NHA governing board gives nod to integration of central health schemes with AB-PMJAY


NEW DELHI: The Governing Board of NHA has approved a proposal to integrate existing health schemes of central ministries with Ayushman Bharat scheme for employees and other beneficiary groups such as CAPF personnel, construction workers and manual scavengers, an official statement said. The Governing Board of National Health Authority (NHA), which implements the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY), met on Thursday to review the implementation of the scheme under the chairmanship of Union Health Minister Harsh Vardhan.

Among the major matters discussed were the impact of COVID-19 on Ayushman Bharat-PMJAY, how to resolve the challenges that arose out of the pandemic in healthcare delivery, and the performance of empanelled private healthcare providers in different states, the NHA said in a statement.

“The Governing Board approved the proposal to integrate existing health schemes of Central Ministries with Ayushman Bharat Pradhan Mantri Jan Arogya Yojana for employees (including government and contractual employees), and other beneficiary groups such as building and construction workers, manual scavengers, road accident victims and Central Armed Police Force (CAPF) personnel,” the statement said.

“The NHA Governing Board gave in-principle approval for implementation of any healthcare scheme for employees (including government employees) and other beneficiaries extended by central ministries/departments/PSUs/ autonomous bodies, based on their request, to be implemented on a common Ayushman Bharat PMJAY platform,” it said.

This is expected to seamlessly integrate all stakeholders in the ecosystem leading to enhancement of the overall efficiency and effectiveness of the extension of health services.

When implemented, the proposals will help integrate existing health schemes run by central ministries and departments of Government of India with AB-PMJAY.

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“Such a synergy between both the central health schemes and Ayushman Bharat-PMJAY would support the promotion of supply side development and enhance demand creation for healthcare services,” Vardhan was quoted as saying in the statement.

Further, inter-operability between both schemes would be highly beneficial for patients who are situated in geographical areas with limited healthcare facilities and will now be able to access these, especially through the portability feature of PMJAY.

“I urge all my Cabinet colleagues to work with us to bring healthcare closer to crores of beneficiaries and their dependents. I ensure full support to all ministries in this initiative towards convergence and building of a common, national health ecosystem,” he was quoted as saying.

The meeting was also attended by other board members — NITI Aayog CEO Amitabh Kant, Union Health Secretary Rajesh Bhushan, Joint Secretary Department of Expenditure Sanjay Prasad, and NHA CEO Indu Bhushan among others.

Indu Bhushan said, “The NHA has already developed advanced state-of-the-art IT platforms that will be leveraged to integrate the central health schemes with AB-PMJAY and enable seamless delivery of health services.

“This will ensure ease of implementation of schemes and leverage the potential of integrated data systems. In addition, NHA has built the capacity to administer cashless health insurance services in over 23,000 hospitals across the country (including public and private hospitals in rural and urban areas),” it said.

The governing board also gave a go-ahead to conduct insurance pilots for covering the missing middle/non-poor population (comprising varied sections of non-poor population like informal sector workers, self-employed, professionals, employees in MSMEs) that is spread across occupations, geography and income strata, utilising the PMJAY framework, the statement said.

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These will help in understanding what works and what doesn’t, the complexities of self-pay covers on voluntary basis, especially for people engaged in informal sector, issues regarding adverse selection, health seeking behaviour, affordability, reach and distribution, healthcare supply side participation, customer feedback and other mechanisms etc, the NHA said.

Information security is an ever-evolving domain and new cyber threats are also becoming more sophisticated. NHA’s Information Security Policy is intended to be a living document which is revised at least once a year to ensure that the PMJAY ecosystem is adept enough to counter any information security threats, the statement said.

“The Governing Board also approved the revised 2.0 version of the policy which will establish controls that are even more stringent in order to better prepare for auditing and compliance requirements. A penalty clause has been included for a solid strategy around effective communication and enforcement of policy,” it said.





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