Bid to improve implementation of health insurance scheme
- A joint working group (JWG) comprising senior officials from IRDAI and National Health Authority (NHA) has been formed to recommend measures to help improve the implementation of the Centre’s Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) or the health insurance scheme for the poor.
- The 11-member group, with NHA Deputy CEO Dinesh Arora as the chair and lRDAl Executive Director Suresh Mathur as the co-chair, would submit a report on various aspects pertaining to network hospitals’ management; data standardisation and exchange; fraud abuse and control; and common IT infrastructure for health insurance claims management.
- The JWG would define hospital infrastructure and facility audits to understand capacity of hospitals as well as specialists availability and chalk out a roadmap for one common list of accredited verified hospitals for the entire industry.
- Under the fraud and abuse control component, the JWG would make recommendations in six months to help detect and deter frauds through a common repository and capacity-building.
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