OFFICE OF THE STATE MEDICAL COMMISSIONER ESI CORPORATION, REGIONAL OFFICE 5-9-23, HILL FORT ROAD, ADARSHNAGAR, HYDERABAD-63 e-mail: [email protected] TEL NO.23232356, 57 & 58, EXTN: 229, TEL-FAX NO.23237382 NOTICE INVITING EXPRESSION OF INTEREST (EOI) FOR EMPANELMENT OF SECONDARY CARE SERVICES TO ESI BENEFICIARIES OF TELANGANA STATE ESIC is a statutory body under the Ministry of Labour & Employment providing Comprehensive health care through a network of dispensaries and hospitals to the insured persons and their family in majority of States / Districts of the Country. In its Reform Agenda under ESIC 2.0, the ESIC expanded its Services across the country. In this endeavor, ESIC is extended its coverage in the newly identified areas in the already implemented districts of Telangana intends to provide secondary medical health care services in those areas through tie-up with eligible healthcare providers (Except Hyderabad). Expression of Interest (EOI) are invited from Government/Semi Government/CGHS approved / Private Hospitals for the empanelment for providing Secondary Medical Care (Specialty) treatment services on cashless basis to ESI Beneficiaries at CGHS rates as per ESIC conditions. The applicants may download all the documents such as the Application form, Terms and Conditions (Annexure-I), Expression of Interest form (Annexure-II), Information about Services being offered (Annexure-III), undertaking regarding rates (Annexure-IV), Undertaking (Annexure-V) and List of Centres where services are to be provided (Annexure-VI) from the website www.esic.nic.in. Duly filled application in PDF format may be sent to the SMC by e-mail at the e-mail id [email protected] with subject line reading “EOI FOR EMPANELMENT FOR SECONDARYCARE (SPECIALITY) TREATMENT”. Hard copy may be send in a sealed envelope with the superscription “EOI for empanelment for Secondary care” addressed to: The State Medical Commissioner, Employees’ State Insurance Corporation, Regional Office, 5-9-23, Hill Fort Road, Adarsh Nagar, Hyderabad, Telangana, Pin-500063 Last date of submission of application: 24/11/2017 (Friday) 05.00 P.M. Application received after the scheduled date and time shall summarily be rejected. Sd/- State Medical Commissioner ESIC EXPRESSION OF INTEREST (EOI) FOR EMPANELMENT OF SECONDARY CARE SERVICES Application Form (For empanelment of Hospitals for secondary care treatment) To, The State Medical Commissioner, ESI Corporation Regional Office, 5-9-23, Hill fort Road, Adarsh Nagar, Hyderabad-500063 Subject: Expression of Interest (EOI) for Empanelment for Secondary Care treatment to ESI Beneficiaries. Sir, In reference to your advertisement in the news paper /website dated……………………..., I / We wish to offer the Secondary Care (Specialty) treatment services to ESI beneficiaries on cashless basis. I / We pledge to abide by the terms and conditions of the EOI document and I / We also certify that the above information as submitted by me / us in Annexure I, II, III, IV and V is correct and I / We fully understand the consequences of default on our part, if any. Place: Date: (Name and signature of the Applicant) Enclosures: Duly filled Annexure I, II, III, IV, and V. Note: Incomplete application form without signature / annexures will not be considered. Annexure I TERMS AND CONDITIONS (Please read all terms and conditions carefully before filling the application form and annexure thereto.) Empanelment is for secondary care of ESIC beneficiaries in new implementation areas. 1. General Terms and Conditions: A) Hospitals providing secondary care treatment services (it does not include the services by the super specialists) may apply. B) Duly completed EOI forms may be sent to SMCs E- mail and physical copy to SMC. The application should be super scribed “EOI for empanelment of Hospitals for Secondary Care (Specialty)”. Applications received after the scheduled date and time and without necessary documents shall summarily be rejected. C) Rates of package and procedure / investigation will be as per Central Government Health Scheme (CGHS) rates as per ESIC conditions. D) Contract may be awarded to one or more Tenderers depending upon the concentration of ESl Beneficiaries E) The Applicant should apply for at least five Specialties in secondary care (i.e. Medicine, Surgery, Gynecology & Obstetrics, Orthopedics and Pediatrics) F) Successful applicants shall have to furnish a Performance Bank Guarantee of Rs. Two Lakh from a nationalized bank having validity of 24 months plus 6 months from the date of agreement. G) Application form and (Annexure I, II, III, IV& V) should be duly filled and signed by the Proprietor, or duly authorized person with official seal / rubber stamp. H) The applications, if received from the Hospitals / Diagnostic Centers which have been de-empanelled by ESIC / CGHS or any other Govt. Institution, will not be taken into consideration for three years from the date of de-empanelment. (The institution has to give undertaking in this regard in Annexure-V). I) The applicant or his / her representative should always be available/ approachable over phone. For this purpose, a Nodal Officer shall be nominated by hospital to interact with ESIC Beneficiaries / State Medical Commissioner (SMC) office. His/her mobile number/e-mail ID / fax details should be made available to ESIC& should also be displayed at the helpdesk provided for ESIC Beneficiaries. J) The empanelled Centre must be standard one (and if NABH or equivalent accreditation as per CGHS submit such proof) and should have standard equipment, re-agents etc, qualified and trained manpower. K) The hospital should have facility to receive referral letter as soft copy and to submit bill and other documents to bill processing agency online. The empanelled centre shall send the bills in hard copy within 07 days of discharge to the SMC Office. L) Members of the Inspection Committee as constituted by SSMC shall visit the Empanelled Centre before entering in to the contract and during the period of empanelment. The Applicant shall be prepared to explain / reply the queries of the members of the inspection Committee /authorized person of ESIC during the period of empanelment. M) An Agreement on stamp paper of appropriate value shall be signed with Hospitals that are approved for empanelment after, scrutiny of bids evaluation thereof. The incidental charges related to agreement shall be borne by the Empanelled Centre. Only those applications will be considered for Award of contract that fulfill all the technical Conditions and also have satisfactory report of inspection committee constituted by SMC Office. Bid must be accompanied with all prescribed mandatory documents duly verified and signed, failing which the bid will not be entertained. 2. Eligibility: 1. Hospitals already on the panel of CGHS may be empanelled. (Attach copy of valid letter of empanelment with CGHS) 2. The other hospitals applying for secondary care treatment facilities must satisfy the following conditions : General purpose hospital providing specialty treatment / investigation facilities having 50 or more inpatients medical beds (excluding ICU beds) and in the following specialties: I. General Medicine II. General Surgery III. Obstetrics and Gynecology IV. Pediatrics V. Orthopedics VI. ENT VII. Ophthalmology VIII. Imaging and in-house diagnostic facilities IX. Dental Specialty X. Blood Bank XI. Others (if any) Note: a. In respect of the above, it is clarified that the first five specialties from the serial no. I to V are must for empanelment. However, conditions with regard to number of beds and number of specialties are relaxable, if there are no hospitals satisfying above mentioned conditions. b. In addition to the above, the hospital must have: I. Intensive Care Unit II. 24 hours emergency services managed by technically qualified staff III. Provision for dietary services to the patients IV. Information is to be submitted in annexure III (Preference will be given to the hospital having in-house imaging and diagnostic facilities and blood bank) 3. Specialty Eye Centre: can be empanelled if fulfilling the criteria as defined by CGHS 4. Conditions related to packages and other rates: The fixed payment for secondary care services is as under: i) Rs.200/- per patient for medicines and its dispensation at the time of discharge for both package and non package cases. ii) Fixed Rs.450/- per visit per patient for providing services of OPD, investigations, treatment including cost and dispensing of medicines. Drugs for chronic illness like hypertension, diabetes, cardiac problem etc. should be taken from ESIS system. a) Package rate shall mean and include lump sum cost of in-patient treatment/diagnostic procedure/ day care for which a ESI beneficiary has been permitted by the competent authority or for treatment under emergency from the time of admission to the time of discharge as per CGHS terms and conditions. b) In order to remove the scope of any ambiguity on the point of package rates, it is reiterated that a package rate for a particular procedure is inclusive of all sub procedures and all related procedures to complete the treatment procedure. The patient shall not be asked to bear the cost of any such procedure/items. 6. The hospital should be well equipped and engaged in providing Medical and /or Surgical facilities. The facility should have an operational pharmacy and diagnostic services. In case, health provider does not have any operational pharmacy and diagnostic services, they should be able to link with the same in close vicinity so as to provide 'cashless' service to the patient. 7. Hospital should have qualified doctors and nursing and other staff under its employment round the clock. 8. The empanelled hospital shall not refuse to treat any ESI patient. The hospital shall levy CGHS rates as per ESIC conditions. 9. Hospital / Diagnostic Centers empanelled with SMC, ESIC AP and Telangana shall not charge more than CGHS rates. If Empanelled Hospital / Diagnostic Centre’s rates are lower than the CHGS rates then the former will be charged.