PM unhappy with PMJAY rollout in BJP-ruled states

Ayushman Bharat ‘poorly managed’ in UP, MP

Despite having promoted the Pradhan Mantri Jan Arogya Yojana (PMJAY) or Ayushman Bharat healthcare scheme as offering cashless treatment of up to `5 lakh per family among rural poor annually, key states, especially the larger ones in northern and central India like Uttar Pradesh, Bihar and Madhya Pradesh have been identified as laggards in terms of their implementation by the Prime Minister personally.

Incidentally, both Uttar Pradesh and Madhya Pradesh are ruled by the BJP, while the saffron party is in power in Bihar in alliance with the JD(U). The BJP-led NDA had promoted PMJAY as a major gamechanger in rural healthcare during the 2019 Lok Sabha elections.

In a recently held review

◗ ACCORDING TO highly placed sources, Modi was especially peeved over the fact that despite the scheme having been launched more than two years back (in September 25, 2018), a large number of private hospitals are yet to get empanelled under it

meeting of his pet scheme, Mr Modi is learnt to have asked these states along with some smaller ones like Arunachal Pradesh and Goa to pull up their socks while implementing PMJAY. These two states are also ruled by the BJP.

According to highly placed sources, Mr Modi was especially peeved over the fact that despite the scheme having been launched more than two years back (in September 25, 2018), a large number of private hospitals are yet to get empanelled under it.

As the ambitious scheme is meant to benefit around 10 crore rural poor, greater number of hospitals, especially private ones, need to be brought within the ambit of Ayushman Bharat.

During the course of the meeting, which was attended by the chief secretaries of the aforementioned states, Mr Modi is understood to have directed the Union health ministry officials to start a special drive to empanel more hospitals, especially in tier 2 and tier 3 cities, by March 31, 2021.

He also directed them to fix a time frame for completing 100 per cent enrolment in Union Territories, sources said.

While thousands of people enrolled under the scheme have been given ecards, a large number of patients complain that these cards are not accepted by many hospitals (mainly private ones) as

many of them are not empanelled under it, sources further added.

Keeping this in mind, the Prime Minister is said to have directed state officials to make a serious effort to expedite e-card generation simultaneously while empanelling more hospitals under PMJAY.

Mr Modi also underlined the need to strengthen the care mechanism between health and wellness centres as well as PMJAY.

While the Centre has aggressively promoted the scheme as offering cashless treatment of up to `5 lakh per family among the rural poor, covering more than 1,000 procedures at empanelled public and private hospitals, it follows a prospective payment mechanism, where the higher ceiling of the treatment cost is fixed.

So if the treatment cost exceeds the fixed package amount allowed under Ayushman Bharat, the patient has to pay the remaining sum from his or her pocket.

As the package prices are on the lower side, many private hospitals were reluctant to come under the ambit of the scheme during its initial days.

Though later some hospitals did join it after the Centre upwardly revised the costs of some procedures, several of them are out of its purview, thus affecting the scheme’s performance in many key states.