Rates of 400 treatment procedures under the PM-JAY hiked

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In a bid to strengthen the private sector participation in the national health protection scheme, the government has increased the rates of around 400 treatment procedures under the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY). The hike ranges between 20% and 400%.

It has also added a new medical package related to black fungus management.

The rates for ICU with ventilator support have been revised by 100% and without ventilators by 136%. The rates for HDU (High Dependency Unit) have been revised by 22%. The hike in prices for routine wards is 17%.

Union Health Minister Mansukh Mandaviya said, “The revised packages for oncology will enhance cancer care for the beneficiaries in the country. The addition of new packages related to black fungus will be a huge relief to the beneficiaries. I am sure that the rationalised HBP will further improve the uptake of scheme in private hospitals leading to reduced out-of-pocket expenditure for the beneficiaries.”

The NHA, the implementation agency, has effected the rate revision. The revised rates are applicable on radiation oncology procedures, medical management procedures like those for dengue, acute febrile illness, etc, surgical package treatment for black fungus.

Currently, Ayushman Bharat PM-JAY covers 1,669 treatment procedures out of which 1,080 are surgical, 588 medical and one unspecified package.

The Ayushman Bharat PM-JAY aims to achieve the target of universal health coverage and provide access to free and affordable healthcare services to the citizens residing in the remotest of the areas.

The scheme aims to provide free and cashless healthcare services up to Rs 5 lakh per family per year to over 10.74 crore poor and vulnerable families (over 53 crore beneficiaries) as per Socio-Economic Caste Census (SECC)-2011 database.

Since the inception of the scheme, more than 2.2 crore eligible AB-PMJAY beneficiaries have been provided with health coverage for secondary, tertiary and daycare procedures for the treatment of diseases and medical conditions through a vast network of 24,000 Empanelled Health Care Providers (EHCP), the statement said,

The Health Benefits Package (HBP) defines the scope of healthcare services being provided and also determines the extent of financial risk protection to the beneficiaries, the statement said.