NHA revises health benefit packages of PM-JAY scheme

The National Health Authority (NHA) has revised the health benefit packages of Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana (PM-JAY) with an aim to empanel many new private hospitals under the scheme so as to provide free treatment and quality healthcare to lakhs of vulnerable families.

On Thursday, NHA, which is the nodal agency for the implementation of PM-JAY, declared that there has been an increase in the rate of 270 packages, in addition to 237 new packages, adoption of 43 stratified packages while there is no change to the rate of 469 packages.

The officials at the NHA also mentioned that without compromising the range of treatment covered under the PM-JAY, 554 packages will be discontinued, and there is a reduction in the rate of 57 packages.

Union Health and Family Welfare Minister Dr Harsh Vardhan said: "We are confident that with the revision in the packages of PM-JAY, many new private hospitals will get empanelled for the scheme. This will help improve the access to good quality healthcare, and lakhs of vulnerable families will receive free treatment."

Currently, PMJAY has 1,393 treatment packages out of which 1,083 are surgical, 309 medical and one unspecified package. The NHA has said that since the launch, it has been receiving feedback on various aspects of the scheme including existing HBP and their rates.

Dr Indu Bhushan, CEO, NHA, explained: "In the spirit of cooperative federalism, before finalising the changes, the feedback was also taken from the States and Union Territories. Their feedback was examined by the review committee".

He said: "The States/UTs, which are using insurance model or a combination of trust and insurance model shall have the autonomy to either continue using existing package master till their current contract period ends or shift to the new version after making suitable amendments in their contract."

The revised oncology packages will revamp cancer care for the beneficiaries and are aligned to reflect the current best practices in the country.

Dr Vardhan explained: "These revised rates are expected to further augment cancer care in the country, along with a drastic reduction in the catastrophic expenses associated with it. Oncology packages have been split to include multiple regimens of surgical and medical oncology, complemented by radiotherapy regimens."

NHA added that a conscious attempt has been made to standardize the nomenclature and definitions of the packages.

NHA, in collaboration with the World Health Orgsation (WHO) has initiated the process of aligning the HBP with the International Classification of Health Interventions (ICHI) and the International Classification of Diseases (ICD) coding of the WHO.

When completed, India may become the first country to use ICHI in its HBP list, said the official.

PM-JAY, India's flagship healthcare scheme, provides a cover of Rs 5 lakh per family per year to around 50 crore poor and vulnerable individuals. Within one year of the scheme, 46.5 lakh hospital treatments were provided amounting to claims worth Rs 7,490 crore.

( With inputs from ANI )