The revised version of Health Benefit Packages (HBP 2.2) will see rates of some health packages increase by 20% to 400% under the Pradhan Mantri Jan Arogya Yojana (PM-JAY). The National Health Authority (NHA), the apex body for implementing Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY) has revised the rates of over 400 Health Benefit Packages (HBP), besides adding a new medical management package related to black fungus.

“I am glad that the revised version of Health Benefit Packages (HBP 2.2) will strengthen the empanelled hospitals to provide better healthcare services to beneficiaries under Ayushman Bharat PM-JAY. The revised packages for oncology will enhance cancer care for beneficiaries in the country. Addition of new packages related to black fungus will be a huge relief to beneficiaries. I am sure that the rationalised HBP will further improve the uptake of schemes in private hospitals, leading to reduced out-of-pocket expenditure for beneficiaries,” Union minister of health and family welfare Mansukh Mandaviya said while announcing the new rates on Tuesday.

NHA CEO R.S. Sharma said the authority constantly works on the feedback received from stakeholders for rationalisation of health benefit packages. “Since the inception of the AB PM-JAY scheme, new packages have been added to cover more disease conditions and regular rates of the packages are being revised to provide better healthcare services.”

According to the NHA, the rate revision has been done in categories, including radiation oncology procedures, medical management procedures such as those for dengue, acute febrile illness etc, surgical package treatment for black fungus, and other procedures like right/left heart catheterisation, PDA closure, arthrodesis, cholecystectomy, appendicectomy etc.

Under medical management procedures, rates for ICU with ventilator have been revised by 100%, rates for ICU without ventilator by 136%, rates for HDU by 22%, and prices for routine ward by 17%. The HBP 2.2 is expected to be rolled out from November, 2021, NHA said in a press release.

AB PM-JAY currently has 1,669 treatment procedures, out of which 1,080 are surgical, 588 medical, and one unspecified. The target is to achieve universal health coverage and provide access to free and affordable healthcare services to citizens in the remotest of the areas.

In 2018, AB PM-JAY was launched with HBP 1.0 with a total of 1,393 packages. The scheme aims to provide free and cashless healthcare services up to ₹5 lakh per family per year to over 10.74 crore poor and vulnerable families (over 53 crore beneficiaries), according to the Socio-Economic Caste Census (SECC)-2011 database.

Since the inception of the scheme, more than 2.2 crore eligible AB PM-JAY beneficiaries have been provided with health coverage for secondary, tertiary and day care procedures for treatment of diseases and medical conditions through a vast network of 24,000 Empanelled Health Care Providers (EHCP).

HBP’s are designed to cover diseases with high incidence/ prevalence rates and diseases which contribute to the maximum out-of-pocket expenditure.

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