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  • RGJAY Formulated After a Lot of Research

RGJAY Formulated After a Lot of Research

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Public health minister Suresh Shetty on Wednesday reiterated that the Rajiv Gandhi Jeevandayi Arogya Yojna (RGJAY) is one of the finest schemes that the state government has brought in the health sector.

Its first phase, launched in 2011 in eight districts including two from Vidarbha (Amravati and Gadchiroli), has benefited 1.5 lakh patients (25–28% cardiac and 28% oncology). In the next phase to be launched by UPA chairperson Sonia Gandhi in the city on Thursday, all the 27 districts will be covered.

"The scheme has been formulated after a lot of research and the rates fixed for each procedure are not at all inadequate as is being claimed by private practitioners. The propaganda that big private hospitals are withdrawing is farce. In fact, the department has requests flowing every day for affiliation in the scheme," he told TOI.

He categorically said a 'no' to the demand of a grant by private hospitals to compensate for the low rates. The new scheme will ensure refund of all the expenses made by hospital under the scheme which was not the case with earlier Jeevandayi Yojna. The only aspect that Shetty told TOI will be looked into is possibility of a revised rate plan for paediatric cardiac surgeries.

RGJAY Formulated After a Lot of Research

Reacting to the objections on closure of Rashtriya Swasthya Bima Yojna (RSBY) Shetty clarified that it was being done just to avoid duplication. For disease like pneumonia, diarrhoea, fever etc which are not covered under RGJAY, he said these diseases can be treated at government medical colleges free of cost for BPL patients.

Earlier, the state minister Fauzia Khan speaking to TOI said that it was the duty of corporate and charitable hospitals to stay out of profiteering. Government gives a lot of sops to them in the form of land, tax benefits etc. In return asking them to conduct certain procedures at less cost is nothing wrong. But she offered to reconsider the issue of revising RSBY.

Box – The Sickle Cell Society requests Sonia Gandhi to ensure launch of national sickle cell control act and treatment acts in Maharashtra in all districts. He has also requested her to include sickle cell under the 'right of persons with disabilities' act

Features of Rajiv Gandhi Jeevandayi Arogya Yojna
  • A health insurance policy scheme for BPL and Above Poverty Line (excluding white card holders) with National Insurance Company as insurer.
  • All transactions to be cashless and online and online claim statements within 15 days of application by hospitals.
  • To cater for 2.11 crore people with less than Rs 1lakh or less annual income in all 27 districts.
  • Insurance based scheme with Rs333 premium to be paid entirely by state government.
  • Health cards to be issued to beneficiaries for identification soon. Until then, ration cards and other ID proofs to be used.
  • 971 surgeries/therapies/procedures from 30 specialties excluding knee and hip joint replacements.
  • The upper limit of all procedures is Rs1.5 lakh (per family) and for kidney transplant it is Rs2.5 lakh.
  • In first phase total 144 hospitals were empanelled while in second phase this number will go to 222 which is later expected to rise to about 370.
  • To cover all pre–existing diseases.
  • Beneficiaries can register their complaints on 155388 or 18002332200.
  • Arogya mitras to help patients round he clock in all empanelled (govt and pvt) hospitals.
  • A one month run–off period will be allowed after expiry of policy.
  • 350 doctors and non doctors to work 24X7 to monitor the scheme which includes issuing clearances, cross checking diagnosis and treatment modalities and results. Documents of pre–psot treatment documents to be submitted online.
  • Telephonic approval for emergency patients.
Source
Times of India
21 November 2013,
Nagpur, India
by - Snehlata Shrivastav

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