Dr. Harsh Vardhan, Union Minister of Health and Family Welfare today launched the revamped Central Government Health Scheme (CGHS) and the Umbrella schemes of Rashtriya Arogya Nidhi (RAN) and Health Minister’s Discretionary Grant (HMDG) on National Health Authority (NHA)’s IT platform in the presence of Shri Ashwini Kumar Choubey, Minister of State for Health and Family Welfare.The Union Health Minister was delighted to inform everyone present thatthis was a solid step towards digitalization of healthcare services: “It was one of my dream initiatives and I have been waiting to see the launch of these schemes on NHA’s IT platform. This will enable seamless delivery of healthcare services to eligible beneficiaries under these schemes by making whole process paperless.”He said that in his 28 years of public service, he had always encountered marginalised people in need of treatment. The delay of cash on account of the High Out of Pocket Expenditure often deferred the treatment which proved fatal in critical cases like those involving cancer.Dr. Harsh Vardhan observed that he personally knows many people who have not been able to avail the entitlement benefits despite presence of well-intended government schemes. Due to lack of timely intervention through these schemes, delayed response and hurdle in these cases, the poor and needy people were not able to avail the benefits of the health schemes on time. Dr. Harsh Vardhan noted that these bureaucratic hassles stood in the principles of Antyodaya espoused by Shri Deendayal Upadhyay.He lauded the visionary leadership of Prime Minister PM Shri Narendra Modi for using technology for welfare delivery to citizens envisaged under Digital India: “Just like the Technological interventions in opening bank accounts, Public Financial Management System (PFMS), subsidies through Direct Benefit Transfer (DBT), Ayushman Bharat scheme for paperless treatment of patients, today’s initiative of convergence of CGHS, RAN and HMDG with NHA platform is also designed to with the vision of making the healthcare services available transparently and swiftly to the needy citizens.” He acknowledged the contributions of Shri Indu Bhushan, Former CEO, NHA whose work and recommendation laid the foundation for today’s development.
The Union Health Minister remarked that the CGHS, a comprehensive Health Scheme for Serving Employees, Pensioners, Members of Parliament, ex-MPs, etc., and their dependent family members, during last 7 years has expanded to 72 Cities with more than 38 lakh beneficiaries are covered under the scheme. He noted that although CGHS started in 1954 in New Delhi, wherein till 2014 only 25 cities were covered. CGHS retired pensioners are provided Cashless treatment at empanelled centres which will now be made seamless in the new platform. The present Unit Trust of India Infrastructure Technology and Services Limited (UTI-ITSL) bill clearing platform will run concurrently till midnight of 10/11 June 2021 to ensure that the CGHS pensioner beneficiaries don’t have face any inconvenience.Dr. Harsh Vardhan noted that e-referral module developed by NIC has enabled CGHS dispensaries and wellness centres to issue online referral to empanelled hospitals. The hospital’s processing of application, submission of claims, CGHS team’s sanctioning, release of payment would be done online on the platform henceforth.Dr. Harsh Vardhan informed that under RAN, financial assistance up to Rs 15 lakhs is provided to poor patients suffering from major life-threatening diseases/cancer/rare diseases, for medical treatment at Government hospitals. The eligibility criteria to avail services under RAN had been based on State/UT-wise BPL threshold. But getting a state specific BPL certificate from competent authority has remained a time-consuming process. Similarly, under HMDG a maximum amount of Rs.1,25,000/- is provided to patients whose annual income does not exceed Rs.1,25,000/-, to defray a part of the expenditure on hospitalization/treatment in Government Hospitals.
Beneficiaries can apply for financial assistance under both schemes by providing their Ration card number and undergoing beneficiary verification process at any of the empanelled Govt. hospital. Their application will be processed in-house by the respective hospital and treatment can be started. On submission of the treatment details by the respective hospital, claims will be processed and payment would be released.Shri Ashwini Kumar Choubey called the digitized versions of the Flagship schemes a gamechanger and said, “It is extremely important moment today that from now onwards existing beneficiaries of RAN/HMDG and CGHS will not have to run from pillar to post. For the last three years, I used to feel pained whenever I used to see RAN files and the assistance could not be provided to the eligible beneficiary in a fix time manner and this led to delay/denial of treatment under the scheme for needy people.” He expressed his elation that AB PM-JAY beneficiaries would be able to avail the benefit under RAN scheme for the treatment beyond five lakhs that are not covered under the scheme. He noted that other similar schemes are being planned to be rolled out on NHA’s IT platform and will help in better utilization of resources, de-duplication of beneficiaries, standardized service delivery and will lead to economies of scale.Dr R.S. Sharma, CEO, National Health Authority stated that verification of beneficiary’s identification, pre-authorization and their claim settlement through our IT system can now be carried out without any physical movement of files.Shri Rajesh Bhushan, Union Health Secretary joined the event digitally. He congratulated the NHA for this feat which would set an example for digitization of services.Dr. R. S. Sharma, CEO, National Health Authority (NHA), Dr. Dharmendra Singh Gangwar, Additional Secretary and Financial Adviser (Health), Shri Alok Saxena, Additional Secretary (Health), Dr. Sunil Kumar, Director General of Health Services,Dr. Vipul Agarwal, Deputy CEO, NHA and other senior officials were present at the event in person.