The Modi Government's ambitious healthcare scheme, Ayushman Bharat Pradhan Mantri Jan Arogya Yojana — providing insurance cover of Rs 5 lakh to over 10 crore families — will be backed with proper legal provisions to prevent frauds and forgery. The scheme is set to be launched nationally on September 25, the birth anniversary of RSS ideologue Pt Deendayal Upadhyay.
Union Health Minister JP Nadda said that prevention, detection and deterrence have been given adequate attention in the Anti-Fraud Guidelines, part of the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana to be rolled out in 29 States/UTs who have signed MoUs with the Centre.
Over 8,000 hospitals have offered to join the network of empanelled facilities that would provide inpatient care to the identified beneficiaries, and 1,350 medical packages-covering surgery, medical and daycare treatments-have already been identified, said Nadda at a press conference on Monday here.
He said that penalties could be monetary, de-empanelment or under IPC section or just a reprimand, depending on the gravity of the punishment. The Minister further elaborated that NHA 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.
Immediately after launch, every eligible family will receive a letter informing them about the entitlements and with the names of all members of the family. The QR code in the letter will be used for verification. Pre-authorisation for hospitalisations under the scheme will take half an hour, the Minister said.
To address the query of beneficiaries, regarding the scheme, a dedicated call centre will start from September 5th in multiple vernacular languages. Also, for facilitating the beneficiaries, identified from per socio-economic caste census, Pradhan Mantri Jan Arogya Mirtra will be appointed in the hospitals empanelled with the scheme. "Arogya Mitras training is being conducted in collaboration with National Skill Development Corporation (NSDC) and Ministry of Skill Development to strengthen implementation and operational preparedness.
"Training has already been initiated in 15 States/UTs," Nadda said.
"They will be the primary point of facilitation for the beneficiaries to avail treatment at the hospital and thus, act as a support system to streamline health service delivery," he said adding that seven States have decided to adopt the Insurance mode, 18 will follow the Trust route while 9 are following the mixed model.
The services will include more than 1300 procedures covering pre and post hospitalisation, diagnostics, medicines etc., and the beneficiaries will be able to move across borders and access services across the country through the provider network seamlessly.