New Delhi (NVI): The Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) is an entitlement-based scheme and there is no requirement of registration or enrolment of beneficiaries. Accordingly, no scheme specific card is required to avail benefits under the scheme, the Lok Sabha was informed today.
However, in order to create awareness and facilitate availing of benefits, after verifying the identity of beneficiaries under the scheme, e-cards have been issued to the beneficiaries, Minister of State for Health and Family Welfare, Ashwini Kumar Choubey said in a written reply.
A Memorandum of Understanding (MoU) has also been signed with Common Service Center (CSC) e-Governance Services India Limited, under Digital India Initiative of Government of India, for utilising their network of CSCs to verify AB-PMJAY beneficiaries’ identity under the scheme for issuance of e-card.
Besides, beneficiary identification process is undertaken at all the empanelled hospitals including private service providers through Pradhan Mantri Arogya Mitras (PMAMs).
Further, Open Beneficiary Identification System policy has been launched whereby states can deploy and engage services of different public or private entities to facilitate the beneficiary identification process.
Replying to another question, the Minister said that under AB-PMJAY, there are 1,393 health benefit packages and their rates have been defined.
These packages are common for public and private hospitals empanelled under the scheme. The hospitals are paid on the basis of the rate fixed for a particular package, Ashwini Kumar Choubey said.
Some actions have been taken to prevent abuse under AB-PMJAY which includes all admissions require pre-authorizations from respective State Health Agencies (SHAs), comprehensive set of anti-fraud guidelines issued, regular anti-fraud advisory notes are also issued to all states advising them on measures to be adopted to prevent, detect and deter fraud.
Some actions have been taken to prevent misuse under AB-PMJAY which includes a close watch on utilisation data through real time dashboards to identify suspect cases for over utilization, suspect cases and entities are flagged based on different fraud control triggers and results are shared with State agencies for further investigation.
-sb
