Ayushman Bharat

Pradhan Mantri Jan Arogya Yojana

Quarterly Review Meeting (Group 1)| 19th Sept 2019

Dr. Praveen Gedam | Deputy CEO, NHA

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PM-JAY Report Card: Good Momentum has been created…

10.3 Crore
Beneficiaries Verified
44 lakh worth Rs. 6,805 crores
Hospital Admissions
18,235+
Hospitals Empanelled
41,000+ 2

Portability cases

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Agenda of Arogya Manthan (1/2)

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Agenda of Arogya Manthan (2/2)

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 Action Items for 1 year celebration

● Ayushman Bharat Arogya Manthan shall be on 30th Sept. and 1st Oct.
● Send itinerary and arrange for travel of nominated beneficiaries/
PMAMs/Hospitals/CSE VLEs before 23rd Sep
● Confirm the presence of ACS/Pr. Sec (Health)
● Confirm the participation of Hon'ble Health Minister (invitations have been
shared)
● SHA should share the participation details of their officials
● Pr. Sec should present the working group outcome to HFM
● Interaction with the nominated beneficiaries
● Organising Ayushman Bharat Diwas on 23rd
● PSD file of Comic Book has been shared, State may use it
● Selected states may share details of special requirement for market place

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 Percentage of eligible families with PM-JAY e-Cards

States/UTs should take drive to distribute eCards

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 Experience till now: Awareness

State # Total Villages % of villages with atleast 1 ecard % of villages with atleast 1 treatment

Bihar 45,170 76% 40%

Chhattisgarh 20,602 89% 88%

Haryana 7,541 91% 56%

Himachal Pradesh 21,091 72% 31%

Jammu and Kashmir 7,510 85% 38%

Jharkhand 33,148 84% 62%

Madhya Pradesh 55,871 95% 44%

Manipur 3,907 55% 25%

Meghalaya 7,232 90% 43%

Uttar Pradesh 1,06,957 73% 31%

Uttarakhand 17,008 93% 39%

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Experience till now: Awareness

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Penetration of PM-JAY e-cards in Bihar

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Penetration of treatment and active hospitals in Bihar

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Pending e-Card approvals

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Claims overdue State-wise

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Portability payments pending

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Payments pending for National Institutes of Eminence

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 Release of Grant-in-aid action points

States/UTs yet due to release their share States/UTs yet to submit Utilisation Certificates

S No. State S No. State

1 Bihar
1 Bihar
2 Dadra & Nagar Haveli

3 Himachal Pradesh 2 Dadra & Nagar Haveli

4 Kerala 3 Kerala
5 Meghalaya
4 Nagaland
6 Nagaland

7 Puducherry 5 Puducherry

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 Key decisions from NHA Governing Board meeting

1. Rationalisation of Health Benefit Packages

• Discontinuation of packages
• Reduction in rates of packages
• Addition of packages
• Increase in rates of packages
• Adoption of stratified packages
2. PM-JAY Bronze Quality Certification Standards have been approved
3. Approval of PM-JAY IT 2.0 for further upgradation of systems

States/UTs may consider aligning their HBPs of various schemes with these.

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 Status of renewal of Insurance Contracts

S No. State Description

Renewal due on 22nd Sept

1 Jharkhand
2019.

Renewal due on 30th Sept

2 Dadra & Nagar Haveli
2019.

Renewal due on 22nd Sept

3 Nagaland
2019.

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 PMJAY - Centralised Public Grievance Redressal and Monitoring
System (CPGRAMS)- Pending Status

Sl. No Name Received Total Pending 0 to 60 Days 61 to 90 Days > 90 days

1 Uttar Pradesh 219 14 13 0 1

2 Bihar 36 8 7 1 0

3 Jharkhand 31 4 2 2 0

4 Himachal Pradesh 8 2 2 0 0

5 Jammu and Kashmir 8 1 0 1 0

6 Andhra Pradesh 1 1 1 0 0

  Grand Total 303 30 25 4 1

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 PMJAY Central Grievance Redressal- Pending status

Total Grievances Total

Sl. No State 0-30 Days 31-90 Days > 90 days
Registered Pending
1 Chhattisgarh 3,657 949 51 3 895
2 Jharkhand 1,684 774 113 26 635
3 Bihar 441 197 68 9 120
4 Kerala 401 158 59 64 35
5 Himachal Pradesh 218 30 6 0 24

6 Jammu And Kashmir 170 122 5 5 112

7 Tamil Nadu 34 19 8 3 8

8 Dadra And Nagar Haveli 32 10 1 0 9

9 Andhra Pradesh 17 14 8 4 2
10 Daman And Diu 15 8 1 0 7
  Grand Total 6,669 2,281 320 114 1,847

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 National Call Centre integration with State Call centre
• States where integration is • States where integration support required
completed • Andhra Pradesh • Jharkhand
• Bihar • Kerala
- Himachal Pradesh
• Chhattisgarh • Meghalaya
• Tamil Nadu (request pending) • Nagaland
• Jammu & Kashmir • Tripura

# of phone calls made per executive per day should be around 100. If no of incoming calls are
less, outgoing calls should be made to beneficiaries to seek the feedback.

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 Human resources in some States/UTs and
their districts needs to be strengthened…

States & UTs

Bihar
Jharkhand
North Eastern – All States except Assam need to strengthen capacity

Union Territories - Andaman & Nicobar, Lakshadweep, Dadra Nagar

Haveli, Daman & Diu, Chandigarh and Puducherry

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 Other Items

1. BioAuths- pilots must in Sept. Compulsory from Oct. for all states/UTs.
2. Data Warehouse to be set up by all States requiring Data from our end
3. Integration on API Gateway by all brownfield States
4. All eligible inpatients/day care patients coming to hospitals should be
converted into PM-JAY.
5. A flexi-fund may be maintained at the hospital level for – diagnostics, drugs,
consumables, implants, transportation, loss of wages, incentives to staff, etc.
Suitable GOs needs to be issued.
6. Forward and backward linkages / referrals to ensure continuum of care
7. Publicity of the scheme in the hospital. Help desks.
8. Trainings of doctors

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Status of Anti-fraud responses from States

1/2

1/2
1/2

1/3

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 Some States are yet to roll-out PM-JAY…

Not Signed the MoU or

Status
Have Withdrawn
Telangana Ongoing Discussion
Odisha Ongoing Discussion
No response
Delhi
received
West Bengal Withdrawn

All other 32 States/UTs are implementing PM-JAY.

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Thank You