Health Protection Scheme: Govt Proposes Rates for Treatment
The plan is likely to be launched by August, the registration for hospitals expected to begin by June 15
The government has proposed rates for more than 1,350 treatment packages ranging from 1000 rupees to more than 1.50 rupees per lakh, for the Pradhan Mantri Rashtriya Swasthya Suraksha mission. On Thursday, the government issued a 205-page tender document, making the prime minister’s ambitious health protection plan a step closer to implementation. The rates proposed to depend on the type of treatment and procedure.
The document is expected to help countries choose insurance companies for the program, which covers up to 5,000 rupees for 100 million poor families in the country. More than 20 specialties such as heart disease, cancer care, neurosurgery, neonatal care have been covered in the draft. For example, the rate of orthopedic surgery was set as the application of skin traction at Rs 1,000, while the aortic replacement under heart and chest surgery would be Rs 1.60.
Some 610 of the 1,354 listed parcels will be authorized for pre-authorization by the insurance company, according to the project. Hospitals accredited by the National Accreditation Council for Hospitals and Health Care Providers (NABH) will be allowed to impose 10-15% more than the rates set out in this document.
Packages including CGHS
The insurance company does not incur any payments under the policy of expenses incurred under conditions that do not require hospitalization, external congenital diseases, fertility procedures, vaccines, suicide and fixed plant status. “There was a very rigorous process (package prices decided) . We looked at packages including CGHS, packages from all different countries and our experience with RSBY.” Accordingly, the first draft and peer review were prepared by Niti Aayog.
We hope that states will start this process within two weeks,” he said. Adding that the plan would be ready for work by August.