Will work with govt for implementation of AB-NHPM: IMA

The IMA on Friday said it will work with the government for the successful implementation of the Ayuhsman Bharat - National Health Protection Mission (AB-NHPM) even as the differences continue over the package rates for the health insurance scheme.

The Indian Medical Association (IMA), India's largest association of private doctors, has demanded that the government re-negotiate reasonable and fair package rates for its flagship scheme.

The scheme aims to provide a coverage of Rs 5 lakh per family annually and benefit more than 10 crore poor families.

The IMA has said that the package rates fixed by the government are very low and at such low rates, it was "impractical" to provide quality services.

A detailed meeting was held today between the National Health Agency (NHA), the apex body for implementation of the scheme and the IMA to discuss the modalities of implementing the AB-NHPM.

CEO of Ayushman Bharat, Indu Bhushan, and deputy CEO Dinesh Arora held a three-hour long deliberation with IMA president Ravi Wankhedekar and IMA secretary general RN Tandon along with other team members.

"While the differences on the package rates continue, the IMA agreed to work together for successful implementation of the mission in the interest of the poor and weaker sections of the society," an official statement said.

Bhushan said the participation of the private sector is critical and sought the IMA's complete support. Wankhedekar said that this is a visionary mission and the IMA fully supports Ayushman Bharat.

The NHA also clarified that NABH (National Accreditation Board for Hospitals and Healthcare Providers) is not mandatory for the hospitals to get empanelled.

"However, the NHA will encourage hospitals to get NABH (National Accreditation Board of Health) pre-entry level accreditation and NQAS (National Quality Assurance Standards) for achieving quality milestones. The hospital with NABH/NQAS accreditation can be incentivised for higher package rates subject to procedure and costing guidelines," it said.

Meanwhile, the NHA under the Health Ministry has launched a pilot for Beneficiary Identification System (BIS), a process whereby the identification criteria (as per AB-NHPM guidelines) will be applied on SECC and RSBY database to confirm application from 'entitled' beneficiaries.

Ayushman Bharat will target about 10.74 crore poor, deprived rural families and identified occupational category of urban workers’ families as per the latest Socio-Economic Caste Census (SECC) data.

Additionally, all such enrolled families under RSBY that do not feature in the targeted groups as per SECC data will be included as well, the statement said.

The BIS pilot drive was initiated at Sonipat, Haryana today.

The objectives of the pilot are to test the BIS application in both rural and urban settings, and to be able to match the SECC beneficiaries with the application search result.

The families were also covered in the Additional Data Collection Drive (ADCD) and individuals were advised to bring both their Ration cards, voter ID card, Aadhaar card or any other government prescribed identity proof.

The Centre's recently announced packages in its ambitious NHPM under which treatment for coronary bypass, knee replacements and stents among others would be provided at 15-20 per cent cheaper rates than the Central Government Health Scheme (CGHS).

Under the 205-page draft model tender document which was shared with the states last month, knee and hip replacements were fixed at Rs 9,000 each, stenting at Rs 40,000, coronary artery bypass grafting (CABG) at Rs 1.10 lakh, caesarian delivery at Rs 9,000, vertebral angioplasty with single stent at Rs 50,000 and hysterectomy for cancer at Rs 50,000.