The letter is, indeed, dated 16 Apr 2019.
The question is we have not heard anything on the subject in the last two years whether the proposal has been accepted or not.
As it is, the ECHS HQs woke up for the same after 9.5 years after the CGHS made that possible for their beneficiaries. And now no follow up, I assume.
We are really in mess with ECHS becoming very malfunctioning machinery. Instead of being proactive for the healthcare for the veterans, even copying something from the other takes 9 years and then remains unimplemented.