Ayushman Bharat Pradhan Mantri Jan Arogya Yojana to be launched in Odisha. An agreement has been signed between the central and state governments for this. National Health Agency (NHA) has given a list of vendors to print Ayushman Bharat cards. It has been informed that the distribution of cards will start in February. After the implementation of Ayushman Bharat Yojana in the state, what will change and what benefits the beneficiaries will get, a grassroots discussion has started.
GJAY and PM-JAY will be Merged
According to the state health department, the state government’s ‘Gopabandhu Jan Arogya Yojana’ (GJAY) and ‘Ayushman Bharat Pradhan Mantri Jan Arogya Yojana’ will be merged. 1.03 crore families of the state will get medical facilities under Ayushman Bharat Yojana. Out of that, 67 lakh beneficiaries will join Ayushman Bharat and remaining more than 33 lakh beneficiaries will join GJAY. But all the crores of beneficiaries will be given in one form. 5 lakhs for male and 10 lakhs for female members will get medical facilities. Earlier two cards were issued to each beneficiary of a family. But in Ayushman Bharat Yojana, each member of the family will be given one written card. So that a member of the family can get this benefit wherever they are.
Patients can get treatment through this card in 30,000 hospitals across the country. So that the cost of GJAY treatment of the state government will be reduced. About 150 hospitals outside the state are affiliated to the erstwhile Biju Swasthya Kalyan Yojana (BSKY) or the current Gopbandhu Jana Arogya Yojana (GJAY). After the implementation of ‘Ayushman Bharat’, these hospitals will be excluded from the state government’s health insurance scheme.
Ayushman Vay Vandana Yojana for Above the Age of 70 Years
According to an official of the health department, under Ayushman Bharat Yojana, people above the age of 70 years will get medical facilities. It is estimated that there are more than 23 lakh people of this category in the state. Ayushman Vay Vandana Yojana has been implemented to treat people above the age of 70 years. Senior citizens will have to apply for this on the central government portal with their Aadhaar card. If the age is correct in the Aadhaar card, he can get 5 lakh medical benefits. Because there is no ration card or other restrictions for this benefit. Even the government does not have any database of this category of people. So all people above 70 years of age who want to get health insurance benefits can apply on the portal and get this benefit.
Immediate Payment will be Available as per Claim or Patient Treatment
Similarly, earlier BSKY-affiliated hospitals were paid monthly after checking the number of patients treated. In other words, it took about a month and a half for the hospitals to get the money for the treatment. But after the implementation of Ayushman Bharat Yojana, immediate payment will be available as per claim or patient treatment. Hospitals can claim multiple times in a month if necessary. It has been reported that the hospitals will get their treatment money in less days than before.
Health insurance plans have been accused of arbitrary and fraudulent billing by hospitals. To prevent this, an Anti-Fraud Unit (SAFU) will be formed in the state. A senior officer along with a number of staff will be housed in this unit. They will check the bills coming from the hospitals. Along with this, District Vigilance Unit will also be formed at the district level. AI help will be taken to verify the suspicious claims of hospitals. It has been informed that the money will be verified and paid through AI software.
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