Over 23,000 hospitals have been empanelled so far and more than 12.5 crore e-cards have been issued, a health ministry statement said.
Also, 57 per cent of the total amount utilised under the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) has been for tertiary procedures related to treatment of major illnesses like cancer, cardiac ailments, orthopaedic problems, and neo-natal, Vardhan said as he chaired the ‘Aarogya Manthan’ 2.0 celebrating the second anniversary of AB-PMJAY.
Vardhan pointed out that 45 per cent of the empanelled hospitals are private facilities providing 52 per cent of the overall treatments and raising 61 per cent of the hospital admissions claims amount, the statement said.
As the “world’s largest public-supported health assurance scheme”, it provides financial risk protection to over 53 crore Indians from economically and socially disadvantaged backgrounds by assuring them with a health cover of Rs 5 lakh per eligible family per year to avail cashless inpatient secondary and tertiary healthcare, Vardhan noted according to the statement.
“It has provided treatments worth more than Rs 15,500 crore. It has saved crores of lives and households from getting wiped out due to catastrophic expenditure on health that pushed an estimated 6 crore families below poverty line each year,” he was quoted as saying in the statement.
Nearly half of the beneficiaries have been girls and women.
He also added that in these two years, the scheme has provided free treatment to more than 1.26 crore beneficiaries, the statement said.
He also outlined the scheme’s portability as one of its outstanding feature.
“An eligible patient from any state implementing PMJAY can avail of cashless treatment anywhere in India, in any empanelled hospital. Portability has been built into the design of the scheme and enabled 1.3 lakh citizens of the migrant population to avail of care at the nearest hospital,” he was quoted as saying in the statement.
He added that PMJAY’s capability building approach would go a long way in making Prime Minister Narendra Modi’s dream of Atmanirbhar Bharat a reality.
He congratulated the 32 states and union rerritory governments who have committed to the scheme.
He presented awards to the winners of the Ayushman Bharat PMJAY start-up grand challenge to support the implementation of PMJAY along seven implementation challenges such as beneficiary empowerment, increasing quality of care, minimising fraud and abuse control, and hence, help transform healthcare delivery to the poorest citizens, the statement said.
The Union health minister launched the AB-PMJAY Joint Certification Programme.
“I am confident that this promising programme will develop the skills and knowledge of relevant stakeholders in medical audit and health insurance for accurate and efficient processing of claims and prevention and detection of fraud and abuse,” he stated.
He also released the “AB-PMJAY Anti-Fraud Framework: Practitioners’ Guidebook”.
This will serve as a useful tool for the states as it is a repository of the anti-fraud guidelines, techniques, advisories along with legal remedies/course of action presently available under applicable Indian laws, the statement said.
This guidebook will serve as an excellent instrument for capacity-building for the state health agencies to take effective measures for prevention, detection and deterrence of fraud under AB-PMJAY, he stated.
“The focus this year will be on expanding the reach of the PMJAY network and services to other left-out population groups such as manual scavengers, road traffic victims, truck drivers, among others through convergence with other central health schemes.
“Along with the recently-launched National Digital Health Mission, which will build the necessary digital health ecosystem to enable enhanced access to safe, timely, quality and affordable healthcare for 1.3 billion Indians, Ayushman Bharat will become a pillar of the country’s healthcare system,” Vardhan added.
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