Media Reports vs. Facts: Understanding AB PM-JAY Beneficiary Treatment
Media reports have claimed that beneficiaries of the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY) have availed treatment even after being declared dead on the system. However, these reports are based on misconceptions and require clarification.
Pre-Authorization and Patient Admissions: Clarifying the Timelines
It is important to understand that under the AB PM-JAY, hospitals are allowed to initiate a pre-authorization request up to three days after the patient’s admission. Unfortunately, in some cases, patients pass away during treatment before the pre-authorization request can be raised. This unfortunate occurrence does not indicate fraud or misuse of the system.
Dual Hospital Usage: The Role of Ayushman Cards Explained
Reports of beneficiaries availing treatment in two hospitals simultaneously often involve children up to 5 years old using their parents’ Ayushman Cards. For instance, a mother admitted for treatment may deliver a baby, which might require care in a different hospital. Such cases lead to the apparent use of a single card for two patients.
Mobile Numbers and Beneficiary Identification: A Limited Role
Contrary to assumptions, mobile numbers play a limited role in beneficiary verification for AB PM-JAY. The program primarily uses Aadhaar-based e-KYC for identification. While mobile numbers are captured for communication purposes, they are not pivotal to beneficiary eligibility.
Strengthening the System: Addressing Concerns and Recommendations
In response to the recent Comptroller and Auditor General of India (CAG) report, the National Health Authority and Ministry of Health & Family Welfare are taking measures to enhance the AB PM-JAY system. The objective is to ensure the platform’s robustness, efficiency, and prudent functioning.
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