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Quarterly Review Meeting (Group 2 )| 20 th Sept 2019 Dr Praveen Gedam | Deputy CEO, NHA

Ayushman Bharat Pradhan Mantri Jan Arogya Yojana. Quarterly Review Meeting (Group 2 )| 20 th Sept 2019 Dr Praveen Gedam | Deputy CEO, NHA. 1. 10.3 Crore Beneficiaries Verified. PM-JAY Report Card: Good Momentum has been created…. 44 lakh worth Rs. 6,8 29 crores Hospital Admissions.

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Quarterly Review Meeting (Group 2 )| 20 th Sept 2019 Dr Praveen Gedam | Deputy CEO, NHA

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  1. Ayushman Bharat Pradhan Mantri Jan Arogya Yojana Quarterly Review Meeting (Group 2)| 20th Sept 2019 Dr Praveen Gedam | Deputy CEO, NHA 1

  2. 10.3 Crore Beneficiaries Verified PM-JAY Report Card: Good Momentum has been created… 44 lakh worth Rs. 6,829 crores Hospital Admissions 18,188+ Hospitals Empanelled 2 42,000+ Portability cases 2

  3. Agenda of Arogya Manthan (1/2) 3

  4. Agenda of Arogya Manthan (2/2) 4

  5. 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 Action Items for 1 year celebration 5

  6. Percentage of eligible families with PM-JAY e-Cards States/UTs should take drive to distribute eCards 6

  7. Experience till now: Awareness 7

  8. Experience till now: Awareness 8

  9. Penetration of PM-JAY e-cards in Uttar Pradesh 9

  10. Penetration of treatment and active hospitals in Uttar Pradesh 10

  11. Pending e-Card approvals 11

  12. Claims overdue State-wise 12

  13. Portability payments pending 13

  14. Payments pending for National Institutes of Eminence 14

  15. Release of Grant-in-aid action points States/UTs yet due to release their share States/UTs yet to submit Utilisation Certificates 15

  16. 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 • PM-JAY Bronze Quality Certification Standards have been approved • Approval of PM-JAY IT 2.0 for further upgradation of systems Key decisions from NHA Governing Board meeting States/UTs may consider aligning their HBPs of various schemes with these. 16

  17. Status of renewal of Insurance Contracts 17

  18. PMJAY - Centralised Public Grievance Redressal and Monitoring System (CPGRAMS)- Pending Status 18

  19. PMJAY Central Grievance Redressal- Pending status 19

  20. National Call Centre integration with State Call centre • States where integration support required • Assam • Arunachal Pradesh • Gujarat • Haryana • Karnataka (request pending) • Madhya Pradesh • Manipur • Mizoram • Rajasthan • Utter Pradesh (West) • States where integration is completed • Punjab • Uttar Pradesh (East) • Maharashtra # 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. 20

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

  22. BioAuths- pilots must in Sept. Compulsory from Oct. for all states/UTs. • Data Warehouse to be set up by all States requiring Data from our end • Integration on API Gateway by all brownfield States • All eligible inpatients/day care patients coming to hospitals should be converted into PM-JAY. • 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. • Forward and backward linkages / referrals to ensure continuum of care • Publicity of the scheme in the hospital. Help desks. • Trainings of doctors Other Items 22

  23. Status of Anti-fraud responses from States 23

  24. To conclude • Ayushman Bharat Arogya Manthan (30th Sept. to 1st Oct) • Increase generation of e-Cards/Golden Cards • Convert in-patients into pre-authorisation of PM-JAY (Check PM-JAY eligibility of all in-patients) • Faster settlement of hospital claims (15 day TAT compliance) 24

  25. Thank You

  26. 9766620000 Praveen Gedam

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