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Ayushman scheme will cover drugs, diagnostic expenses pre and post hospitalisation

PTI Aug 28, 2018

The government's ambitious Ayushman Bharat scheme, that will pay up to Rs 5 lakhs in hospitalisation costs to poor and vulnerable families, will also cover drugs and diagnostic expenses 3 days prior to and 15 days post hospitalisation.





He was speaking at an an event where the logo of the Pradhan Mantri Jan Arogya Yojna (PMJAY) or Ayushman Bharat was unveiled along with Data Privacy and Information Security Policy and Anti-fraud Guidelines. Nadda said strict action will be taken against those involved in running fake websites which lure people with bogus schemes in the name of the government's insurance scheme.

He said for identification of beneficiaries of the Ayushman Bharat scheme, letters will be sent to every family having a QR code. Pre-authorisation for the scheme will be done in half an hour, he added. The scheme will be launched on September 25 on the birth anniversary of Pandit Deendayal Upadhyay, as announced by Prime Minister Narendra Modi.

Nadda said around 85 per cent of rural families and 60 per cent of urban families have been identified so far under the scheme. Asked whether the scheme was being renamed after former prime minister Atal Bihari Vajpayee, he said, "Its name is Pradhan Mantri Jan Arogya Yojna. We just released the logo." 

Nadda said a cover of Rs 5 lakh per family per year will be given under the scheme which covers 10.74 crore poor and vulnerable families. "Three days ahead of admission and 15 day after discharge, people will be given free medicines, diagnostics and all others," he said replying to a query on till how many days before admission and after discharge, the patients will get facilities free of cost.

The objectives of the AB-PMJAY are to reduce out-of- pocket hospitalisation expenses, fulfil unmet needs and improve access of identified families to quality inpatient care and day-care surgeries, the minister said. The services will include more than 1,300 procedures covering pre and post hospitalisation, diagnostics, medicines among others, and the beneficiaries will be able to move across borders and access services across the country through the provider network seamlessly, Nadda added.

He said 29 states and UTs have signed the MoU and started working on implementation of the scheme while pilots have started in 16 states and UTs. Other states and UTs will also start pilots before fully launching the scheme on September 25, he said. 

"The scheme's architecture and formulation has undergone a truly federal process, with stakeholder inputs taken from all states and UTs through national conclaves, sectoral working groups, intensive field exercises and piloting of key modules," the health minister said.

He said strict action will be taken against those running fake websites about Ayushman Bharat and added no enrolment is required for beneficiaries and there is no payment for obtaining services at empaneled hospitals. "Criminal cases will be lodged against fraudulent websites and agents trying to collect money from beneficiaries, he added. 

To strengthen implementation and operational preparedness, he said training has already been initiated in 15 states and UTs. The government has given total flexibility to the states to choose their own modes of implementation among Insurance, Trust or Mixed Mode and it is ready to provide the required support as well, the minister said.

The National Health Agency Information Security and Data Privacy are being institutionalised to provide adequate guidance and set of controls on the secure handling of beneficiaries' personal data and sensitive personal data in compliance with all laws and regulations applicable, he said.

"The information security is based on international best practices and India specific regulations and more than 94 controls set at various levels for secure handling of sensitive personal data," he said. On expenses, he said the government stands committed to support the people who need it. 

"Our effort is to benefit the maximum number of people. It is a political commitment. Whatever expenses are there, we will give it" he said adding the call centre for this scheme will start from September 5. Asked if the government had hurried into announcing the scheme as a part of the identification process was still underway, he said, "This is a continuous process." 

"Around 85 per cent have been covered so they can take its benefit. The rest 15 per cent we are trying to reach them. It will be done in a month or two," he said. Nadda said the hospitals which want to facilitate the scheme beneficiaries, they have to have a "Arogya mitra" who just has to be computer literate and the rest of the training will be given to him by the ministry.

Asked if states like Delhi were yet to take a decision on joining the scheme, he said they were on board and the MoU will be signed soon. Nadda also said he had asked the Odisha chief minister to take a decision on joining the scheme so that people benefit through it.

 

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