Executive Summary:
This notification from the Employees State Insurance Corporation concerns user charges and other details for the Other Beneficiaries and Members of Their Families Medical Facilities Scheme 2010. It specifies rates for Non-Insured Persons availing medical services in underutilised ESIC Hospitals, as approved by the Central Government, according to the ESI Act of 1948. Objections or suggestions regarding this notification will be considered if received within 30 days of its publication.
Key Points / Main Content:
* **Applicability:** Applies to Non-Insured Persons using underutilised ESIC Hospitals.
* **Rates for Medical Services:**
* OPD Consultation: ₹10 per consultation.
* IPD Care: 25% of Central Government Health Scheme (CGHS) packaged rates applicable for the city (or neighboring city/state if not available).
* Medicines: Provided at actual cost, if available.
* **Definition of Underutilised Hospital:** An ESIC Hospital where bed occupancy is less than 60% during the last two financial years.
* **Hospital List and Operation:** The Director-General will specify the names of underutilised hospitals and their operational modalities.
* **Objections and Suggestions:** Any objections/suggestions regarding this notification should be sent within 30 days of publication to Shri S. Ravichandran, Addl. Commissioner PD, Employees State Insurance Corporation, New Delhi.
Impact Analysis:
* **Non-Insured Persons (Other Beneficiaries):**
* Impact: Non-Insured Persons gain access to medical facilities at underutilised ESIC Hospitals but will be charged user fees for OPD consultations, IPD care, and medicines.
* Action Required: Be aware of user charges for services availed.
* **ESIC Hospitals (Specifically Underutilised Hospitals):**
* Impact: Underutilised ESIC hospitals can now provide services to Non-Insured Persons, potentially increasing revenue and bed occupancy. The Director-General will specify operational modalities.
* Action Required: Implement the rate structure and operational modalities as specified by the Director-General.
* **Employees State Insurance Corporation:**
* Impact: The ESIC is responsible for implementing and overseeing the scheme and considering any objections or suggestions to the notification.
* Action Required: Review and consider any objections/suggestions received within 30 days of the notification's publication.
Key Entities Referenced
Employees State Insurance Corporation: An Indian government organisation responsible for providing financial protection to workers in the event of sickness, maternity, disablement and death due to employment injury.
New Delhi: The capital city of India, where the notification was issued and the Employees State Insurance Corporation is located.
Other beneficiaries and members of their families medical facilities scheme 2010: A scheme that allows certain beneficiaries and their family members to avail medical facilities.
Gazette of India: The official government publication containing notifications, rules, and regulations.
Employees State Insurance Act, 1948: An act of the Parliament of India that provides certain benefits to employees in case of sickness, maternity, and employment injury.
Central Government Health Scheme: A health scheme by the Indian government providing comprehensive medical care facilities to central government employees and pensioners.
Shri S. Ravichandran: Addl. Commissioner PD, Employees State Insurance Corporation, to whom objections and suggestions regarding the notification may be addressed.
Panchdeep Bhawan, C.I.G. Marg, New Delhi: The address of the Employees State Insurance Corporation where Shri S. Ravichandran is located.
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2649 GI/2019 (1)2 THE GAZETTE OF INDIA : EXTRAORDINARY [PART III—SEC. 4]
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[िवOापन-III/4/असा./60/19]
EMPLOYEES’ STATE INSURANCE CORPORATION
DRAFT NOTIFICATION
New Delhi, the 15th April, 2019
No. N-12/13/1/2019-P&D.—In exercise of the powers conferred under Sub-para 6 of the “Other
beneficiaries and members of their families medical facilities scheme 2010” as notified vide GSR 654(E) in
the Gazette of India Extraordinary [Part II Section 3(i)] dated 04th August 2010, the Director General,
Employees’ State Insurance Corporation hereby notifies the rate of user charges and other details of the
scheme referred to in Section 73 D of the Employees’ State Insurance Act, 1948 (34 of 1948) as the Central
Government has approved the availment of medical services in the under-utilised ESIC Hospital by Non-
Insured Persons as other beneficiaries in the “Other Beneficiaries and Members of Their Families Medical
Facilities Scheme 2010” framed under Section 73-B of the ESI Act, 1948.
1. Out-Patient Department (OPD) Consultation at the rate of Rs 10/-(Rupees Ten Only) per
consultation.
2. In-Patient Department(IPD) care at the rate of 25% (Twenty Five percent) rates of Central
Government Health Scheme(CGHS) packaged rates applicable for the city (If not available the
rate of the neighboring city or the State).
3. Medicines shall be provided (if available) at the actual cost.
4. An under-utilised Hospital for the purpose of this notification shall be the ESIC Hospital where
the bed occupancy is less than 60 % during the last two financial years.
5. The name of under-utilised hospitals and their operational modalities shall be as specified by
Director General from time to time.
Any objection or suggestion, which may be received from any person in respect of this notification
within a period of 30 days from the date of publication, will be considered by the Employees’ State Insurance
Corporation. The objections and suggestions, if any, may be addressed to Shri S. Ravichandran, Addl.
Commissioner (P&D), Employees’ State Insurance Corporation, Panchdeep Bhawan, C.I.G. Marg, New Delhi
– 110 002 (e.mail: dir-pnd@esic.nic.in).
S. RAVICHANDRAN, Addl. Commissioner
[ADVT.-III/4/Exty./60/19]
Uploaded by Dte. of Printing at Government of India Press, Ring Road, Mayapuri, New Delhi-110064
and Published by the Controller of Publications, Delhi-110054.