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Nod for Ministries’ schemes integration with AB PM-JAY

The Governing Board of National Health Authority (NHA) chaired by Union Minister of Health and Family Welfare, Dr. Harsh Vardhan, today met to review the implementation of Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY).

Among the major agenda items discussed was the impact of COVID-19 on Ayushman Bharat PM-JAY, how to resolve the challenges that arose out of the pandemic in healthcare delivery and, the performance of empanelled private healthcare providers in different States on COVID-19.

The Governing Board approved the proposal to integrate existing health schemes of Central Ministries with Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY) to employees (including Government and contractual employees), and other beneficiary groups such as building and construction workers, manual scavengers, road accident victims and Central Armed Police Force personnel.

The NHA Governing Board gave in-principle approval for implementation of any healthcare scheme for employees (including Government employees) and other beneficiaries extended by central ministries/ departments/ PSUs/ Autonomous bodies, based on their request, to be implemented on a common Ayushman Bharat PM-JAY platform. This is expected to seamlessly integrate all stakeholders in the ecosystem leading to enhancement of the overall efficiency and effectiveness of the extension of health services.

When implemented, the proposals will help integrate existing health schemes run by Central Ministries and Departments of the Government of India with AB PM-JAY. Presiding over the meeting as the Governing Board Chairman, Dr. Harsh Vardhan, Union Minister of Health and Family Welfare, said, “Such a synergy between both the Central health Schemes and Ayushman Bharat PM-JAY would support in the promotion of supply side development and enhance demand creation for healthcare services. Further, inter-operability between both Schemes would be highly beneficial for patients who are situated in geographical areas with limited healthcare facilities and will now be able to access these, especially through the portability feature of PM-JAY.” He added, “I urge all my Cabinet colleagues to work with us to bring healthcare further closer to crores of beneficiaries and their dependents. In this, I ensure full support to all Ministries in this initiative towards convergence and building of a common, national health ecosystem.”

The meeting was also attended by other Board members– Amitabh Kant, CEO, NITI Aayog, Rajesh Bhushan, Secretary Health, MOHFW, Sanjay Prasad, Joint Secretary Department of Expenditure, Dr. Ambrish Mithal (domain expert), Dr. R K Patel (domain expert), Principal Secretaries (Health) of Uttar Pradesh, Daman & Diu and Dadra & Nagar Haveli and Member Secretary, Dr. Indu Bhushan, CEO, NHA.

Dr. Indu Bhushan, CEO, National Health Authority, AB PM-JAY, said, “NHA has already developed advanced state-of-the-art IT platforms that will be leveraged to integrate the Central health schemes with AB PM-JAY and enable seamless delivery of health services. This will ensure ease of implementation of schemes and leverage the potential of integrated data systems. In addition, NHA has built the capacity to administer cashless health insurance services in over 23,000 hospitals across the country (including public and private hospitals in rural and urban areas).”

The Governing Board also gave a go-ahead to conduct insurance pilots for covering the missing middle/Non-Poor population (comprising varied sections of non-poor population – informal sector workers, self-employed, professionals, employees in MSMEs etc) that is spread across occupations, geography and income strata, utilizing the PM-JAY framework. These will help in understanding what works and what doesn’t, the complexities of self-pay covers on voluntary basis, especially for people engaged in informal sector, issues regarding adverse selection, health seeking behaviour, affordability, reach and distribution, healthcare supply side participation, economies and efficiencies, customer feedback and other mechanisms etc.

Information security is an ever-evolving domain and new cyber threats are also becoming more sophisticated. NHA’s Information Security Policy is intended to be a living document, which is revised at least once a year to ensure that the PM-JAY ecosystem is adept enough to counter any information security threats. The Governing Board also approved the revised 2.0 version of the Policy, which will establish controls that are even more stringent, in order to better prepare for auditing and compliance requirements. A penalty clause has been included for a solid strategy around effective communication and enforcement of policy.

Ayushman Bharat PM-JAY Update:

Overall Hospital Admissions: 1.16 crore

Amount Authorized for Hospital Admissions: Rs. 15,090 crore

Hospitals empanelled: 23,030

Covid-19 Tests: 77,000

Covid-19 Treatments: 30,756

MB Bureau

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