New Delhi: Pre-authorisation for health insurance claims under the Pradhan Mantri Jan Arogya Yojana (PMJAY) will be completed and communicated to the hospital within 30 minutes, said Health Minister JP Nadda, while unveiling the logo for the ambitious scheme.
The pre-authorisation stage is a provisional sanction that would keep a check any false claims where people avail health insurance despite them not being essential because the money will be reimbursed.
The PMJAY scheme will have set guidelines for pre-authorisation and the process will be mandatory for 636 of the 1,350 packages offered.
When asked about the vital minutes that would be lost by a patient in an emergency situation for these procedures, Nadda said, "It will take half an hour."
MoU for the ambitious scheme — that is expected to reach 50 crore people across 10 crore households — has been signed by 29 states and Union territories so far, Nadda announced on Monday.
The minister also added that with fake websites for the scheme proliferating, the government was going to crack down on the menace.
“We are very serious about acting against fake websites, there is no need for enrolment and no payment of fee is required. There will be a QR code in each letter through which beneficiaries will be identified. Once a family is verified, a card will be given to them,” he said.
As announced by Prime Minister Narendra Modi in his Independence Day speech, PMJAY or the Ayushman Bharat scheme, will be rolled out on September 25, the birth anniversary of RSS ideologue Pandit Deen Dayal Upadhyay.
Nadda informed that the Rs 5 lakh health insurance and assurance scheme will cover about 10.74 crore poor and vulnerable families as listed in the socio-economic caste census data.
The health minister added that the process of enlisting government and private hospitals in the scheme is still on.
Under this health insurance scheme, the cost of diagnostic procedures, drugs administered three days before admission and two days after would also be covered. “Treatment at government hospitals is free but there are fees that are charged. That will be covered under the scheme.”
He also addressed the opposition that the scheme has faced from other political parties in power in states like Punjab and West Bengal and said, “We first consulted with the states before going to the cabinet. This is cooperative federalism.”
The funding for the scheme will be divided as per a 60:40 ratio between the Centre and state governments while for the North Eastern States, Jammu and Kashmir, Himachal Pradesh and Uttarakhand it will be 90:10. For Union Territories without a legislature, the central funding will be 100 percent.
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