Insurance Regulatory and Development Authority of India (IRDAI) and National Health Agency (NHA) has decided to set up a joint working group for better implementation of Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY).
The joint working group will be chaired by Dinesh Arora,Deputy CEO of NHA.It will have 10 members from both the organisations.The committee will form (a)one common list of verified hospitals for the entire industry and (b)will also develop a standard reporting format to detect and deter fraud and abuse across government insurance schemes.
Ayushman Bharat is the National Health Protection Scheme, which targets to cover over 10 crore poor vulnerable families (around 50 crore beneficiaries) providing coverage of up to ₹5 lakh (per family per year) for secondary and tertiary care hospitalisation.The benefit cover will include pre and post-hospitalisation expenses.
It has subsumed the on-going centrally sponsored schemes –Rashtriya Swasthya Bima Yojana (RSBY) and the Senior Citizen Health Insurance Scheme (SCHIS).It is an entitlement based scheme with entitlement decided on the basis of deprivation criteria in the Socio Economic Caste Census database.
NHA is the apex agency that looks after the implementation of PMJAY. Recently, Cabinet had approved the restructuring of existing National Health Agency as “National Health Authority”.