(a)whether the Employees’ State Insurance Corporation proposes to set up societies across the country for time bound delivery of services to its beneficiaries;
(b)if so, the details thereof along with the expenditure/financial cost likely to be involved therein; and
(c)the steps taken by the Government to transfer the reimbursement amount to beneficiaries with due diligence in a timebound manner?
MINISTER OF STATE (IC) FOR LABOUR AND EMPLOYMENT
(SHRI SANTOSH KUMAR GANGWAR)
(a) & (b): The 46th Indian Labour Conference held on 20th and 21st July, 2015 in one of its recommendation stated that “The ESIC should directly run the health services in all the States, state should not be asked to bear the cost of medical expenses.” Therefore, the matter was taken up in 166th meeting of the ESI Corporation on 07.08.2015, a sub-committee was formed. In the 167th meeting, the sub-committee submitted its report and it was decided to form State Autonomous Body under Section 58(5) of the ESI Act, 1948. Structure of the State Autonomous Body was circulated and all state Government were informed to constitute a State Autonomous Body by 31.03.2017 so as to be eligible for 100% expenditure up to the ceiling from ESIC. Due to some states going for assembly election, deadline was further extended to 30.06.2017.
Contd..2/-
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14 states accepted the proposal for State Autonomous Body and are entitled to get the benefit of 100% bearing of expenditure up to the ceiling, laid down from time to time, by ESI Corporation subject to them forming State Autonomous Body/Society as per structure approved by Corporation in its 172th meeting held on 06.12.2017. However, for rest of the states existing arrangement of sharing expenditure in the ratio of 7/8:1/8 shall continue. For the states forming State Autonomous Body/Society, funds shall be directly transferred to the Society which is likely to enhance the medical benefit service delivery in respective states under ESI Scheme available to its beneficiaries.
(c): From time to time, ESI Corporation has undertaken steps to ensure due diligence while processing reimbursement claim of ESI beneficiaries. The steps taken include administrative reform measures and Information Technology (IT)/online processing of such reimbursement claims. In addition CPGRAMS also monitors such cases at ESIC Head Quarter.
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