Government proposes rates for over 1,000 treatments under Ayushman Bharat scheme

The government has proposed rates of over 1,350 treatments ranging from Rs 1,000 to Rs 1.5 lakh under the PM Modi's flagship health protection scheme — Ayushman Bharat.

The government issued a 205-page draft model tender document on Wednesday for the Pradhan Mantri Rashtriya Swasthya Suraksha Mission, according to a report in The Times of India. On the basis of this document, states can now select insurance companies for the scheme, which promises up to Rs 5 lakh cover for 10 crore poor families in the country.

Rates of treatment under the government-sponsored National Health Protection Scheme (NHPS), is around 15-20 percent lower than that of Central Government Health Scheme (CGHS). The CGHS provides comprehensive medical care to government servants, pensioners and their dependants.

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“There was a very rigorous process used (to decide the package rates). We looked at packages including CGHS, packages from all different states and our experience with RSBY. Based on that, the first draft was prepared and peer-reviewed by Niti Aayog,” Indu Bhushan, CEO of Ayushman Bharat National Health Protection Mission told  The Economic Times.

The documents lists the rates for over 20 specialties like cardiology, cancer care, neurosurgery and neo-natal care depending on the type of therapeutic category and procedure. For instance, the rate for an orthopaedic procedure like application of skin traction has been set at Rs 1,000, while aortic arch replacement under cardio thoracic surgery would be Rs 1.60 lakh.

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These rates, however, are flexible and states may make further changes. "These (guidelines) are only indicative. States have been given the flexibility to look at them and they may make some changes," Bhushan said.

Bhushan added that the states would start this process in a couple of weeks as the scheme would be rolled out in August.

Hospitals accredited by the National Accreditation Board for Hospitals and Healthcare Providers (NABH) will be allowed to charge 10-15 percent more than the rates set in this document.