Delhi AIIMS directs to provide seamless healthcare services to AB-PMJAY beneficiaries

New Delhi: Taking note of the issues being faced in the implementation of the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) at the premier health institution, the All India Institute of Medical Sciences (AIIMS), New Delhi, Director Dr M Srinivas directed to provide seamless services to patients.

The need for mandatory biometric authentication at the time of patients' discharge was stressed at a recently held meeting at the AIIMS, Delhi to address the challenges of effective execution of the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana. 

The nursing staff were directed to ensure that Pradhan Mantri Arogya Mitras (PMAMs) at the Ayushman Kendra are informed and authentication is carried out before the patients are discharged.

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Accountability measures for non-compliance were emphasised, the AIIMS said in a statement.

AIIMS Delhi Director Dr M Srinivas convened the meeting recently to discuss and tackle the issues hampering the effective execution of the Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) at the premier hospital.

The meeting brought together key stakeholders and experts to deliberate on the challenges and formulate a roadmap for overcoming them, the AIIMS said.

The meeting delved into several key points and a consensus was reached on some crucial matters.

The issue of cost disparity between estimates provided by the treating doctors and the approved PMJAY health benefits package was discussed.

The departments were urged to explore ‘Make in India’ implant options to align with package rates without compromising the quality.

The increasing trend of sending investigations outside the AIIMS was highlighted. It was proposed that AIIMS conduct all relevant investigations in-house to reduce costs and enhance service quality, the statement said.

It was decided that PMJAY beneficiaries prescribed oral chemotherapy in the OPD or daycare settings must receive the prescribed drugs without hindrance.

The nursing officers were instructed to facilitate drug issuance based on approved PPD (Per Patient Day) the day before dispensing.

The nursing and medical record officers were tasked with ensuring proper scanning of the medical records and uploading barcodes/stickers of surgical consumables onto the TMS portal for efficient claim processing.

The Heads of Departments (HODs) were urged to ensure cooperation between the residents and PMJAY staff for timely access to necessary investigation reports, expediting the claim submission process.

The departments were directed to swiftly implement organ and tissue transplant and onco-anaesthesia and palliative medicine specialties as part of the Health Benefit Package (HBP) 2022.

Concerns about undue pressure on the PMAMs and Patient Care Managers (PCMs) due to delays in pre-authorisation for unspecified packages were raised. The stakeholders were reminded to avoid unnecessary harassment of the PMAMs and PCMs, the statement added.

Efforts were focused on minimising local purchases for the PMJAY beneficiaries through in-house mechanisms and rate contracts.

Streamlining the reimbursement process for the PMJAY beneficiaries treated within the departments was stressed while emphasizing the need for proper budgetary justification.

The instances of abrupt pre-authorization cancellations by the State Health Agencies (SHAs) were noted and the stakeholders were called upon to cooperate in managing these cases.

The departmental heads were entrusted with ensuring successful implementation of PMJAY across all units within the AIIMS and extending equal treatment to all entitled beneficiaries.

Dr Srinivas urged all stakeholders to collaborate and resolve the challenges faced in AB-PMJAY implementation to provide seamless healthcare services to deserving beneficiaries.

The concerted efforts of all involved will undoubtedly lead to the successful realization and implementation of the scheme’s objectives at the AIIMS, New Delhi, he said.