News Analysis India

Tag: Pradhan Mantri Jan Arogya Yojana

  • MP shocker: Ayushman Bharat scheme beneficiaries found being treated by in closed hotel in Jabalpur

    By Express News Service

    BHOPAL: Surprise police raid at a closed hotel in Jabalpur city of Madhya Pradesh, revealed that a makeshift hospital was being run there, by those owning the hotel as well as the adjacent private hospital. Most of the patients admitted at the hotel-cum-makeshift hospital were beneficiaries of the central government’s Ayushman Bharat Pradhan Mantri Jan Arogya Yojana.

    According to Jabalpur district chief medical and health officer (CMHO) Dr Sanjay Mishra, the entire operation on Saturday was carried out by the district police, following specific information about the hotel (closed since the COVID pandemic) being used to run a makeshift medical facility, particularly to cater to the medical needs of the Ayushman Bharat scheme.

    “The police team was accompanied by Dr Adarsh Vishnoi, the nodal officer for the Ayushman Bharat scheme in Jabalpur district and another official of the health department. The police action in the company of health department staff, not only revealed that a hospital was being run at the hotel without any permission from the health department but a CT scan centre too was being operated at the basement of the same non-operational Hotel Vega,” Mishra said.

    The makeshift hospital at the hotel was being run by the family which operates the adjacent Central India Kidney Hospital. The private hospital is operated by the family of Dr Ashwini Pathak, a prominent nephrologist of the Netaji Subhash Chandra Bose government medical college in Jabalpur only.

    The Hotel Vega which is adjacent to the hotel was operated by Dr Pathak’s son, but hasn’t been functioning since the COVID pandemic.

    Visuals of the police raid at the hotel revealed that around 70 Ayushman Bharat scheme beneficiaries were being treated at the non-operational hotel sans proper facilities. In many rooms, two patients were being treated on one bed.

    Most of these Ayushman Bharat scheme beneficiary patients hailed from districts adjoining Jabalpur district, including Damoh district.

    According to a senior health department official, the district police has been told clearly that the hospital had not been given any permission to run a medical facility at the non-operational hotel.

    The official added the possibility of fraud in the Ayushman Bharat scheme through the admission of patients from neighbouring districts at the hotel functioning as a hospital, cannot be ruled out, but further probe is needed.

    However, Dr Ashwini Pathak, whose family runs the Central India Kidney Hospital as well as owns the non-operational Vega Hotel, denied any foul play or wrongdoing at the hospital being run at the closed hotel.

    “It’s not a hotel anymore, but we’re running 100 beds medical facility thereafter permission from the Victoria (District Hospital). We’re not charging a single rupee from the Ayushman Bharat scheme card holders,” he claimed.

    BHOPAL: Surprise police raid at a closed hotel in Jabalpur city of Madhya Pradesh, revealed that a makeshift hospital was being run there, by those owning the hotel as well as the adjacent private hospital. Most of the patients admitted at the hotel-cum-makeshift hospital were beneficiaries of the central government’s Ayushman Bharat Pradhan Mantri Jan Arogya Yojana.

    According to Jabalpur district chief medical and health officer (CMHO) Dr Sanjay Mishra, the entire operation on Saturday was carried out by the district police, following specific information about the hotel (closed since the COVID pandemic) being used to run a makeshift medical facility, particularly to cater to the medical needs of the Ayushman Bharat scheme.

    “The police team was accompanied by Dr Adarsh Vishnoi, the nodal officer for the Ayushman Bharat scheme in Jabalpur district and another official of the health department. The police action in the company of health department staff, not only revealed that a hospital was being run at the hotel without any permission from the health department but a CT scan centre too was being operated at the basement of the same non-operational Hotel Vega,” Mishra said.

    The makeshift hospital at the hotel was being run by the family which operates the adjacent Central India Kidney Hospital. The private hospital is operated by the family of Dr Ashwini Pathak, a prominent nephrologist of the Netaji Subhash Chandra Bose government medical college in Jabalpur only.

    The Hotel Vega which is adjacent to the hotel was operated by Dr Pathak’s son, but hasn’t been functioning since the COVID pandemic.

    Visuals of the police raid at the hotel revealed that around 70 Ayushman Bharat scheme beneficiaries were being treated at the non-operational hotel sans proper facilities. In many rooms, two patients were being treated on one bed.

    Most of these Ayushman Bharat scheme beneficiary patients hailed from districts adjoining Jabalpur district, including Damoh district.

    According to a senior health department official, the district police has been told clearly that the hospital had not been given any permission to run a medical facility at the non-operational hotel.

    The official added the possibility of fraud in the Ayushman Bharat scheme through the admission of patients from neighbouring districts at the hotel functioning as a hospital, cannot be ruled out, but further probe is needed.

    However, Dr Ashwini Pathak, whose family runs the Central India Kidney Hospital as well as owns the non-operational Vega Hotel, denied any foul play or wrongdoing at the hospital being run at the closed hotel.

    “It’s not a hotel anymore, but we’re running 100 beds medical facility thereafter permission from the Victoria (District Hospital). We’re not charging a single rupee from the Ayushman Bharat scheme card holders,” he claimed.

  • Only 13 per cent of hospitalized patients got PM-JAY: Analysis

    Express News Service
    Only 6.05 lakh people out of 50 crore eligible people covered under Pradhan Mantri Jan Arogya Yojana, availed the benefit of the Ayushamn Bharat health insurance scheme for COVID-19 until June 30, 2021.

    This means, out of an estimated 45,50,000 people who were hospitalized for COVID treatment in public or private hospitals, only 13 percent got the insurance, indicating poor execution of the program by the government.

    Though there is no official data available on statewide hospitalization of COVID-19 patients, based on mathematical modelling, data available in some state COVID dashboards and media reports, the analysis concluded that on average 15 per cent of the COVID-19 patients were isolated in hospitals.

    38 per cent of the people (17.3 lakh) self-financed or borrowed their way through, while 49 per cent (22.2 lakh) relied on other health insurance schemes. Andhra Pradesh and Karnataka were the best states when it came to effective implementation of PM-JAY, as per an analysis by Jeevan Raksha, an initiative of Proxima Consulting.

    “There is no trace of PM-JAY scheme in some states such as Punjab and Gujarat, where not even a single person reaped the benefit of the scheme. In Assam (619), Bihar (19), and Uttar Pradesh (875) collectively only 1513 PM-JAY beneficiaries have got treatment for COVID 19. There was no trace of effective implementation in North-Eastern state and union territories,” the analysis read.

    “80 per cent of the PM-JAY beneficiaries were from Andhra Pradesh, Karnataka and Maharashtra. Karnataka and Andhra Pradesh added additional families into the PM-JAY scheme beyond those families who are part of the Socio-Economic Caste Census (SECC). In both the states, 38 per cent and 55 per cent of the patients were covered by government insurance. This demonstrates effective implementation. However, the majority of people in other state and union territories faced the brunt and spent from their own pocket,” Mysore Sanjeev, convenor, Jeevan Raksha.

    In Maharashtra, 18 per cent of the hospitalizations were covered by the scheme. As per the analysis, in North-Eastern states, around 43,000 people could have been hospitalized for treatment but only around 2000 people got PM-JAY cover, while in Tamil Nadu, which is among the states severely affected by COVID-19, 3.71 lakh people could have been hospitalized but only 10,377 got this insurance.

    Although Gujarat, Tamil Nadu, Uttar Pradesh and Bihar have covered 43.8 lakh, 74.9 lakh, 1.16 crore, 1.08 crore families under Ayushman Bharat on paper, the number of people who received the insurance, in reality, was 0, 10,377, 875 and 19 respectively. Jammu and Kashmir, Himachal Pradesh and Haryana also saw a poor impact of the scheme. 

  • Mucormycosis patients to be treated free of cost under health schemes: Uddhav government to HC

    Citizens will receive free treatment for mucormycosis at pre-identified hospitals and nursing homes across Maharashtra under the above schemes, the state said.

  • Punjab Vigilance Bureau unearths health insurance scam worth crores under PMJAY scheme

    By Express News Service
    CHANDIGARH:  Punjab Vigilance Bureau has unearthed a scam running into crores under the Pradhan Mantri Jan Arogya Yojana-Aushmaan Bharat scheme, in which private hospitals have obtained health insurance claims from insurance company on the basis of fake bills for treatment of patients possessing smart health cards.

    DGP-cum-Chief Director of Vigilance Bureau, BK Uppal, said it has come to light that several well known private hospitals in Jalandhar, Hoshiarpur and Kapurthala have prepared hefty fake bills in the names of smart card holders for treatment under Ayushman Bharat scheme and received insurance claims from IFFCO Tokio.

    The company had rejected hundreds of claims pertaining to government hospitals causing a huge loss to the state exchequer. “A regular vigilance inquiry has been registered to investigate this scam worth crores,” Uppal said.

    Giving details of preliminary findings, he said several fake bills of private hospitals had been cleared by the insurance company, but reimbursement bills forwarded by government hospitals were rejected.

    “The Punjab government has incurred financial losses during the last one year from these three districts.”

    Revealing the modus operandi, he said that a patient named Paramjeet Kaur was admitted to hospital gall bladder stone but did not undergo surgery.

    In this regard, the hospital prepared a fake bill of `22,000 for this patient and claimed reimbursement form IFFCO TOKIO under the Ayushman Bharat health insurance scheme.

  • Centre nod to creation of reserve fund for health from cess proceeds levied under Finance Act

    By Express News Service
    NEW DELHI:  The Union cabinet on Wednesday approved the Pradhan Mantri Swasthya Suraksha Nidhi (PMSSN) as a single reserve fund for share of health from the proceeds of health and education cess levied under the Finance Act, 2007.

    The Centre said the salient feature of PMSSN is that it is a single, non-lapsable reserve fund for health in the public account and proceeds of share of health in the health and education cess will be credited into it.

    The accruals, said the government, into the PMSSN will be utilised for the flagship schemes of the health ministry such as Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana, Health and Wellness Centres, National Health Mission and Pradhan Mantri Swasthya Suraksha Yojana.

    It could also be utilised for emergency and disaster preparedness and responses during health emergencies and any future programmes or schemes that targets to achieve progress towards sustainable development goals and the targets set out in the National Health Policy, 2017.

    The administration and maintenance of the PMSSN are entrusted to the health ministry. The expenditure on such schemes of the ministry would be initially incurred from the PMSSN and thereafter, from gross budgetary support.

    “The major benefit will be enhanced access to universal and affordable health care through availability of earmarked resources, while ensuring that the amount does not lapse at the end of financial year,” maintained the health ministry.

  • COVID-19 vaccination: Non-empanelled private hospitals can give jabs

    By Express News Service
    NEW DELHI:  In a move that will allow a significant rise in the number of health facilities being used as Covid vaccination centres, the Centre permitted states to start inoculation at private hospitals, not empanelled under any Central or state-run health insurance schemes.

    The states and Union territories were also urged not to store, preserve, conserve or create a buffer stock of the COVID-19 vaccines, the Union Health Ministry said in a statement, a day after the start of the second phase of India’s inoculation drive in which the coverage has been expanded to include everyone above 60 and those over 45 with specified co-morbidities.

    The development came as the vaccinations for those above 60 and those over 45 with underlying diseases crossed the 2.1-lakh mark. 

    When the second phase of the nationwide Covid vaccination drive started on Monday, the Centre had permitted only private hospitals empanelled under the Pradhan Mantri Jan Arogya Yojana, Central Government Health Scheme and state health insurances.  

    At an official review meeting with the states, the Centre reiterated there is no shortage of the vaccines and hence, adequate vaccine doses should be allocated to the COVID Vaccination Centres (CVCs).

    “The central government has adequate stock and will provide the required vaccine doses to the states and UTs,” it said.

    The Centre also urged the states to utilise 100% capacity of all private hospitals empanelled under the insurance schemes to enable them to effectively function as Covid vaccination centres.

    The states and the UTs were also told to ensure adequate allocation of COVID-19 vaccines to all hospitals, government as well as private, for the entire duration for which vaccination sessions have been planned.

    The states in consultation with the private hospitals should open vaccination slots for 15 days to a month and announce this as part of their vaccine time table, it added.

    “They have to ensure adequate allocation of vaccines to all hospitals for the entire duration for which sessions are planned.”

    The states and UTs were asked to regularly collaborate with the private hospitals to ensure that their optimum capacity for vaccination is utilised.

    “Private hospitals not empanelled under the above-mentioned three categories have also been permitted to operate as CVCs if they have an adequate number of vaccinators, adequate space for observation of the vaccinated, adequate cold chain arrangement and adequate arrangement for the management of Adverse Events Following Immunisation(AEFI),” the statement said.

    In addition to all the government health facilities, all private hospitals empanelled under the CGHS, the AB-PMJAY and the state health insurance schemes can function as CVCs, subject to them mandatorily adhering to certain norms, the statement said.

    All private vaccination centres should have effective crowd management protocols in place, along with facilities for seating, water, proper signage etc.

    They should also ensure adherence to COVID-appropriate behaviour among the beneficiaries.

    The state and district administrations would proactively facilitate this, the health ministry said.

    “Further, states and UTs in consultation with the private hospitals should open the vaccination slots for 15 days to a month and announce this as part of their Vaccine Time Table,” it added.

    Amid reports of lakhs still struggling to register and getting vaccination slots on CoWIN, authorities, meanwhile, insisted that the portal is equipped to handle a large number of users at a time.

    The portal can be scaled up to accommodate all potential and eligible beneficiaries. It should be put to effective use as the backbone of the vaccination programme, it further said.

    This information was shared by Union Health Secretary Rajesh Bhushan and Dr Ram S Sharma, the Chairman of the Empowered Group on Vaccine Administration (Co-WIN) and member, National Expert Group on Vaccine Administration of COVID-19 (NEGVAC), during a high-level review meeting with the additional chief secretaries, principal secretaries and secretaries of the health and family welfare departments of all the states and Union territories through a video-conference.

    They also reviewed the status and pace of the second phase of the countrywide COVID-19 vaccination programme.

    Ram Sewak Sharma, the CEO of the National Health Authority who also heads the empowered group on Covid vaccination, said that the glitches occurred since people started downloading the mobile app of CoWIN, which is only available to the administrators.

    “This made the app slow for one or two hours, but it picked up pace later,” he said, adding that it was a people-friendly system that will get better. 

    Meanwhile, the cumulative number of COVID-19 vaccine doses given in the country has crossed 1.54 crore which include 6,09,845 shots administered on Tuesday, the Union Health Ministry said in its provisional data.

    The countrywide vaccination drive was rolled out on January 16 with healthcare workers (HCWs) being inoculated against the virus.

    Vaccination of the frontline workers (FLWs) started on February 2.

    The next phase of COVID-19 vaccination commenced on March 1 for those who are over 60 years of age and for people aged 45 and above with specified co-morbid conditions.

    A total of 1,54,61,864 vaccine doses have been given, as per the provisional report till 7 pm, the ministry said.

    These include 67,32,944 HCWs who have taken the 1st dose and 26,85,665 HCWs who have taken the 2nd dose, 55,47,426 FLWs (1stdose), 828 FLWs (2nd dose), and 4,34,981 beneficiaries more than 60 years old and 60,020 beneficiaries aged 45 and above with specific co-morbidities, the ministry said.

    A total of 6,09,845 vaccine doses were given till 7 pm on Tuesday, the forty-sixth day of nationwide COVID-19 vaccination.

    Out of which 5,21,101 beneficiaries were vaccinated for 1st dose and 88,744 HCWs and FLWs received 2nd dose of vaccine as per the provisional report, the ministry said, adding final reports would be completed for the day by late night.

    (With PTI Inputs)

  • Coronavirus pandemic causes dip in utilisation of PM’s Jan Arogya Yojana

    Express News Service
    NEW DELHI: Less than half the money allocated for the Centre’s flagship health scheme Pradhan Mantri Jan Arogya Yojana has been utilised in 2020-21, as health services across the country suffered due to pandemic and lockdown, government data shows.

    As per the expenditure profile document of the Union Ministry of Health and Family Welfare, Rs 6,400 crore was allocated for the scheme before being revised to only Rs 3,100 crore as hospitalisation rates drastically fell March onwards.

    For the coming fiscal too, the government has estimated Rs 6,400 crore for the programme.

    Launched in September 2018, PMJAY provides for free secondary and tertiary hospitalisation of up to Rs 5 lakh for nearly 10 crore families across the country and covers 1573 procedures including 23 specialties.

    Officials in the National Health Agency said the massive fall in expenditure under it had been on account of the change in health seeking behaviour of listed beneficiaries during the pandemic period.

    “In several states, most of the functional hospitals had converted into Covid hospitals because of which services for other ailments took a beating,” said an official in the finance section of the NHA.She added that delay in release of funds by several states have also been a major concern.

    “We release central share only after the state contributes its share and that equation got disrupted due to the pandemic.”

    The latest economic survey tabled in the Parliament said that general care-seeking as seen in the PMJAY claims exhibited a V-shaped recovery after falling during the lockdown but has reached the pre-Covid levels in December 2020.

    A report titled “PM-JAY Under Lockdown: Evidence on Utilization Trends PM-JAY” by the NHA released in June had said that women, children and the elderly were hit worse than men. While cancer treatment fell by nearly 64 per cent, child birth- both normal deliveries and Caesarean Sections — fell by 26 %, the report revealed.

    Also, there was wide variation in claim volume trends across states, with the steepest declines (over 75 per cent) in Assam, Maharashtra and Bihar, while much smaller declines (about 25 per cent or less) were observed in Uttarakhand, Punjab and Kerala.  

    Under the scheme, general medicine has been the overwhelmingly major clinical specialty used since 2018, with its share continuously growing. 

  • Worry for government? Economic survey finds poor service in private hospitals

    Express News Service
    NEW DELHI:  Despite push from the government for promotion of privatisation in the health sector, the latest Economic Survey has underlined the poor quality of service in private hospitals and suggested setting up agencies to assess the quality of doctors and hospitals.

    As per the report tabled in Parliament on Friday, while the share of public institutions has increased both in hospital and outpatient care, the private sector dominates in total healthcare provision in India.

    Around 74 per cent of outpatient care and 65 per cent of hospitalisation care is provided through the private sector in urban India.

    Citing a research study, the report highlights that a large proportion of deaths in India manifests due to poor quality of healthcare than insufficient access.

    ALSO READ | Focus on growth, don’t worry about Fiscal deficit: CEA Subramanian on road ahead for Indian economy

    To understand the difference in quality between the public and private sector providers, data from the Centre’s flagship Pradhan Mantri Jan Arogya Yojana has also been used.

    The data show that mortality rate for neonatal procedures is much higher in private hospitals than in public hospitals — 3.84 per cent and 0.61 per cent, respectively.

    Also, public sector patients get readmitted to the same hospital 64 per cent of the time versus 70 per cent for private hospitals.

    “So, a large proportion of deaths in India manifesting due to poor quality of healthcare is likely to reflect that the quality of treatment in the private sector may not be significantly better than that in the public sector in India,” says the report.

    ALSO READ | Services sector likely to contract by 8.8 per cent in FY21 despite record 34 per cent jump in FDI inflows: Survey

    The report also says the problem of asymmetric information in healthcare is reflected in the substantial variation in costs for treating the same disease between the public and private sector.

    As argued above, the quality of treatment in the private sector does not seem to be markedly better when compared to the public sector.