"As per the implementation plan, 1,20,000 community health officers will be placed at the SHC level AB-HWCs by 2022," Choubey told Rajya Sabha.
The Ayushman Bharat - Pradhan Mantri Jan Arogya Yojana (AB-PMJAY, which aims to provide health cover of Rs 5 lakh per family per annum to around 10.74 crore poor and vulnerable families, has created impact towards generation of employment, both short term and long term in nature, Choubey said.
The hospitals empanelled under the scheme are required to have 'Pradhan Mantri Arogya Mitras' for managing the helpdesk and other related activities.
Further, implementation of the AB-PMJAY will lead to increase in demand of healthcare, both in public and private hospitals, resulting in increased demand of doctor, paramedics and all professional jobs which are necessary for setting up and augmentation of health infrastructure, the minister said.
The design of AB-PMJAY is robust and implementation during the first year has been successful, he said.
However, awareness under the scheme needs to be increased to improve the reach of the scheme. The access to quality health care services can be improved by empanelling more private hospitals across all the geographies. Also, capacity needs to be continuously improved at all levels of implementation, Choubey said.
States and UTs are being regularly oriented on the challenges in the implementation of AB-HWCs.
Elaborating the steps taken for effective implementation of the AB-PMJAY, the minister said the health insurance scheme is being governed on a zero-tolerance approach to any kind of fraud.
It covers entire gamut of activities for prevention, detection, and deterrence of different kinds of fraud that could occur in the PMJAY at different stages of its implementation.
A comprehensive set of anti-fraud guidelines from the time of launch of the scheme has been out in place.
All packages prone to fraud are reserved for public hospitals or need mandatory pre-authorization and require detailed documentation before claims are paid.
As any set pattern of fraud is found, the guidelines are further tightened and additional safeguards are included to plug the loopholes.
A National Anti-Fraud Unit (NAFU) has been created for overall monitoring and implementation of anti-fraud framework supported by State Anti-Fraud Units (SAFU), the minister said.
For beneficiary empowerment, they are made aware and educated about their rights -- how to avail free benefits, what to expect, and where to report grievance for denial of treatment, charging of money by hospital, etc.
The process involves system-based messages to each beneficiary at the time of creation of his/her e-card, hospitalisation and discharge. Feedback is captured through outbound calls, and post-paid letters after the treatment. Beneficiaries can call 14555 a 24x7 toll free helpline number if they face any issues during treatment.
The transaction data is monitored on real time basis through dashboards and regular joint medical audits of hospitals are undertaken with the State Health Agency (SHA), both random and purposive, to identify any wrongdoing.
More than 350 hospitals have been served show-cause notice/suspended/de-empanelled in different states so far, Choubey said.
A close watch is also maintained on wrongful enrolment of beneficiary and over 4,000 common service centres and Pradhan Mantri Arogya Mitra IDs have been deactivated in 21 states, he added.
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