NHA reviewing feedback on PMJAY packages for possible rationalisation: Minister

The National Health Authority (NHA), the apex body implementing the flagship Ayushman Bharat- Pradhan Mantri Jan Arogya Yojna (AB-PMJAY), is reviewing feedback on various aspects of packages offered under the scheme, including duplication and other anomalies, for possible rationalisation, Parliament was informed on Tuesday.

Responding to a question on whether the Centre is planning to review over 1000 medical packages being offered to patients under the scheme, Minister of State for Health Ashiwni Choubey told Rajya Sabha that "there is no proposal" in this regard.

While deciding the package rates, one of the underlying principles was that full capacity of private hospitals was not being utilized and PMJAY is to provide additional volumes to them without additional investments in infrastructure and manpower etc, the minister stated.

"Since the launch of AB-PMJAY on September 2018, feedback on certain aspects of benefit packages such as terminology, duplication and any anomalies like repetition of packages, different rates for same procedures in different specialities etc., have been received and NHA is reviewing this feedback for possible rationalization, if required," Choubey said in his reply.

Under AB-PMJAY, 1393 benefit packages along with rates have been put in place for usage of hospitals empanelled under the scheme for providing the treatment to the beneficiaries.

The package rates are indicative in nature and states have the flexibility to decrease or increase up to 10 per cent depending on their suitability. Further, states could retain their existing package rates, even if they are higher than the prescribed 10 per cent flexibility slab, he said.

The states also have the flexibility to change the package rates up to 10 per cent for the aspirational districts and in the cases of NABH accredited hospitals.

The package rates were decided as per the recommendations of a Committee headed by Director General Health Services, Government of India and peer reviewed by NITI Aayog, Choubey elaborated.

The recommendations of the committee were based on a series of consultations with various stakeholders including medical professionals, AIIMS, hospitals' associations, industry bodies etc. For specific packages, subgroups spread across different super specialties were formed. The subgroups had prominent experts from national institutions like AIIMS, he said.