Prime Minister Narendra Modi on Wednesday announced the launch of the Ayushman Bharat-National Health Protection Scheme on a pilot basis in some states on the occasion of Independence Day, with a full-scale rollout of his pet project scheduled on 25 September.
The ambitious AB-NHPM aims to provide a coverage of Rs 5 lakh per family annually, benefiting more than 10 crore poor families.
The scheme will target poor, deprived rural families and identify occupational category of urban workers' families, 8.03 crore in rural and 2.33 crore in urban areas, as per the latest SECC data. It will cover around 50 crore people.
Here is all you need to know about Ayushman Bharat:
The Centre has allocated about Rs 10,000 crore for the project, which is claimed to be the world's largest government-funded healthcare insurance programme. It is yet to release its share of the funds to the states.
The Union health ministry has launched a formal process to empanel public and private hospitals to achieve universal health coverage under the programme.
The Centre is simultaneously carrying out identification of beneficiaries. Under the process, 80 percent of beneficiaries, based on the Socio-Economic Caste Census (SECC) data in the rural and the urban areas, have been identified.
The health ministry has included 1,354 packages in the scheme under which treatment for coronary bypass, knee replacements, and stenting among others would be provided at 15-20 percent cheaper rates than the Central Government Health Scheme (CGHS).
Each empanelled hospital will have an 'Ayushman Mitra' to assist patients and will coordinate with beneficiaries and the hospital. They will run a help desk, check documents to verify the eligibility and enrolment to the scheme," the official said.
Also, all the beneficiaries will be given letters having QR codes which will be scanned and a demographic authentication conducted for identification to verify the individual's eligibility to avail the benefits of the scheme.
Further, the government recently clarified that the NABH is not mandatory for hospitals to get empanelled under the scheme. However, hospitals with NABH/NQAS accreditation can be incentivised for higher package rates subject to procedure and costing guidelines.
Also, the basic empanelment criteria allows empanelment of a hospital with a minimum of 10 beds, with the flexibility provided to the states to further relax this if required.
While Punjab, Kerala, Maharashtra, Karnataka and Delhi are yet to come on board, Odisha has refused to be a part of the scheme. As many as 22 states have preferred to run the scheme on "trust model".
Sub-group to be set-up to study treatment pricing
NITI Aayog will set up a sub-group to look into the complaints of private hospitals regarding pricing of treatment of key ailments proposed by the government under Ayushman Bharat.
The government has already come out with a draft model tender document, which was shared with the states last month. It has proposed prices of knee and hip replacements at Rs 9,000 each, stenting at Rs 40,000, coronary artery bypass grafting (CABG) at Rs 1.10 lakh, caesarian delivery at Rs 9,000, vertebral angioplasty with single stent at Rs 50,000 and hysterectomy for cancer at 50,000.
Responding to the draft tender, the Indian Medical Association (IMA) in June had said that the package rates were too low and "unacceptable". Hospitals would have to compromise on quality, exposing patients to danger, it said.
In order to resolve the impasse between the government and IMA, Niti Aayog decided to set up a sub-group of experts to go into the pricing of treatment under the Ayushman Bharat.
Beneficiary level of Ayushman Bharat
- All families listed in the SECC database as per defined criteria will be covered. No cap on family size and age of members.
- Priority to the girl child, women and senior citizens.
- Covers secondary and tertiary care hospitalization.
- All pre-existing diseases covered. Hospitals cannot deny treatment
- 1,350 medical packages covering surgery, medical and daycare treatments, cost of medicines and diagnostics
You can check online whether you are eligible for the cover under the scheme by following below mention steps:
- Log on to the Ayushman Bharat website
- Click on the ‘Download Beneficiary List’ tab
- Select ‘Rural’ or ‘Urban’ depending on you place of residence
- Enter mobile number to receive one-time password
- Enter the OTP and download the list
With inputs from agencies
Updated Date: Aug 16, 2018 12:56 PM