Pune Charitable Hospitals asked to implement MJPJAY Health scheme

Pune: Health activists across Pune have welcomed the recent directive asking charitable hospitals in the city to implement the Mahatma Jyotirao Phule Jan Arogya Yojna (MJPJAY), a state-run health insurance scheme aimed at providing free and quality healthcare to the economically weaker sections.

The directive follows the tragic death of Tanisha Bhise, which prompted the Maharashtra government to constitute an inquiry committee headed by Rajani Kshirsagar. The panel emphasised the need for charitable hospitals to extend the benefits of state-sponsored health schemes like MJPJAY and the National Child Health Programme to the poor.

Medical Dialogues had previously reported that in the wake of the tragic incident at Deenanath Mangeshkar Hospital in Pune, where a mother of twin babies lost her life reportedly being denied admission, the Maharashtra government has made it mandatory for all charitable hospitals in the state to enroll in government health schemes. These include the Mahatma Phule Jan Arogya Yojana (MPJAY), the Pradhan Mantri Jan Arogya Yojana (PMJAY), and the National Child Health Programme.

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According to the news reports, an official from the Charity Commissioner’s Office stated that the state, through a Government Resolution (GR) issued in April, had directed charitable hospitals to implement the Mahatma Jyotiba Phule Jan Arogya Yojana (MJPJAY) and other health schemes. Charitable hospitals in Pune had been asked to initiate the procedure for implementation, and many had already begun the process. The implementation is currently under review.

Under Ayushman Bharat - Pradhan Mantri Jan Arogya Yojana, beneficiaries receive cashless health coverage of up to ₹5 lakh per family per year, applicable for more than 1,200 treatments. Additionally, the scheme provides a separate insurance cover of ₹1.15 lakh per family, offering comprehensive protection for Maharashtra’s population.

The scheme provides end-to-end cashless and quality medical care for identified secondary and tertiary conditions that require hospitalisation, through a network of empanelled hospitals.

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According to the Pune Mirror, Deepak Jadhav, a health activist, welcomed the step, saying, “The MJPJAY is not implemented in charity hospitals in Pune and Mumbai. This should have been done earlier only. Charity hospitals take benefits of various government schemes but don’t give back to patients. Implementation of MJPJAY and Ayushman Bharat at charity hospitals will benefit poor people across the state. Currently, there are many schemes for poor patients like MJPJAY, Ayushman Bharat, and Urban Poor Scheme. But all these schemes are not centralised. With centralisation of these schemes, no poor will leave without treatment.”

However, Dr Abhay Shukla, national co-convener of Jan Swasthya Abhiyan, expressed both hope and caution. Speaking to Pune Mirror, he said, “There are issues with charitable hospitals providing free care to the needy. Without solving existing problems, adding additional schemes to charitable hospitals can increase more problems. However, this can have a positive impact as under MJPJAY, range of care is limited. While under charitable hospitals, complex care is available for patients. Thus, patients in need will get more range of care under the decision.”

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He added that it should be clearly defined whether treatments under MJPJAY at charitable hospitals would be provided free of cost or if the hospitals would receive a refund from the government.

Dr. Sanjay Patil, Chairman of the Hospital Board of India, Pune, noted that while some hospitals support the scheme, others are opposed to it. The rates fixed by the government are significantly lower than the actual cost of treatments in private hospitals.

He also highlighted bureaucratic delays, stating that the government reimburses private hospitals very late. He further suggested that the government should consult organizations like the Indian Medical Association when determining the cost of treatment.