The State Government employees and pensioners would be able to avail the benefit of Out Patient Department (OPD) and pathology under the Atal Ayushman Uttarakhand Yojana. These benefits are not available to other beneficiaries of the scheme. The chairman of the State Health Agency (SHA), D K Kotia told The Pioneer that the benefit of OPD and pathology is being provided to the employees and pensioners. “They were earlier availing the benefit of medical reimbursement which they now would not be able to get since the AAUY has been made mandatory for them. The SHA would deduct a fixed amount from the salaries of the employees, depending on their grade pay for the scheme. The State Government had decided to bring all its employees and pensioners under the ambit of the AAUY from January 26,” he said. He, further, said that since the AAUY is being run on trust mode, it is different from earlier schemes like Mukhyamantri Swasthya Bima Yojana (MSBY) where insurance companies were involved. He informed that the SHA has entered into an understanding with an Implementation Support Agency (ISA) to expedite the claims made by the hospitals.
Kotia said that a system to clear the claims made by the hospitals has been made under which they would get payment within 15 days. For delay of every 15 day period, ISA would pay an interest of 1% which is deliberately kept high (24 percent per annum) to ensure early claim settlement.
The chairman SHA said that there is no issue of budget as an amount of Rs 71 crore has been sanctioned by the State Government in the supplementary budget. In response to a question regarding empanelment of hospitals not registered under Clinical Establishments Act, Kotia said that the SHA is not mandated to implement Clinical Establishments Act. He added that the SHA is following the guidelines set up by the National Health Agency for empanellment.