Respected Regional Directors and Nodal Officers,
We have been receiving numerous complaints from pensioners and their representative forums regarding non-compliance with the Employees State Insurance Corporation Pensioners’ Medical Scheme 2006. It has been brought to our attention that Nodal Officers and ESIC doctors are not adhering to the guidelines established by Headquarters. This notification was published on August 7, 2024.
The revised guidelines for ESIC-PMS 2006, effective May 25, 2021, were implemented to provide efficient and seamless medical services to pensioners and their families, akin to CGHS standards. These guidelines, sanctioned by the ESI Corporation in its 184th meeting, outline procedures for cashless super-specialty treatments, emergency care, ESIC hospital treatments, private hospital treatments, and reimbursement processes.
You are requested to ensure that all medical treatments for pensioners are provided in strict accordance with these guidelines and any subsequent updates issued by Headquarters.
This communication is issued with the approval of the competent authority.
