The Employees’ State Insurance Corporation (ESIC) has officially issued amendments to its Referral Policy 2023 for Super Specialty and Specialty Services. The notification, addressed to directors and medical officers across ESIC hospitals and institutions, introduces revised norms for healthcare accreditation, dialysis unit standards, and financial guarantees required from empaneled Health Care Organizations (HCOs).
These changes aim to streamline quality standards and improve service access, especially in smaller cities, without impacting ongoing contracts.
🛑 Key Notes:
- These changes are effective immediately from the date of the notification (01.07.2025).
- No impact on existing contracts; changes apply prospectively.
- All previous clauses in conflict with these points are superseded.
- The directive has been issued with the approval of the Director General, ESIC.
📊 Table of Key Amendments to ESIC Referral Policy 2023
| Para No. | Existing Policy | Amended Policy |
| 18.1 | The Health Care Organizations (HCOs) in Class X and Y cities must be mandatorily accredited by NABH and NABL. HCOs in Class Z cities should preferably be accredited by NABH. | – HCOs in Class X cities: Mandatory NABH & NABL accreditation – HCOs in Class Y cities: Preferably NABH-accredited; 6 months allowed for full or entry-level accreditation – HCOs in Class Z cities: Preferably NABH-accredited |
| 18.6 | Standalone dialysis centres should have minimum: – Type X city – 10 dialysis units – Type Y & Z cities – 6 dialysis units | Same unit requirement: – Type X – 10 units – Type Y & Z – 6 units ➤ Neurology, Nephrology, ENT, and Eye added as permissible standalone specialties ➤ Standalone units must have 10 beds and above, except Lab services |
| 19.10 | Earnest Money Deposit (EMD) and Performance Bank Guarantee (PBG) to be submitted by HCOs as per IP population within 25 km. (Z-category cities receive relaxation) – In PBG column only: ₹10,00,000 (Rs. Ten Lakhs) | Revised EMD & PBG based on IP population: 1. ₹10,00,000 – IP population >1,00,000 2. ₹5,00,000 – IP population 50,000 to 1,00,000 3. ₹2,50,000 – IP population 10,000 to 50,000 4. ₹1,00,000 – IP population <10,000 ➤ IP data to be provided by the Regional Director’s Office |
🧩 Conclusion:
This amendment reflects ESIC’s ongoing commitment to quality assurance and equitable access in referral services. The updated policy ensures better-defined benchmarks for empanelment and encourages participation from a broader set of service providers, especially in Class Y and Z cities.