Domiciliary Medical Equipment for ECHS Beneficiaries

Domiciliary Medical Equipment for ECHS Beneficiaries – Executive Instructions: ECHS Order dated 10.06.2022

Central Organisation ECHS
Integrated HQ of MoD (Army)
Adjutant General’s Branch
Thimayya Marg
Near Gopinath Circle Delhi Cantt-110010

B/49761/AG/ECHS/Medicine Policy/2022

10 Jun 2022

IHQ of MoD (Navy)/Dir ECHS (N) Air HQ (DAV)/Coord
HQ Southern Command (A/ECHS) HQ Eastern Command (A/ECHS) HQ Western Command (A/ECHS) HQ Central Command (A/ECHS) HQ Northern Command (A/ECHS)
HQ South Western Command (A/ECHS)
HQ Andaman & Nicobar Command (A/ECHS) All Regional Centres

EXECUTIVE INSTRUCTIONS : DOMICILIARY MEDICAL EQUIPMENT FOR ECHS BENEFICIARIES

1. Please ref the fwg (copies attached) :-

(a) Gal (MoD/DoESW) letter No 24(8)03/US(WE)/D (Res) dt 19 Dec 2003.

(b) Central Org ECHS letter No B/49761fAG/ECHS/Pol icy dt 31 May 2018 .

(d) Got (MoD/DoESW) letter No 18(114)/2017/WE/D(Res-I) dt 18 Sep 2019 .

(e) Central Org ECHS letter No B/49761/AG/EC HS dt 09 Dec 2019.

(f) Min of Health & Family Welfare O.M. No. S.11011/37/2019-ECHS dated 01 Dec 2020 .

2. The responsibility of providing Domiciliary Medical Equipment to ECHS beneficiary and their dependents rest with SEMO (Commandant/CO Service Hospital) when use of such equipments is considered essential on medical grounds on recommendation of the Service Specialist/Government Hospital Specialist. The cost of equipment.will not exceed CGHS rates as amended from time to time. The prevailing CGHS rates of listed Domiciliary Medical Equipments are given in Appx ‘A’.

3. Issue Procedure.

(a) Through SEMO. Based on advise of concerned Specialist of Service/Govt hosp, OIC ECHS Polyclinic will forward ·demand to SEMO. SEMO will procure the said Domiciliary Medical Equipment and issue the same to the ECHS beneficiary . Copy of IVs and RVs will be forward to ECHS Polyclinic for record. If demand is not fulfilled within 90 days of the receipt of demand from the polyclinic, then NAC should be given by SEMO and the sup order should be cancelled.

(b) Individual Reimbursement : Grant of Prior Sanction. Based on advise of concerned.Specialist of Service/Govt hosp, ECHS beneficiary has an option to purchase the Domiciliary Medical Equipment and claim reimbursement after taking prior approval as per following procedure :-

(aa) Domiciliary Medical Equipment for Which Ceiling Rates are available. ECHS beneficiary requests for prior sanction from concerned Director RC ECHS through OIC ECHS Polyclinic based on recommendation of concerned Specialist of Service Hospital or Government Hospital. Director RC ECHS will issue prior sanction letter to the individual beneficiary based on the recommendation of a/m specialists and request by the beneficiary.

(ab) Domiciliary Medical Equipment for Which no Ceiling Rates are available. Domiciliary Medical Equipment other than those listed in Appx ‘A’ , like Insulin pump etc which are issued to CGHS beneficiaries for which no CGHS ceiling rates exist and are recommended for domiciliary use for ECHS beneficiaries by Service Specialist/Govt Hospital Specialist will require prior sanction of the High Power Committee as mentioned vide Para 5 of Gol (MoD/DoESW) letter No 22A(37)2018M’E/D (Res-I) dated 15 Jan 2019. Composition of the High Power Committee would be as under :-

(a) JS, ESW – Chairman

(b) Government Hospital Specialist Doctor – (of concerned specialty) – Member

(d) Director (Medical), CO ECHS – Member-Secretary

(e) Representative of MoD (Fin/Pen) – Member.

(ac) Once prior sanction is obtained, the equipment can be purchased by the ECHS beneficiary and claim may be submitted to OIC PC who will verify documents and upload the claim as individual reimbursement on BPA portal. Reimbursement will not exceed prevailing CGHS rates.

(ad) Following documents should be submitted by ECHS Beneficiary for claiming reimbursement of Domiciliary Medical Equipment : –

(aa) Prior sanction letter of Director RC ECHS.

(ab) Original Bill of Domiciliary Medical Equipment or High Powered Committee.

(ac) Contingent Bill.

(ad) Cancelled Cheque/Bank details of beneficiary. (ae) Copy of ECHS Card of beneficiary.

4. Consumables. The consumables for the equipments will be procured by SEMO/Comdt/CO Hosp and issued under arrangements of OIC Polyclinic. In case item is NA medical stores of Polyclinic, consumables will be issued through Authorised Local Chemist (ALC). If the same is not available in ALC/dispensary of ECHS Polyclinic then NA on prescription will be given to the beneficiary based on which he/she can purchase from local market and claim reimbursement.

5. Repair & Maintenance/Annual Maintenance. Cost of repair & maintenance will be borne by the beneficiary themselves and will not be reimbursable.

6. Replacement of Domiciliary Medical Equipment. Request for replacement of Domiciliary Medical Equipment after completion of five years can be processed based on condition of the equipment. Following procedure will be adopted for Replacement of Domiciliary Medical Equipment :-

(a) Domiciliary Medical Equipment procured by SEMO. If Domiciliary Medical Equipment is procured and issued by SEMO and equipment is non-functional after completion of five years of purchase, Unserviceability Certificate will be obtained by OIC ECHS Polyclinic from Authorised Service Engineer of OEM with assistance of SEMO if required. Based on Unserviceability Certificate, Replacement of Domiciliary Medical Equipment can be processed in similar manner as for the first issue of machine/equipment.

(b) Domiciliary Medical Equipment procured by Individual Beneficiary. If the Domiciliary Medical Equipment is non-functional after completion of five years of purchase, then Individual beneficiary should obtain Unserviceability Certificate from Authorized Service Engineer of OME of that Domiciliary Medical Equipment. Based on Unserviceability Certificate, Replacement of Domiciliary Medical Equipment can be processed in similar manner as for the first issue of machine/equipment.

(c) In case Domiciliary Medical Equipment becomes unserviceable before five yrs,the warranty conditions will apply if the eqpt is under warranty . If the warranty period is over, similar procedure as given out in Para 6 (a) & 6 (b) above will be followed.

7. Expenditure.

(a) The expenditure on procurement of Domiciliary Medical Equipment by the SEMO will be debited to Major Head 2076 Minor Head 107 (C) Code Head 363/01.

(b) The expenditure on procurement of Domiciliary Medical Equipment by the individual beneficiary will be debited to Major Head 2076 Minor Head 107 Code Head 365/00 for which the payment will be made by respective Regional Centres as per extant procedure for payment of individual reimbursement.

8. CFA.

(a) Domiciliary Medical Equipment procured by SEMO. CFAs will be as per schedule 2.4, DFPDS-2016 as amended from time to time.

(b) CFA for individual reimbursement of cost of Domiciliary Medical Equipment will be as per Para 1 of Govt of India, Ministry of Defence (DoESW) ID No 25(01)/2018/WE/D(Res- I) dt 09 Jul 2019 as amended from time to time.

9. These instructions will supersede all previous policy letters issued earlier with respect to issue of Domiciliary Medical Equipment to ECHS beneficiary .

10. This has approval of MD ECHS.

(Panchal Kalpeshkumar S)
Lt Col
Jt Dir (Med) For MD ECHS

Encls : As above

Appx ‘A’
(Refer to Central Org ECHS
letter No B /49761/AG/ECHS/
Medicine Policy/2022 dt 10 Jun 2022

Ser No	Eqpt	Recommended By Concerned Specialist of Service Hosp/Govt Hosp	Ceiling Rate	Remarks
(a)	CPAP/ BIPAP machine	Respiratory Medicine Specialist/Medical Specialist	(i) CPAP – Rs 45,000/- + GST. (ii) BIPAP (earlier Bi-Level CPAP) – Rs 68,000/- + GST. (iii) Bi-Level Ventilatory System – Rs 1,05,000/- + GST.
(b)	Hearing Aid	ENT Specialist	(i) Digital BTE – Rs 8,000/- + GST. (ii) Digital ITC/ CIC – Rs 9,000/- + GST.	(i) The cost of BTE type hearing aids shall also include the cost of hearing mould. (ii) The cost of ITC/CIC type hearing aids shall also include the cost of customised shell. (iii) Body worn/ pocket type category and Analogue STE category with ceiling rates Rs 3,000/ per ear and Rs 7,000/– per ear have been excluded, since they have become obsolete.
(c)	Artificial Appliances Related to Mobility Aids	Neuro Surgeon/ Neuro Physician/ Orthopaedician/ Surgeon	(i) The appliances will be allowed for re issue on completion of 5 yrs in case of adults and 2 yrs in the case of children except motorized wheel chair and tricycle. (ii) Motorized wheel chair and tricycle may be re-issued after 5 Yrs irrespective of age. (iii) Approved rates as per Appx ‘B’.
(d)	Nebuliser, Glucometer, Oxygen Concentrator	Medical Specialist	(i) Oxygen Concentrator – Rs 45,000/ + GST. (ii) Nebuliser – Rs 3,000/- or actual cost whichever is less. (iii) Glucometer – CGHS rate
(e)	Any other item recommended for domiciliary use authorized under CGHS scheme	Concerned Specialist	CGHS rates will apply

Appx ‘B’
(Refer to Central Org ECHS
letter No B /49761/AG/ECHS/
Medicine Policy/2022
dt 10 Jun 2022

MOBILITY AIDS

Ser No	Name of Orthosis	Approved Rate/Price (Child above 12 Yrs)	Approved Rate/Price (Child 7-12 Yrs)	Approved Rate/Price (Child 0-6 Yrs)
1.	Walking Stick (Adjustable Aluminium)	Rs 350/-	Rs 350/-	Not Applicable
2.	Tripod/Quadripod walking stick Aluminium	Rs 750/-	Not Applicable	Not Applicable
3.	Auxiliary Crutch/Elbow crutch (Aluminium Adjustable)	Rs 850/-	Rs 650/-	Not Applicable
4.	Walking/Rollator (Aluminium)	Rs 1500/-	Rs 1200/-	Rs 900/-
5.	CP Chair/GP Stand	Not Applicable	Rs 7300/-	Rs 7000/-
6.	CommodeChair	Rs 2500/-	Rs 2500/-	Not Applicable
7.	Wheel Chair Folding (Chrome Plated)	Rs 7000/-	Rs 4000/-	Not Applicable
8.	Motorized Wheel Chair :-
	(i) Quadriplegic wheel chair with chin and head control	Rs 1,10,000/-	Not Applicable	Not Applicable
	(ii) Quadriplegic wheel chair with joy stick	Rs 60,000/-	Not Applicable	Not Applicable
	(iii) Motorized wheel chair (Handle driven)	Rs 35,000/-	Not Applicable	Not Applicable
9.	Tricycle Hand Propelled	Rs 6000/-	Not Applicable	Not Applicable