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NHPS: Government allocates Rs 10,000 crore to implement 'Modicare' during 2018-19

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NHPS, known unofficially as ‘Modicare’ is expected to provide 100 million poor and vulnerable families cover of up to Rs 5 lakh for secondary and tertiary treatment.
NHPS, known unofficially as ‘Modicare’ is expected to provide 100 million poor and vulnerable families cover of up to Rs 5 lakh for secondary and tertiary treatment.

The government has decided to allocate Rs 10,000 crore initially to implement the Ayushman Bharat-National Health Protection Mission (AB-NHPM), health minister JP Nadda said on Thursday.

This amount is flexible and will be used to cover costs of setting up technology systems and verifying entitled beneficiaries in addition to paying premiums to states that are implementing the scheme through insurance models, the minister told reporters at a press briefing.

The Union Cabinet had approved the launch of the centrally sponsored scheme on Wednesday evening.

While the minister said that the allocation was for 2017-18 and 2018-19, some officials ET spoke to said the fund was actually approved for the period 2018-2020. This translates to an allocation of around Rs5,000 crore to implement the scheme annually.

“They (the cabinet) have approved this scheme for two years with a central share of Rs10,490 crore,” a senior government official said on condition of anonymity. “The outgo on the premium will be less because the scheme will start later.”

This fund for the scheme is likely to come from the additional 1% health cess announced in the union budget, separate from the Rs 85,217-crore budgetary support approved by the union cabinet for the National Health Mission upto March 2020, said health ministry officials at the briefing.

AB-NHPM aims to provide 100 million poor and vulnerable families up to Rs 5 lakh cover for secondary and tertiary care and expects to reduce patient hospitalisation expenditure. Finance minister Arun Jaitley, in his budget speech on February 1, had billed the scheme as the world’s largest government-funded healthcare programme.

The health ministry has laid out a four-month timeline to ensure the scheme is ready for implementation in all states at the same time, said the officials.

By July-end, the ministry will have worked out operational guidelines for states, trained district officials, awarded tenders, empanelled hospitals and finalised the types of treatment packages that AB-NHPM is applicable to, the health minister said.

The ministry will also authenticate the data provided in the Socio-Economic Caste Census 2011 with the rural development ministry to update the information to identify true beneficiaries for the scheme, Nadda said.

By then, the ministry would also have made operational the National Health Agency to manage the scheme’s implementation at the central level and carried out zonal meetings with states to fine tune the system, he said.

In July, the ministry will also start testing the IT system for the scheme, which includes safeguards to prevent its fraudulent use, in different states, he said.

“This is a new scheme. We’ve included all the learnings of RSBY. We’ve included all the learnings of the States who had their own independent (programmes in preparing it),” said Nadda.

The minister, however, did not clarify on the insurance premium rates the government was seeking, but added that budget would not be a problem as more funds can be infused if required.

When the scheme was announced, the government estimated it to cost around Rs 10,000 crore annually. Government think tank Niti Aayog estimated the premium alone to be Rs 1,000-1,200 per family, translating to Rs 10,000- Rs 12,000 crore for all.

Nearly 1,350 procedure packages, including packages for cancer care, are currently being finalised and will include elements such as cost of medicines required in treatment, said health secretary Preeti Sudan.

In the first phase, the packages will not include organ transplants, she said.

The government intends to provide family cards with unique QR codes to the scheme’s beneficiaries, she said. It also intends to gradually encourage states starting with insurance models to opt for trust models, Sudan said.

The expenditure incurred in premium payment would depend on actual market-determined premiums in the regions where it will be rolled out, the government had said in a press statement following the cabinet nod.

AB-NHPM is expected to rein in patient hospitalisation expenditure, which has increased nearly 300% over the last decade in India, according to a release about the cabinet’s approval.



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