ESI beneficiaries to get medical care under Ayushman Bharat package
By TIOL News Service
NEW DELHI, SEPT 14, 2019: THE ESI Corporation during its 178 th meeting held yesterday under the Chairmanship of Mr Santosh Kumar Gangwar, Minister of State for Labour & Employment (Independent Charge), has taken some very important decisions towards improvements in its service delivery mechanism.
In the meeting, approval has been accorded to provide cashless Secondary and Tertiary medical care services under Ayushman Bharat package rates to entitled ESI Beneficiaries in newly implemented area of 102 designated Districts through PMJAY empanelled hospitals in States where PMJAY has been adopted by the State Governments. Further, to avoid any hassle in smooth implementation of this initiative, ESI Beneficiaries will be dealt through PMJAY logistics/IT facilities for registration, billing etc. as is done for PMJAY beneficiaries, up to a maximum limit of Rs. 5 lakhs worth of medical expenditure, beyond which individual case will be channelled to ESIC for seeking approval for further expenditure on ESI Beneficiary.
Similarly, PMJAY beneficiaries may get in-house medical treatment services as per Ayushman Bharat approved packages from underutilized ESI Hospitals while National Health Agency (NHA) will make payment to ESIC directly. Further, various State Government running ESIS Medical Scheme, shall also be requested to enrol ESIS Hospitals under Ayushman Bharat Scheme for providing medical services to PMJAY Beneficiaries, similar to ESIC Hospitals.
ESIC to set-up 100 bedded Hospital at Srinagar and 30 bedded Hospital at Leh
During the meeting, in principle approval was accorded for setting up of 100 bedded Hospital at Srinagar and 30 bedded Hospital at Leh.
Opening up of Medical Services at under-utilized Dispensary-cum-Branch Office (DCBO) to Non-Insured Person (Non-IPs):
ESIC has, in principle, taken decision to open its under-utilized Dispensary-cum-Branch Office (DCBO) pan-India to Non-IPs on nominal user charges basis on the same line of opening its under-utilized hospitals.
ESIC Hospitals at Sarojani Nagar (Lucknow) & Jajmau (Kanpur) opened for non-Insured Persons:
Earlier, ESI Corporation had earlier taken decision to allow Non-Insured Persons to avail medical services from its under-utilized ESIC Hospitals, and thereafter ESIC Hospitals at Alwar (Rajasthan), Bihta (Bihar), Gulbarga (Karnataka), Bareilly and Varanasi (Uttar Pradesh) were opened for Non-Insured Persons as well. Now Non-Insured Persons can avail the medical services at a nominal charge of Rs. 10/- for consultation and at the rate of 25% of CHGS package rates for IPD at ESIC Hospitals situated at Sarojini Nagar (Lucknow) and Jajmau (Kanpur) Uttar Pradesh.
Cash reward of Rs. five lakh announced by Hon'ble LEM to Arjuna Awardee ace para-shuttler Mr Pramod Bhagat, an employee of ESIC:
During the meeting, Mr Gangwar announced a cash reward of Rs. 5.00 Lakh for ace para-shuttler Mr Pramod Bhagat. Mr Bhagat is an ESIC employee posted in Odisha region.
Besides above, around 40 other agenda/reporting items pertaining to improvement in services/benefits to Insured Persons and their beneficiaries and other administrative matters were deliberated upon and approved during the meeting.
The other dignitaries participating in the meeting were Dr. Harak Singh Rawat, Minister for Labour & Employment, Govt. of Uttarakhand, Mr Heera Lal Samaria, Secretary, Labour & Employment, Members of Parliament Mr Ram Kripal Yadav, Ms. Dola Sen, Mr John Barla and Mr Raj Kumar, Director General, ESIC, Smt. Anuradha Prasad, Addl. Secretary, Labour & Employment, Govt. of India, ESI Corporation Members, representatives of State Govts. and ESIC.