PM’s health scheme approves 23,287 claims worth Rs38-cr in first 10 days
08 Oct 2018
Ten days after its launch, the country’s most-ambitious health care programme, Pradhan Mantri Jan Arogya Yojana (also known as Ayushman Bharat) has catered to more than 30,000 patients and approved claims worth Rs38.1 crore through both public and private hospitals.
Of the total 23,299 claims worth Rs45 crore submitted so far, 23,287 claims have been approved as of 2 October.
Official data show that the average claim size per patient is Rs19,357.
As on date, 32,814 hospitals have applied for empanelment, of which 13,865 have been empanelled or are in the process of being empanelled.
But, the scheme that aims to provide a coverage of Rs5 lakh per family annually, benefiting more than 107 million poor families for secondary and tertiary care hospitalisation through a network of empanelled health care providers, was seen to be misused by those who do not fall in the eligible category.
The National Health Agency (NHA), responsible for implementing the PMJAY, has issued a circular to states to authorise district collectors and district magistrates to identify eligible beneficiaries under the scheme.
The NHA has asked the officers to introduce exclusion clauses in the Socio-Economic and Caste Census (SECC) data to identify those not eligible for the scheme.
The Ayushman Bharat- Pradhan Mantri Jan Arogya Abhiyan (AB-PMJAY), was launched pan-India by Prime Minister Narendra Modi from Jharkhand on 23 September.
Early this month, Dinesh Arora, Deputy CEO of Ayushman Bharat, tweeted about a 67-year-old lady from Diglipur in North Andaman Islands, who was wheeled into government-run Govind Ballabh Pant Hospital at Port Blair with heavy bleeding.
She was diagnosed with cervix cancer. Sadly, people on the island, have no access to radiotherapy.
“She was flown into private-run MIOT hospital in Chennai and treated. Transportation costs were covered under the scheme,” said Arora.
However, that is a rare case and everyone may not enjoy the facility as people may find it difficult to get the right treatment at the hospital available.
Also, there are no medical co-ordinators at hospitals to advise patients on the facilities available at the empanelled hospitals.
Indu Bhushan, CEO of Ayushman Bharat, said the scheme will be rolled out in Jan Swasthya Sahyogs first.
Meanwhile, five states have resisted joining the scheme saying they have reservations about the scheme that offers benefits without equal costs, an argument insurance companies also raise against Ayushman Bharat.
While 31 States and union territories are on board, five non-BJP-ruled states, including Delhi (Aam Aadmi Party), Odisha (Biju Janta Dal), Punjab (Congress), Kerala (Left Democratic Front) and Telangana (Telangana Rashtra Samithi), are resisting from participating in the scheme.