17-Oct-2022: PM kickstarts distribution of PMJAY-MA Yojana Ayushman cards in Gujarat via video conferencing
The Prime Minister, Shri Narendra Modi kickstarted the distribution of PMJAY-MA Yojana Ayushman cards in Gujarat via video conferencing, today. The Prime Minister also interacted with the beneficiaries of PMJAY-MA Yojana Ayushman cards via video conferencing.
Interacting with Shri Piyushbhai from Tuwar in Banaskantha, the Prime Minister enquired about his family and his recent health conditions. The Prime Minister was happy to know that the Ayushman Bharat scheme had given him a new lease on life. The Prime Minister assured him that the government will always take care of everyone like him.
The Prime Minister interacted with Shri Damor Lalabhai Somabhai from Mahisagar and inquired if his cancer treatment went through well. The Prime Minister expressed delight that Shri Damor’s treatment was covered by the Ayushman Bharat scheme and he did not have to spend a single penny. He also urged Shri Damor to take a vow to quit tobacco and asked him to spread awareness about the scheme.
Smt. Ramilaben, Darjee in Gandhinagar informed the Prime Minister that, if Ayushman Card was not available, she would have had to take a loan for her treatment and chances were that she would have avoided the operation. The Prime Minister expressed happiness that mothers and sisters are taking advantage of the scheme.
Addressing the gathering, the Prime Minister expressed delight that such a mega event about public health is taking place just before Dhanteras and Diwali. He noted the coincidence that Dhanteras is at hand and Lord Dhanvantari who is considered to be the originator of Ayurveda is worshipped on the occasion. Quoting the Shastras, the Prime Minister recited, “Arogyam Paramam Bhagyaam” and expressed happiness that under the leadership of Chief Minister Bhupendra Patel, an event of such massive scale was taking place to give Arogya Dhan to lakhs of people of Gujarat.
Referring to the spirit of ‘Sarve Santu Niramaya’ i.e. may all be free of diseases, the Prime Minister said Ayushman Yojana aims for health for all. The Prime Minister appreciated the enormity of the campaign of distributing 50 lakh cards to the people in the state. This bears testimony to the sensitivity of the Gujarat Government. “We have been hearing about health insurance in many countries of the world but India is going beyond that, ensuring health assurance”.
The Prime Minister also highlighted the changed political thinking and work culture. In the earlier governments, schemes for the benefit of the common man had become a mere formality. The money that was spent on these schemes was done keeping in mind a particular area and political interests. “It was necessary to change this situation and we took the lead in this change. Today when planning is done, we first study the condition of common citizens and study their needs”, he said. The Prime Minister continued “Our schemes today directly address the needs of the common citizens”
The Prime Minister emphasized, “When the citizens of the country are empowered, then the country becomes powerful. That's why we have focussed on empowering the common citizen, especially the women of the country”. He listed free gas connection, pucca houses, toilets, free ration, and piped water as examples of this approach. The Prime Minister informed that so far, around 4 crore poor patients have availed the benefit of Arogya under this scheme across the country. He further added that out of this, about 50 lakh poor patients are from Gujarat. Highlighting the commitment, the Prime Minister informed that the government has spent crores of rupees for the treatment of these beneficiaries. Noting that the money would have been spent from the pockets of the beneficiaries if they had to get treatment outside this scheme, the Prime Minister expressed satisfaction that half of the beneficiaries of Ayushman Bharat are my mothers and sisters. Shri Modi further added that these mothers and sisters used to hide their diseases in the interest of the family and suffer because they were afraid of the debt that might pile up due to the high cost of treatment. “Ayushman Bharat Yojana has also liberated poor mothers and sisters from this problem”, he added, “Simply speaking, an Ayushman card is a 5 lakh rupee ATM. This is an ATM card that will keep giving benefits every year” He further explained the benefit that if a person lives for 30-40 years, there will be a guarantee of 1.5-2 crore worth of treatment over that period. “Ayushman card will be your true friend, the biggest troubleshooter”, he added.
The Prime Minister recalled that as the Chief Minister, he had introduced Chiranjeevi, Balbhog and Khilkhilat schemes. Mukhyamantri Amritam was introduced many years ago in Gujarat. The introduction of PMJAY-MA will enable the people of Gujarat to avail benefit of free treatment even outside Gujarat.
Background
As the then Chief Minister of Gujarat, Prime Minister had started the ‘Mukhyamantri Amrutam (MA)’ scheme in 2012 to shield poor citizens from the catastrophic costs of medical treatment and illness. In the year 2014, ‘MA’ Yojana was extended to cover families with an annual income limit of Rs. 4 lakh. The scheme was further extended to several other groups as well and later rebranded as Mukhyamantri Amrutam Vatsalya (MAV) Yojana.
Drawing from the experience of the success of this scheme, the Prime Minister launched the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) in 2018 - the largest health insurance scheme in the world providing coverage of up to Rs. 5 lakh per family per year for primary, secondary and tertiary care hospitalization without any cap on the family size and age. With the launch of the AB-PMJAY, Gujarat integrated MA / MAV Yojana with the AB-PM-JAY scheme in 2019 with the name PMJAY-MA Yojana and the beneficiaries under MA/MAV and AB-PMJAY became eligible for co-branded PMJAY-MA cards.
During the programme, the Prime Minister kickstarted the distribution of these cards which was followed by 50 lakh colour-printed Ayushman cards were distributed to all the beneficiaries across Gujarat at their doorstep by National Health Authority empanelled agencies after performing e-KYC of beneficiaries.
23-Sep-2022: Dr Mansukh Mandaviya to inaugurate Arogya Manthan 2022 to mark 4 years of Ayushman Bharat-PMJAY and 1 year of Ayushman Bharat Digital Mission
Dr. Mansukh Mandaviya, Union Minister of Health & Family Welfare will inaugurate “Arogya Manthan 2022” on 25th September, 2022 to celebrate four years of implementation of Ayushman Bharat Pradhan Mantri – Jan Arogya Yojana (AB PM-JAY) and one year of implementation of Ayushman Bharat Digital Mission (ABDM). Shri Ashwini Vaishnaw, Minister for Electronics & Information Technology, Dr. Bharati Pravin Pawar, Minister of State for Health and Family Welfare and Dr V. K. Paul, Member (Health), NITI Aayog will grace the event. Senior Government officials from the states/UTs will also be present. The two-day event will see active participation from global and national experts from the healthcare sector along with representatives from academia, think-tanks, industry, and media.
The Union Health Minister will kick-start the celebrations by interacting with beneficiaries of AB-PMJAY from across the country on 23rd September 2022.
AB-PMJAY will complete four years of its implementation on 23rd September 2022 and Ayushman Bharat Digital Mission (ABDM) will be marking its first anniversary on 27th September 2022. Fortnight-long celebration in the form of ‘Ayushman Pakhwara' to mark the anniversary of AB- MJAY is already underway in all states implementing the scheme, from 15th to 30th September 2022. Under the ‘Ayushman Pakhwara’, 33 states and UTs participating in AB-PMJAY are organizing awareness programs, health check-up camps and mass drives for Ayushman Card generation for beneficiaries of the scheme.
A Digi Health Expo will bring innovators from public and private sector exhibiting innovative digital health solutions.
The two-day event will have a total of twelve sessions covering a comprehensive list of agenda. Day-1 will have sessions on Universal Health Coverage in India, Promoting Interoperability in Digital Health, Enhancing the Efficiency of PM-JAY, Adoption of Digital Health, Health Technology Assessment for Evidence Informed PM-JAY Decisions and Privacy and Security Issues related to Digital Health. Sessions lined up for Day-2 include Best Practices by States Implementing ABDM, Digital Health Insurance in India, PM-JAY Best Practices by States, International Best Practices in Digital Health, Ensuring Access, Affordability and Quality in Healthcare through PM-JAY and Way Forwards for Digital Health in India.
NHA will also present the Ayushman Utkrishtata Puraskar 2022 (Ayushman Excellence Awards) to felicitate the top performing states, PMAMs (Pradhan Mantri Arogya Mitra) and public hospitals under the AB PM-JAY and best performing states/ UTs, districts, private & government health facilities and digital health solutions under ABDM. The winners of ABDM Hackathon Series Round 1 will also be awarded at the ceremony.
2-Aug-2022: Anti-fraud system for India’s National Health Insurance Scheme (AB-PMJAY)
Ayushman Bharat –Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) is governed on a zero-tolerance approach to any kind of fraud viz. suspect/non-genuine medical treatment claims, impersonation and up-coding of treatment packages/procedures etc.
The Government of India adopts a pro-active approach towards fraud and abuse. It goes on to underscore that several countervailing strategies have been employed under PM-JAY to address various types of fraud and it acknowledges the success of the AI-based technologies deployed under the scheme.
National Health Authority -the implementing agency of AB-PMJAY has issued a comprehensive set of anti-fraud guidelines. Anti-fraud advisories are issued to States/UTs. National Anti-Fraud Unit (NAFU) is created at NHA for overall monitoring and implementation of anti-fraud framework supported by State Anti-Fraud Units (SAFUs) at State level. All claims require mandatory supporting documents along-with on-bed patient photo before approval and payment. The feature of Aadhar-based biometric verification of beneficiary at the time of admission and discharge is launched at all private hospitals. Use of artificial intelligence and machine learning is made for a comprehensive fraud analytics solution to detect fraud pro-actively, develop algorithms that can be used on large volume of data to identify suspect transactions and entities and risk scoring of hospitals and claims. Around 0.18% of the total authorized hospital admissions under the scheme are confirmed as fraud since its inception.
22-Jul-2022: Steps taken to Improve Coverage under AB-PMJAY Scheme
Ayushman Bharat–Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) is an entitlement-based scheme. Eligible beneficiaries can directly visit any empanelled public or private hospital to avail cashless treatment. Ayushman cards are issued to the beneficiaries to create awareness about the scheme. National Health Authority in association with State Health Agencies has fast-tracked the process of issuance of cards to the beneficiaries across the country.
Healthcare services including primary, secondary and tertiary are provided free to all citizens of the country in Central/State Government hospitals. PMJAY’s beneficiary database is defined. 10.74 crore poor and vulnerable families (bottom 40 percent population) identified on the basis of SECC 2011 data are entitled to receive free treatment under the scheme. Further, States/UTs have the flexibility to run their own health protection schemes in alliance with AB-PMJAY at their own cost. Accordingly, States/UTs have expanded the scheme coverage to 14.75 crore beneficiary families at their own cost.
To cover each eligible person as per the 2011 Census under the scheme, guidelines are issued to States/UTs to identify beneficiaries as per deprivation/occupational criteria of SECC and to meet the shortfall in terms of number of eligible beneficiary households vis-à-vis those already identified/verified using their own datasets.
Details of steps taken to improve registrations under the scheme are as under:
- Leveraging grassroots network of healthcare workers (HCWs), frontline workers (FLWs), Panchayati Raj institutions (PRIs), village level entrepreneurs (VLEs) / agents from CSC and UTIITSL to mobilize and verify beneficiaries under “Aapke Dwar Ayushman” (ADA) initiative.
- Leveraging the updated databases of welfare schemes of Central Government Ministries/Departments for better targeting of PMJAY beneficiaries to reach out to eligible individuals from this list to issue Ayushman cards to them.
- Four additional agencies on-boarded, along the lines of CSC and UTIITSL for the generation of Ayushman cards across the country.
- Eight additional agencies on-boarded to ensure immediate approval of Ayushman card requests.
- An enhanced location hierarchy-based search option enabled in SECC database to access village level beneficiary data.
- A revamped “Self BIS” system launched for self / assisted verification.
- Crowd sourced approval functionality enabled for beneficiary record approval.
6-Jun-2022: The Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PM-JAY) Public Dashboard gets revamped with new features
The National Health Authority (NHA) under its flagship scheme of Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY) announced the release of its newly revamped and dynamic public dashboard that provides a granular view of PM-JAY scheme implementation data in a comprehensive manner.
The dashboard is another step in the evolution of PM-JAY scheme that provides a transparent view about the progress of the scheme from a state/UT vantage point. It has an interactive interface which displays key performance indicators about the scheme through informative charts. It aims to provide deeper insights to the public and PM-JAY ecosystem stakeholders to understand the scheme’s performance on a day-to-day basis.
Elaborating on the thought behind the public dashboard, Dr. R.S. Sharma, CEO, NHA said – “The newly revamped PM-JAY public dashboard aims to provide key information and insights about the scheme’s progress through real-time data and analysis. In the long run this will aid in data-driven and evidence-based policy making and promote greater transparency and accountability in the public sector. This is aligned to the Government of India’s mission to ensure minimum government and maximum governance.”
The newly updated dashboard provides detailed information about the number of Ayushman Bharat Cards created, empanelled hospitals and authorised hospital admissions amongst others at both national and state level. It allows users to further view the data distributed according to gender and age. For e.g., in the ‘Age Group’ category under the ‘Ayushman Cards Created’ panel, the pie chart reveals that the highest number of Ayushman Card holders are between the age group of 30 to 44 years while the age groups falling between 15 to 29 years and 45-59 years are trailing close behind.
The dashboard also shows trends pivotable between types of time periods, i.e., either for last 7 days, 30 days or as aggregates since the launch of the scheme. Another insight added to the dashboard is regarding top procedures and specialties availed by the beneficiaries at the empanelled hospitals under the scheme. This data is also pivotable between count of such treatments availed or amount authorized on such procedures.
Dashboard displays national as well as state level data for all these categories with an option to choose ‘state’ provided at top of the webpage. Further, users can also search and view list of patients availing treatment under the scheme at any empanelled hospital spanning across hundreds of districts in India.
The all-new dynamic public dashboard can be accessed at Ayushman Bharat PM-JAY official website (https://pmjay.gov.in) or directly at: NHA | Setu Dashboard (pmjay.gov.in)
14-Feb-2022: Integration with Beneficiary Database under Different Schemes aimed at Enrichment of Database for Implementation of AB PM-JAY
National Health Authority (NHA) is mandated with the implementation of Ayushman Bharat Pradhan Mantri – Jan Arogya Yojana (AB PM-JAY). AB PM-JAY provides health assurance of up to Rs. 5 Lakhs per family per year, for secondary and tertiary care-related hospitalizations. The 10.74 Crore beneficiary families under AB PM-JAY have been identified from the Socio-Economic Caste Census (SECC) of 2011 basis 6 deprivation and 11 occupational criteria across rural and urban areas, respectively.
NHA has collaborated with various ministries implementing welfare schemes to strengthen the different aspects of scheme implementation including inter alia beneficiary awareness campaigns, beneficiary database (SECC 2011) enrichment etc. The beneficiary database enrichment under AB PM-JAY would mean adding additional parameters to database for ease of search. The majority of AB PM-JAY beneficiaries from SECC 2011 are also eligible for benefits under National Food Security Portal (NFSA). NHA is working on integrating the SECC 2011 beneficiary database with NFSA, which will enable beneficiaries to seek information regarding their entitlement under the AB PM-JAY using their ration card number. NHA is also working on a proposal to use Fair Price Shops or Ration shops for providing information related to the scheme and entitlement under the scheme to eligible beneficiaries. This will provide an additional avenue to beneficiaries along with the existing Common Service Center, UTI-ITSL etc., for card creation. This will make the beneficiary identification process very convenient.
However, the existing beneficiary data available with various Government welfare schemes can be meaningfully utilized only if a common identifier is available. Aadhaar being a common identity across the majority of Government databases will enable this integration. Further, Aadhaar also ensures certainty regarding beneficiary identification through e-KYC. e-KYC enables paperless delivery of services in a targeted manner.
In this direction, Unique Identification Authority of India (UIDAI) has issued OMs dated 27th October 2021, 6th December 2021 and 14th December 2021. These OMs have enabled sharing of Aadhaar (collected under any scheme) among different departments of Government. As per the OM, different departments of the Central Government, administering Section 7 or Section 4(4)(b)(ii) schemes, can be treated as a single entity under the Aadhaar (Targeted Delivery of Financial and Other Subsidies, Benefits and Services) Act, 2016.
Accordingly, the Department of Food and Public Distribution (DoFPD) has issued OM File No.14(1)/2018-Comp.Cell (E-342358) dated 06th January 2022 wherein States / UTs were requested to provide necessary assistance and cooperation for sharing of the NFSA ration card data along with the corresponding Aadhaar with NHA. The onus of ensuring the compliance of various provisions and regulations regarding data protection, data storage and data privacy, etc., and in particular, seeking consent will lie with the user departments i.e., in this case NHA.
Following the OM of DoFPD, NHA is following up with States/UTs regarding database integration. States and UTs are providing necessary assistance in this regard. None of the States or UTs has expressed any reservation to NHA in sharing the data. The process of database sharing has already commenced in several States/UTs.