CO ECHS letter No. B/49770/AG/ECHS/Prior/Policy/2023 dated 08 Feb 2023.
It is observed that there is increasing tendency of ECHS beneficiaries resorting to treatment at Non Emp Hosp at their own will without prior sanction which is against the laid down ECHS guidelines and interest of ECHS beneficiaries at large. Non empanelled hospitals have tendency of inflating the bills. The blls are reimbursed for genuine emergencies only but at Non NABH CGHS rates only.
If beneficiary is planning treatment at non empanelled hospital for any planned treatment then prior sanction from concerned Regional Centre is mandatory. There are few categories of ailments for which permission from CO ECHS is required and some cases may involve unlisted implants, procedure or investigation requiring SEMO's permission.
Treatment at non empanelled hosp, without prior approval in case of non-emergency, should invariably be avoided by beneficiaries. OlC and MOs at PC may please be advised to spread this awareness amongst beneficiaries.
