DIRECTORA TE (MEDICAL) DELHIE.S.I. SCHEME: E.S.I. DISPENSARY COMPLEX,

(NEAR WORKS DEPTT.: OPP. POLICE POST)TILAK VIHAR : NEW DELHI - 110 018.

Website : www.esic.org.in & www.esic.nic.in

Press Notice

The Director (Medical) Delhi, E.S.I. Scheme invites letters of consentfrom reputed HospitalslInstitutions situated in East Delhi and NOIDA area forempanelment under E.S.I. Scheme for haemodialysis procedure at their Centresfor patients/beneficiaries covered under E.S.1. Scheme, Delhi/New Delhi/Noidafor a period up to 31.12.2010 at the following rates on cashless basis (byextending credit facility) :-

A dR t *.nnrove a esSI.No. Name of Procedure Approved

Rate (Rs.)1. Haemodialysis for Australia Antigen/H.C.V. Negative case. 10002. Haemodialysis for Australia Antigen/H.C.V. Positive case. 15503. Haemodialysis ofH.I.V. Positive cases 15504. Heparin Free dialysis 10005. Femoral Canula Insertion 8506. Jugular/sub-clavian canula Insertion 22007. Making of A.V. Fistula 41608. A.V. Fistula re-do 35009. Exploration Vessels for making of A.V. Fistula 100010. BloodlBlood Product Transfusion No extra

charge11. Viral Markers 50012. Perm Cath Insertion 1000013. CAPD Catheter Insertion (Open surgical technique) 500014. CAPD Catheter Insertion (Laproscopic technique) 800015. CAPD Catheter re-positioning 600016. CAPD Catheter removal in O.T. 2500

*Terms and conditions are applicable.

The interested hospitals/institutions may submit their proposal conveyingtheir consent duly signed by the authorized signatory along with supportingdocuments like constitution of the Organization, recognition of the Hospital underthe Govt., Earnest Money Deposit in form of demand draft for Rs.50,000/-(Rupees fifty thousand only) in favour of "E.S.I. Fund Account No.l, D (M)Delhi" payable at Delhi, profile of the hospital, number of machines installed inthe hospital etc. which ma~ be submitted to the office of the undersigned at theabove address latest by 261 March, 2010. The terms and conditions related tothe empanelment may be obtained from the office of the undersigned duringworking hours and may also be viewed on the ESIC web-site.

DIRECTOR (MEDICAL) DELHI.

DIRECTORATE (MEDICAL) DELHIE.S.I. SCHEME: E.S.I. DISPENSARY COMPLEX,

OPP. POLICE POST: TILAK VIHAR : NEW DELHI - 110 018.

Subject: Empanelment of Institutes/Hospitals in East Delhi & NOIDA area forhaemodialysis Services in respect of ESI Beneficiaries.

TERMS AND CONDITONS

1. PART-A

1.1 Proposals should reach the office of the Directorate (Medical) Delhi latest by 26th

March, 2010. Proposals received late will not be entertained.1.2 Proposals should be preferably in typed form.

Demand Draft worth Rs. SO,OOO/-(Rupees fifty thousand only) as earnest moneydeposit in favour of" ESIC FUND ACCOUNT NO. 1, D(M)Delhi" payable atDelhi must be enclosed with the proposal conveying consent of the Institutionduly signed by the authorized signatory along with supporting documents likeconstitution of the Organization, recognition of the Hospital under the Govt.,profile of the hospital, number of machines installed in the hospital etc. Earnestmoney in r/o unsuccessful Institutions shall be refunded. But, EMD in r/osuccessful Institutions shall be retained as Security money deposit for fulfillmentof the Terms & Conditions of the contract.

A Pre-receipt, in the following format, for refund of EMD should also beenclosed with the tender.

PRE-RECEIPT

Received with thanks from the Director (Medical) Delhi a sum of Rs. _( ) vide eh. No. towards refund ofEarnest Money Deposit/Security Money Deposit against tender for _investigations as was deposited by us vide D.D. No. dated

for Rs.----- ------

Revenue StampAuthorized Signatory

1.3 The validity of the contract will be up to 31.12.2010 from the date of itscommencement.

1.4 The Director (M) Delhi reserves the right to terminate the contract with anyinstitution prior to its scheduled date of expiry in case the services of the centreare not found satisfactory and in case of breach of terms & conditions of thecontract.

1.5 Rates should be valid at least up to 31.12.2010.1.6 Payment will be made on monthly basis.1.7 ESI patients should be given priority.1.8 The proposals complete in all respects may be sent by post/courier or by hand to

the office of the Additional Director, Medical Branch-Il, E.S.I. Scheme, NearPolice Post, Tilak Vihar, New Delhi - 110 018 so as to reach there on or before26.3.2010.

1.9 A self attested photocopy of PAN No. issued to the Institute/hospital by theIncome Tax Department, should also be enclosed with the Proposal.

2. PART-B

2.1 At least four hours haemodialysis should be provided to all patients under normalcircumstances.

2.2 Provision ofR.O(Reverse osmosis) water supply for haemodialysis of patients ismandatory.

2.3All patients are to be provided bicarb. Dialysis. Pre and P, ~ dialysisinvestigations viz. blood urea, serum cretinine, Australia antigen, anti- HCV,HIV -ELISA etc. would be done at ESI Hospital.

2.4 Though the reports of Viral markers viz. anti HCV, HBsAg, and HIV ELISA ofESIH are reliable, the Centre, at its discretion may get these ill' estigationsdone/repeated. These tests should be done not more than twice ; year in aparticular patient of CKD on maintenance Haemodialysis at ESIC's e), .ense, TheCentre should quote the rates of anti HCV, HBsAg, and HIV EIISA in thetender.

2.5 The centre should be spacious. It should use good quality dialysis mac ines withvolumetric U F Control system for dialysis. It should have adequate number ofwell-trained Dialysis technicians and other personnel. The personnel should beaware of as well as practicing measures to prevent transmission of infections.

2.6 Centre should have provision of carrying out dialysis of Australia antig.n/anti-HCV positive patients as well and such patients shall not be refused dir.. ysis bythe empanelled centres.

2.7 The centre should be willing to transfuse blood or blood products grou .ed andcross-matched at ESI Hospital to the selected patients during haemodialysis.

2.8 ESI officials may carry out surprise checks of the facilities and record-i.ceping atthe empanelled dialysis centre. They may obtain R.O (Reverse osmos: . watersample ofthe centre for quality testing.

2.9 Some injections e.g. Inj. Erythropoietin, Inj. Encifer, Inj. Polybion( B.Complex),Inj. Calcivest, Inj. Comitor etc would be issued to patients from ESIDispensary/hospital. The Centre should be willing to give these injectionsduring/post dialysis at no extra cost.

2.10 In the unforeseen event of dialysis patient becoming ser. .us duringdialysis and requiring urgent hospitalization, such patient may be ~,dmitted asemergency and treated appropriately at the Centre. The complete detrils of suchpatient should be conveyed to the treating Physician at ESIH on the sr ne day (ornext morning if such case is admitted between 4 pm and 9 am or m .ct workingday in case of Govt holiday). Post facto permission/sanction for treatment inwriting from the competent authority of ESIC should be applied for in theseCircumstances. It should be ensured that such patients are shifted to FSI hospitalsoon after stabilization. {All attempts, would however be made not tc refer verysick patients to the empanelled centre. Such patients are being provic.d Dialysisat ESI Hospital, Basaidarapur, N.Delhi}

2.11 Dialyzer re-use is permitted upto four times for Australia antigen! HCV / HIVNEGATIVE patients. For 'POSITIVE patients Dialyzer re-use is not pe.mitted.

2.12 Centre should be willing to do 'Saline' dialysis of patients having bleec.: igdiathesis or when it is stated by ESI Doctor.

2.13 Centre should indicate whether it would be willing to take up patients who aretested HIV positive.

2.14 Femoral/ Jugular vein! Sub-clavian canula should not be re-used.2.15 The empanelled Centre must have provision of "making A.V. Fistula" :,r dialysis

(or getting it made) at an early date. (Facility of making A.V. Fistula s' ..iuld beavailable for both 'negative' as well as 'positive' patients.)

2.16 If a patient who is on regular dialysis at a particular centre comes foremergency dialysis, such patient should be provided the same. ;)ost factopermission in such cases (for extra dialysis session) should be upplied forto the competent authority as soon as possible.It has been noted that patients who do not have a Central line/AV fistula aredenied dialysis at some of the existing empanelled centres. Herein it is clarifiedthat centre may do dialysis of such patients by femoral route/Dl.JC withoutseeking separate permission!sanction (and not deny such patients dialy .s).

2.17 he Centre shall commence dialysis or get A.V. Fistula made only after a writtenletter is received by it from the respective Medical Superintendents;' vuthorizedsignatories of E.S.l. Hospitals at Basaidarapur, Rohini, Okhla, .': .ilmil andDirector (Medical) Noida, E.S.l. Scheme, Sector-24-NOiDA for that particularpatient. A separate letter would be issued for "A.V. Fistula re-do" and the Centreshould carry out re-do operation only after getting this letter. Femoral canula

insertion is implicit in dialysis permission and no separate letter would berequired for it. For DLJC insertions/Sub-clavian catheter too no separate letter is required. However, preferably the patientshould be sent to E.S.I. Hospital for the insertion of DLJC/Subclavian catheter.

3 The empanelled Centre shall provide services on cashless basis to referred E.S.1.beneficiaries only for the procedures for which it shall be empanelled by ESIC atrates approved by ESIC and agreed upon by the empanelled Centre and the ratesshall be binding.

4 A copy of Discharge Slip incorporating brief history of the case, diagnosis, details ofprocedure done, reports of investigation, the treatment given and post dischargeadvise shall be submitted by the empanelled Centre along with the bill.

5 The empanelled center shall bear exclusively any liability arising due to default ornegligence in providing or performance of the medical services by the empanelledCentre who shall alone be responsible for the effect and / or deficiencies in renderingsuch services.

6 The empanelled center shall undertake that during the course of approveddialysis/related procedure on day care/short-admission basis in respect of the ESIbeneficiary, the empanelled Centre will not ask the beneficiary or his attendant topurchase separately the medicines / consumables / equipment or accessories fromoutside and will provide the treatment within the package deal rate, fixed by theESIC which includes the cost of all the items. Appropriate action, including but notlimited to removing from ESIC empanelment and / or termination of thisAgreement, may be initiated on the basis of a complaint, medical audit orinspections carried out by ESI team.

7 The empanelled center will honour permissions issued by the Referring Authorityi.e. Medical Superintendent to the ESI beneficiaries holding valid authorization.Treatment will be provided as per the rates approved by ESIC.

8 In case of any natural disaster / epidemic, the empanelled Centre shall fullycooperate with the ESIC and will convey / reveal all the required information, apartfrom providing treatment.

9 The procedure for submission / payment of bills will be as under:-The bill will be submitted by the empanelled Centre to the MedicalSuperintendent of the respective ESI Hospital till ih of the successive month.

10 The empanelled Centre will treat the ESI beneficiary patient only for the conditionfor which they are referred with permission, and in the specialty and / or purpose forwhich they are approved by ESIC. In case of unforeseen emergencies of thesepatients during admission for approved purpose / procedure, necessary life savingmeasures be taken and concerned authorities may be informed accordingly later withjustification.

11 The empanelled center will not refer the patient to other specialist / other hospitalwithout prior permission of ESIC authorities.

12 DUTIES AND RESPONSIBILITIES OF EMPANELLED CENTERSIt shall be the duty and responsibility of the empanelled center at all times, toobtain, maintain and sustain the valid registration, recognition and high qualityand standard of its services and healthcare and to have all statutory / mandatorylicenses, permits or approvals of the concerned authorities under or as per theexisting laws".

13 EMPANELLED CENTER'S INTEGRITY AND OBLIGATION DURINGAGREEMENT PERIOD

The empanelled center is responsible for and obliges to conduct all contractedactivities in accordance with the Agreement using state-of-the-art methods andeconomic principles and exercising all means available to achieve theperformance specified in the Agreement. The empanelled center is obliged to actwithin its own authority and abide by the directives issued by the ESIC. Theempanelled center is responsible for managing the activities of its personnel andwill hold itself responsible for their misdemeanors, negligence, misconduct ordeficiency in services, if any.

14. LIQUIDATED DAMAGES

The empanelled center shall provide the services as per the requiremen. ; specifiedby the ESIC in terms of the provisions of this Agreement. In case of . iolation ofany provision (s) of the Agreement by the empanelled center, the amount ofsecurity money deposit will be forfeited in part or in whole, at the discretion ofESIC, as agreed Liquidated Damages. In case the amount of Security MoneyDeposit is forfeited or charged in part, the total amount of the security .'eposit willbe maintained intact being a revolving Guarantee. Action may also 1·. taken forremoving the Hospital from the empanelment of ESIC as well as ter. iination ofthis Agreement in addition to any other action as may be deemed fit Jy ESIC inthis regard.

15. For over-billing and unnecessary procedures/admissions, the e. .a amountso charged will be deducted from the pending / future bills of 'theempanelled Centre and the ESIC shall have the right to issue a showcause notice to the empanelled Centre and also to take appropriate actionagainst the empanelled Centre after considering its reply if an:", receivedwithin la days of the receipt of show cause notice, includ. ,g but notlimited to forfeiture of Security Money Deposit in part or in fi i, stoppageof referral to the empanelled centre and de-barring the empanelled centrefor future empanelments under E.S.I. Scheme for a specified pe. ;od.

16 TERMINATION FOR DEFAULT16 (1) The ESIC may, without prejudice to any other remedy fo, breach of

Agreement, by written notice of default sent to the empanelled centerterminate the Agreement in whole or part:

a) If the empanelled center fails to provide any or all of the ~.rvices forwhich has been recognized within the period(s) specifi j in theAgreement, or within any extension thereof if granted by the ESICpursuant to Conditions of Agreement or

b) If the empanelled center fails to perform any other obligation (s) under theAgreement.

c) If the empanelled Centre, in the judgment of the ESIC has .agaged incorrupt or fraudulent practices in competing for or in executing theAgreement.

16 (2) If the empanelled Centre is found to be involved in or associated with anyunethical illegal or unlawful activities, the Agreement will be .nimmarilysuspended by ESIC without any notice and thereafter may tc .rninate theAgreement, after giving a show cause notice and considering its reply ifany, received within 10 days of the receipt of show cause notice.

17. INDEMNITYThe empanelled Centre shall at all times, indemnify and keep indemnified ESICagainst all actions, suits, claims and demands brought or made against it in respectof anything done or purported to be done by the empanelled Centre i.. executionof or in connection with the services under this Agreement and against .iny loss ordamage to ESIC in consequence to any action or suit being brought «gainst theESIC, along with (or otherwise), empanelled Centre as a Party for an. thing doneor purported to be done in the course of the execution of this Agreement. Theempanelled Centre will at all times abide by the job safety measure. and otherstatutory requirements prevalent in India and will keep free and in. mnify theESIC from all demands or responsibilities arising from accidents or loss of life,the cause or result of which is the empanelled Centre's negligence or misconduct.The empanelled Centre will pay all indemnities arising from such incidentswithout any extra cost to ESIC and will not hold the ESIC responsible orobligated. ESIC may at its discretion and shall always be entirely at he cost ofthe Hospital defend such suit, either jointly with the Hospital or singl- in case thelatter chooses not to defend the case.

18. ARBITRATIONIf any dispute or difference of any kind whatsoever (the decision who reof is notherein otherwise provided for) shall arise between the ESIC and the empanelledCentre upon or in relation to or in connection with or arising out of theAgreement, shall be referred to for arbitration by the Director (Medical) Delhi,

who will give written award of his decision to Parties. The decision of theArbitrator will be final and binding. The provisions of the Arbitration andConciliation Act, 1996 shall apply to the arbitration proceedings. The venue ofthe arbitration proceedings shall be at Delhi / New Delhi.

19. MISCELLANEOUS19.1 Nothing under this Agreement shall be construed as establishing or

creating between the Parties any relationship of Master and Servant orPrincipal and Agent between the ESIC and the empanelled Centre.

19.2 The empanelled Centre shall not represent or hold itself out asagent of the ESIC.

19.3 The ESIC will not be responsible in any way for any negligence ormisconduct of the empanelled Centre and its employees for any accidentinjury or damage sustained or suffered by any ESIC beneficiary or anythird party resulting from or by any procedure conducted by and on behalfof the empanelled Centre or in the course of doing its work or performtheir duties under this Agreement or otherwise.

19.4 The empanelled Centre shall notify ESIC of any material change in theirstatus and their shareholdings or that of any Guarantor of the The empanelledCentre shall notify ESIC of any material change in particular where suchchange would have an impact on the performance of obligation under thisAgreement or otherwise.

19.5 This Agreement can be modified or altered only on written mutualagreement signed by both the parties.

19.6 Should the the empanelled Centre gets wound up or partnership isdissolved, the ESIC shall have the right to terminate the Agreement. Thetermination of Agreement shall not relieve the empanelled Centre or theirheirs and legal representatives from the liability in respect of the servicesprovided by the Hospital during the period when the Agreement was inforce.

19.7 The empanelled Centre shall bear all expenses incidental to thepreparation and stamping of this agreement.

20. PART-CApproved Rates are as under :-

SI.No. Name of Procedure Approved RemarksRate (Rs.)

I. Haemodialysis for 1000 The rate include the cost of consumables suchAustralia as lnj. Heparin, Inj. Xylocaine, Fistula needle,Antigen/H.C.V. normal saline, dressing material, dialyzer,Negative case. tubing etc. It also include the cost of Inj. Avil,

2. Haemodialysis for 1550 Inj. Efcorlin , Inj. 25% Dextrose etc. which anAustralia occasional patient may require in case of"AntigenIH.C.V. reaction".Positive case.

3. Haemodialysis of 1550H.LV. Positive cases

4. Heparin Free ( i.e. 1000Saline) dialysis

5. Femoral Canula 850Insertion ( Includingthe cost of famoralcanula, guidewire,Inj.Xylocaine, anti-septicsolution etc.).

6. Jugular/sub-clavian 2200canula Insertion (including the cost ofcanula, relatedconsumables andcheck X-Ray)

7. Making of A.V. Fistula 4160 Rates include dressings & stitch removal.8. A.V. Fistula re-do 3500

(wherever required)9. Exploration Vessels for 1000

making of A.V. fistula10. BloodIBlood Product No extra (blood/blood products would be prr vided by EST

Transfusion charge Hospital).

1.1. Viral Markers 500(Consolidated) (*antiHCV, HBsAg, HIV-ELISA)

12. Perm Cath Insertion (in 10000OT)

13. CAPD Catheter 5000 {Patient for CAPD catheter ins« .ion will beInsertion (in OT) worked up/investigated at ESI lu -spital before(Open surgical sending for Catheter inse:tion; Alltechnique) consumables used for CAPD will :Je provided

14. CAPD Catheter 8000 from ESI hasp/dispensary}Insertion (in OT)(Laproscopictechnique)

15. CAPD Catheter re- 6000positioning(Laparoscopic)

16. CAPD Catheter 2500removal in O,T.

NOTE:-1. Preference would be given to the centre that is willing to do dialysis of HIV

Positive patients as well11. The Centre should use F-6 or equivalent dialyzer for re-use/negative

patients.Ill. All rates should are package rates.

DIRECTOR(MEDI~AL)DELHI