Report No. 51 of 2015 - Performance Audit on Implementation of Ex-servicemen Contributory Health Scheme, Union Government, Defence Services - Army

Overview

Why did we do this performance audit?

Government of India, Ministry of Defence (MoD), in December 2002 sanctioned a health care scheme namely “Ex-servicemen Contributory Health Scheme (ECHS)” to cater for Medicare of all ex-servicemen (ESM) in receipt of pension, including disability and family pensioners, as also their dependents,to include wife/husband, legitimate children and wholly dependent parents.

The total strength of the ex-servicemen and their dependents across the country as of April 2015 was 47.24 lakh. The Scheme aims to provide healthcare on cashless basis to all beneficiaries as applicable in Central Government Health Scheme (CGHS) through a network of ECHS Polyclinics, Service hospitals and private empanelled/Government hospitals spread across the country. The Scheme came into effect from 1 April 2003.

What does this performance audit cover?

We took up the performance audit of the Scheme for the period from 2012-13 to 2014-15 to obtain reasonable assurance that:

  • The ECHS was able to fulfill its mandated aims and objectives;
  • The Scheme was being run efficiently and adequate manpower,infrastructure and equipment were available with the ECHS as per authorisation;
  • The referral mechanism in place was adequate to ensure that inflated bills/unauthorised payments were not made to empanelled hospitals;
  • Provisioning and issue of medicines to polyclinics are made as per requirement;
  • The Online bill processing by the Bill Processing Agency was effective, efficient and the integrity of the data of the Bill processing system was ensured.

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