Include OPD services, broader post-hospitalisation medication in Ayushman Bharat: Parliamentary panel

New Delhi: A parliamentary committee has recommended the phased inclusion of essential OPD services and a broader range of post-hospitalisation medication coverage within the Ayushman Bharat PMJAY scheme.

While acknowledging the scheme's focus on secondary and tertiary inpatient care, the Department-related Parliamentary Standing Committee on Health and Family Welfare stated that the current exclusion of routine OPD services and limited post-hospitalisation medication coverage creates a significant gap in accessible healthcare.

To ensure continuity and build upon the existing framework, the committee proposed a phased approach, starting with the inclusion of essential OPD services for chronic diseases and commonly reported ailments.

Furthermore, extending post-hospitalisation medication coverage beyond the current 15-day limit, particularly for conditions requiring prolonged treatment, would significantly reduce the financial burden on beneficiaries while addressing a need for comprehensive healthcare access.

The panel also recommended the National Health Authority (NHA) implement a proactive, data-driven, and transparent monitoring system focusing on early detection of potential misuse patterns in AB-PMJAY.

This system should go beyond reacting to reported fraud by continuously analysing claim data, hospital activity, and patient feedback to identify statistical anomalies and emerging trends indicating potential abuse, it said.

In the collection and analysis of statistical data and feedback, it urged the Union Health Ministry to consider the extensive use of Artificial Intelligence and digital tools.

This transparent, data-driven approach will not only allow for quicker intervention but also serve as a deterrent, ensuring the scheme's resources are used for their intended purpose and maintaining public trust, the committee said.

The committee also stated that it has learnt that a provision of 4-6 beds are proposed in Day Care Centres for cancer Chemotherapy, and Chemotherapy and medicines are proposed to be provided to the patients in Day Care Centres.

The Committee recommended that the said proposals get actualised on the ground level, the sooner the better.

It also suggested that separate human resources (including health professional and nurse) may be provided instead of seeking from the pool of district hospital for smooth functioning of the centre since there are already scarcity of health professionals in the district hospitals where such professionals must be made available.

Finance Minister Nirmala Sitharaman said in her budget speech that the government will facilitate setting up of daycare cancer centres in all district hospitals over the next three years and 200 of these will be established in 2025-26.

The panel also stressed that non communicable diseases screening should be made an integral component of NPNCD (National Programme for Prevention and Control of Non Communicable Diseases).

The population aged 30 years and above must be undertaken for screening of NCDs like Diabetes, Hypertension, Oral cancer, Breast cancer and cervical cancers under National campaign launched on February 20, 2025, it suggested.