In a first, Uttar Pradesh has been selected as the ‘most improved state’ under the National Health Insurance Scheme (NHIS). The award would be handed over to Alok Kumar, the scheme’s CEO in the state, at a function in Thiruvananthapuram on April 8.
Official sources said that the government took pride in the award as the state was till now infamous for corruption and poor showing in the crucial health sector, especially after the multi-crore scam in the National Rural Health Mission (NRHM) during the Mayawati government.
Barabanki, in neighbouring Lucknow, is being awarded for the work initiated in the district, while the Uttar Pradesh Rural Institute of Medical Sciences and Research in Saifai – the native village of Chief Minister Akhilesh Yadav – has been rewarded for good work as an independent hospital.
Compared to the first phase of the scheme, more than 25% of the below poverty line (BPL) population has been assimilated in the scheme and smart cards for over 48 lakh families have been made.
‘As part of course correction, undertaken as part of the inferences drawn from the first phase of the scheme where the claims were not attended to by listed hospitals due to tardy payment schedules, the anomalies were weeded out by the help of technique and weekly reviews and a server was established at the state level.
‘The intervention and initiative saw miraculous results of the claims made by listed hospitals, as many as 74% were settled within 30 days,’ said an official.
A total of 1,486 hospitals – 823 private and 663 government – have been listed so far under the scheme. The scheme, kick started to benefit the BPL families as per the 2002 census, provides a smart card at a basic fee of Rs 30 which is used to meet all administrative expenses incurred in the scheme.
The field key officer (FKO) is named for the completion of the nomination process in which a family, with considered unit of five, is listed on the smart card.
Smart card holding families are entitled to a sum of Rs 30,000 for one year and treatment for a total of 1,090 pre decided diseases/packages is available through indoor patient facilities. The scheme also entails giving of food and Rs100 per day for transport on discharge from hospital subject to a maximum of Rs 1,000 in a year. 75% of the annual premium on the scheme is borne by the central government and the remaining 25% by the state government.
The hitherto used 32 kb card has been replaced by a 64 kb card so that the beneficiaries can avail the benefits of both the state and central schemes. The cost of a smart card is separately borne by the central government.
Till March 31, 2013, officials pointed out, 48 lakh smart cards have been made in Uttar Pradesh and nomination process is underway in 21 districts, by the end of which 58 lakh beneficiary families are likely to be assimilated in the scheme.