Four States and one Union Territory have signed first MoU with National Health Mission, Government of India for implementing Ayushman Bharat-Pradhan Mantri Rashtriya Swasthya Suraksha Mission (PMRSSM). These states/UTs are Himachal Pradesh, Haryana, Jammu & Kashmir, Uttarakhand and Chandigarh (UT).
These MoUs were signed during Ayushman Bharat Northern Region’s first workshop on PMRSSM at Shimla, Himachal Pradesh. Through these MoUs, these four states and UT will formally commit to implement PMRSSM. The MoU clearly outlines roles of Central and State/UT Governments for implementation of PMRSSM. Similar regional workshops are also planned in due course of time across the country to sign MoU with States/UTs for rolling out of PMRSSM in each region.
Ayushman Bharat scheme
It is Centrally Sponsored health insurance scheme of Ministry of Health and Family Welfare (MoHFW).
Beneficiaries: The scheme will target over 10 crore families belonging to poor and vulnerable population based on Socio Economic and Caste Census 2011 (SECC) database. Beneficiaries can avail of services anywhere in India. This will help to bring a visible relief to the target families by mitigating financial risk arising out of catastrophic health episodes.
Insurance cover: It will provide Rs. 5 lakh insurance cover per family per year, taking care of almost all secondary care and tertiary care procedures. There will be no cap on family size and age in the scheme.
Benefits covered: Pre and post-hospitalisation expenses. It also covers all pre-existing conditions from beginning of policy. It will also pay defined transport allowance per hospitalization to beneficiary. The beneficiaries can avail benefits in both public and empanelled private facilities.
Wellness Centres: Under it, government will set up 1.5 lakh wellness centres across the country by 2022 that will leverage on comprehensive primary health care for preventive, promotive and curative care. These centres will provide preventive, promotive, and curative care for non-communicable diseases, dental, mental, geriatric care, palliative care, etc.
Mission Council: For giving policy directions and fostering coordination between Centre and States for implementation of scheme, Ayushman Bharat National Health Protection Mission Council (AB-NHPMC) will be set up at apex level. It will be chaired by Union Health and Family Welfare Minister.
Role of State Governments: They are allowed to expand scheme both horizontally and vertically. They are also free to choose modalities of its implementation. They can implement through insurance company or directly through Trust/ Society or a mixed model.
Payments for treatment: It will be done on package rate (to be defined by the Government in advance) basis. The package rates will include all costs associated with treatment. For beneficiaries, it will be cashless, paper less transaction. States/ UTs will have the flexibility to modify these rates within a limited bandwidth keeping in view their specific requirements.