Private hospitals milk Army scheme

A popular health initiative for ex-servicemen launched in 2003 is under the scanner for financial irregularities and misuse. Army sources told HT that the Ex-Servicemen Contributory Health Scheme (ECHS) has become a convenient cash cow for some private hospitals which have been furnishing inflated bills and carrying out treatment for which there is neither need nor referral.

Vice Admiral VK Singh, who heads the Armed Forces Medical Services (AFMS), told HT that the ECHS was being exploited recklessly by private hospitals. "Directives have been issued to service hospitals to make referrals to private hospitals only when unavoidable. Our hospitals have also been asked to minutely examine claims made by private hospitals," Singh said.

"We are closely monitoring three hospitals in Delhi and one near Chandigarh," said another senior officer involved with running the ECHS. "We are considering disempanelment as an example to others. Referrals to one of the hospitals was stopped some time ago pending disempanelment."

The scheme is so lucrative that some private hospitals are even conducting recruitment 'camps' in rural areas to convince ex-servicemen to sign up, claim Army sources. And malpractice has become so endemic that the ECHS rejection rate of emergency claims processed by it is a whopping 50 per cent.

"It's a tightrope walk for us. While it is important to curtail unwarranted expenditure, it is equally crucial to ensure that ex-servicemen are not inconvenienced," said a senior officer.

Private hospitals are quick to jump to their defence. Dr Anupam Bhargav, managing director of North Point hospital in Panchsheel Park, said, "Diagnosis depends on the personal acumen of a doctor. While an experienced doctor may ask a patient to get just one test done to arrive at the correct diagnosis, another may require five tests to be sure. It will be unfair to insinuate motives."

North Point was disempaneled by the Central Government Health Scheme (CGHS) a few years ago.

Among the prominent hospitals under the scanner is the Fortis chain. Sources at Fortis (Mohali) said, "Army authorities always look at us with suspicion. We have to recover Rs 18 crore from the ECHS. Disempanelment may be a blessing in disguise."