The Comptroller Auditor General has found irregularities and deficiencies in the functioning of the Ex-servicemen Contributory Health Scheme (ECHS), detecting leakages worth over Rs 105 crore.
The ECHS was launched by the Ministry of Defence in 2002. Financed by the government of India, the ex-military personnel and their dependents drawing pensions are entitled to cashless medical treatment, not just in military hospitals but also in various other public and private hospitals enlisted with the ECHS scheme. All ex-servicemen have been issued an ECHS smart card, according to the official website.
According to statistics, every year the government spends more than Rs. 2,000 crore on the health plan. The scheme aims at providing health care facilities to 47, 24,000 military pensioners.
In India, 426 polyclinics have been set up across the country, according to the ECHS official website.
As per the CAG report, the polyclinics are in a bad shape at present. They lack resources, man-power and of medicines. The report also stated that in certain incidents, there have been cases of two separate claims being filed for the same patient. There have also been cases of unaccounted medical bills, reported The Times of India.
A CAG official told the daily, "Consequently polyclinics were forced to function as referral points for patients to empanelled hospitals/labs, which consumed about 70% of revenue expenditure of the scheme."
"No doubt the ECHS is a wonderful facility to ex-servicemen like us, but it is also a problemâ€”one has to go to the polyclinic, from polyclinic we are referred to Military hospital, then back to avail medicines in the polyclinic. It has irregularities and the government must make it more user friendly," a retired colonel who requested anonymity told IBTimes India.
There have been cases of excess smart cards that can lead to misuse. "Holding and circulating of excess cards not only pose a risk of possible misuse but also resulted in extra payment of Rs 6.69 lakh to the firm on the account," a CAG official said, TOI reports.
As per the CAG report, 'empanelled private hospitals' have adopted unethical practises such as producing fake medical bills, hiking the treatment bill of patients, cases of overpayment to the empanelled hospitals, Times of India reported.
"We observe an overpayment of Rs. 1.92 crore at 20 stations selected in the audit. In Pune alone, the extent of overpayment was Rs 69.84 lakhs," the CAG official was quoted by the daily.