Revision of Ceiling Rates for Intra Ocular Lenses (IOL): ECHS Order

ECHS Order: Revision of Ceiling Rates for Intra Ocular Lenses (IOL) for Hydrophobic Foldable IOL, Silicon Foldable IOL, Hydrophilic Acrylic Lens &  PMMA IOL 

Central Organisation, ECHS

Adjutant General’s Branch

Integrated Headquarters

Ministry of Defence (Army)

Maude Lines

Delhi Cantt-110010

B/49773/AG/ECHS/Rates/Policy 

28 Oct 14

1. Ref Central Org ECHS letter No B/49773/AG/ECHS/Rates/Policy dt 10 Jan 11.

2. The following amendments is hereby made on the basis of CGHS OM No 536/2012/R&H/CGHS dt 21 Aug 14 to Para 16 of Appx ‘C’ of above mentioned letter:-

(a) Hydrophobic Foldable IOL – Rs. 5,000/-

(b) Silicon Foldable IOL – Rs. 3,600/-

(c) Hydrophilic Acrylic Lens – Rs. 5,800/-

(d) PMMA IOL – Rs. 490/-

(a) Hydrophobic Foldable IOL (Multi-piece/Single piece Aspheric) – Rs. 5,800/-

(b) Hydrophobic Acrylic IOL – Rs. 4,500/-

(c) PMMA IOL (AC/PC) – Rs. 500/-

(d) Scleral Fixated IOL – Rs. 3,500/-

3. Reimbursement for LASIK Surgery and INTACS Rings is not recommended.

4. Therapeutic and Bandage contact Lenses for Keratoconus of Corneal Ulcers can be considered on a case to case basis.

5. Further, reimbursement for IOL Implants will be limited to ceiling rates or actual, whichever is less and will be reimbursable in addition to the package rates for cataract surgery procedure. The reimbursement at the above mentioned ceiling rates will be done as per the rates fixed for the various types of IOL mentioned above and the lOL actually used in the surgery. It is mandatory for the operating surgeon of all private empanelled hospital/ECHS beneficiaries to attach the empty IOL sticker, bearing the signature and stamp of the operating surgeon on it, along with the bill in support of type of IOL used, containing its batch number. In the event of the private empanelled hospital not giving the batch number and/or empty IOL sticker, then the beneficiary will be required to obtain the

same from the hospital before the competent authority finally settles the claim for reimbursement.

(Vjay Anand)

Col

Dir (Med)

for MD

Source: http://echs.gov.in/images/pdf/med/med113.pdf