Dimapur, Nov. 25 (EMN): A review meeting on Ayushman Bharat- Pradhan Mantri Jan Arogya (AB-PMJAY) implementation with stakeholders was held at the conference hall of the deputy commissioner’s office, Dimapur, on November 24.
An update from the office of the chief medical officer (CMO), Dimapur, stated that the deputy CMO Dr. Antoly Suu chaired the meeting, while the deputy commissioner, Dimapur, Rajesh Soundarajan, gave a brief introduction of the scheme and its importance in helping the poor in availing cashless and free treatment upto INR 5 lakh per year per family.
It stated that the district co-ordinator R Nokchalemba gave a presentation on AB-PMJAY which envisioned to help mitigate catastrophic expenditure on medical treatment that pushes nearly 6 crores Indians to poverty each year.
The report stated that AB-PMJAY is the world’s largest health insurance scheme fully financed by the government. It provides a cover of INR 5 lakh per family per year for secondary and tertiary care hospitalisation across public and private empanelled hospitals in India.
It added that in Nagaland, there are 81 empanelled hospitals of which 64 are public and 17 are private hospitals. It informed that benefits of the scheme are portable across the country- meaning a beneficiary can visit any empanelled public or private hospital in India to avail cashless treatment. There is no restriction on the family size, age or gender, it added.
During the meeting, discussion was held between the empanelled hospitals both private and public along with the Oriental Insurance Company and Raksha TPA. To improve the BIS (Beneficiary Identification System), it stated that the members have agreed to resume the identification process which was paused due to Covid-19 activities. The members also agreed to check and report any fake and bogus beneficiaries such as fake cards, impersonation of a beneficiary, fake documentation etc. during the beneficiary identification drive.
It was informed that poor internet connectivity and lack of awareness of the scheme especially in the remote areas were some of the major issues hampering the smooth implementation of the drive. Besides, the process of Transaction Management System (TMS) in the web portal was another technical issue that delays the process of identification of beneficiaries.
On payment of pending claims to the hospitals, the insurance companies have assured to clear all dues after receiving the remaining instalments from the state and central governments.
Also speaking at the meeting, the deputy commissioner urged the stakeholders to come up with solutions for improvement of both the BIS and TMS to ensure smooth implementation of the project and visible improvement in the next meeting.
