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New differential pricing proposed for Ayushman Bharat-PMJAY; medical colleges, large private hospitals to be top gainers

Since the launch of the Pradhan Mantri Jan Aarogya Yojana in 2018, the 'low' rates offered for the treatment packages under the scheme have been a major issue of contention between private hospitals and the government. On a few occasion, the rates have also been revised but the hospitals now want a complete overhaul

March 29, 2022 / 06:02 PM IST
Representative image (Source: Reuters)

Representative image (Source: Reuters)

Ahead of announcing new rates for the packages offered under the Centre’s flagship health insurance scheme Ayushman Bharat-Pradhan Mantri Jan Aarogya Yojana (PMJAY), the National Health Authority (NHA) has unveiled a new pricing policy far removed from the current regime.

Under the new plan, medical colleges and private sector tertiary hospitals are set to be the biggest gainers, followed by secondary hospitals in tier 1 and 2 cities.

A concept paper on the new policy, released last week by the NHA, which operationalises PMJAY, showed that in a first, hospitals will be allowed to charge a differential price based on the services they offer and the cities they are located in.

Under the PMJAY scheme, about 50 crore Indians or about 10 crore families categorised as most impoverished, are offered cashless benefits for secondary and tertiary care of up to Rs 5 lakh per person per year.