ITANAGAR, 27 Jun: The Chief Minister Arunachal Arogya Yojana (CMAAY), which provides health insurance coverage to the citizens of the state, is gradually spreading its presence across the state.
The CMAAY has been merged with the Pradhan Mantri Jan Arogya Yojana (PMJAY), a similar scheme of the government of India that aims to help economically vulnerable Indians who are in need of healthcare facilities.
Till now 99,147 families have enrolled under the CMAAY and the PMJAY, which cover 4,30,308 people in the state. The ICR, followed by Upper Subansiri and East Siang districts have witnessed the maximum enrollment. Altogether 8,604 people have availed benefits amounting to Rs 20,93,20,716.
Several major hospitals across India have been empanelled under this. The RKM Hospital in Itanagar, TRIHMS in Naharlagun and Bakin Pertin General Hospital in Pasighat, along with 32 other government hospitals are empanelled within the state.
To cater tertiary care, 27 hospitals outside the state have also been empanelled. Some of the reputed hospitals empanelled under the CMAAY are the CMC in Vellore, the NEIGRIHMS in Shillong, DY Patel Hospital in Mumbai, the GNRC, B Borooah Cancer Institute in Guwahati, etc.
CMAAY CEO Dr Nabam Peter informed that the Chief Minister Arogya Arunachal Society has been set up by the state government for efficient implementation of the scheme. The governing body of the society is chaired by the chief minister, with the health minister as its vice chairman, and the executive committee of the CMAA Society is chaired by “the head of department in health, with the CEO of CMAAY as member secretary, along with other members,” Dr Peter said.
He also gave a brief account of how the idea of health insurance came to the forefront in the state. “The establishment of a state illness assistance fund under the Rashtriya Arogya Nidhi of the union health & family welfare ministry, with 50 percent of the contribution made by the state government in 1996, seeded the idea of health insurance, which led successive chief ministers to tinker around with a scheme for the poor.
“Gegong Apang took the initial steps in 2006 when he was the chief minister, but it couldn’t materialize due to lack of in-house experts. The idea took shape in 2012, when a token amount of Rs 3 crores was allotted in the annual operating plan
of the state budget for the 2012-13 financial year and a committee of secretaries was set up at the behest of the then chief minister Nabam Tuki,” Dr Peter said.
This committee took cues from similar successful schemes like Rajiv Arogyasri of Andhra Pradesh and the Tamil Nadu Chief Minister’s Comprehensive Health Insurance Scheme, and issued the policy for the Arunachal Pradesh Chief Minister’s Universal Health Insurance Scheme (APCMUHIS).
The APCMUHIS was launched as a flagship programme of the state government on 17 September, 2014. The scheme envisaged providing universal and cashless health benefits of upto Rs 2 lakhs as insurance coverage. After initial success, the scheme faltered, and by December 2016, the scheme collapsed.
A committee set up by Chief Minister Pema Khandu, under the chairmanship of then minister Dr Mohesh Chai, to examine the collapse of the APCMUHIS identified many factors, some of which were lack of in-house institutional knowledge of health insurance, quoting of low premium by the insurance company, lack of defined guidelines for adjudication, delayed or non-payment to hospitals by the insurance company, and lack of trigger-based medical audits.
This committee made many recommendations, which led to a restructured scheme which was launched as the Chief Minister Arogya Arunachal Yojana on 25 July, 2018, Dr Peter said.
“A significant feature which differentiates the CMAAY from the APCMUHIS is that it is now administered by the state government in assurance mode by a government society. Meaning, there is no premium paid to any insurance company and all liabilities for healthcare services under the scheme are fully borne by the state government. The service of a management support provider with expertise in health insurance is utilized, enabling the government to closely monitor the scheme. The health coverage has been increased to Rs 5 lakhs per family per year, and the number of listed packages increased,” he said.
Like any other scheme, the CMAAY is also facing its share of teething problems with beneficiaries making several complaints. “Our endeavour will be to learn from each setback. We’ll strive to improve our service delivery by expanding our network of empanelled hospitals and increasing the number of people getting benefits in the government hospitals by making the processes easier. The advantage of the assurance model is that there is scope for changes with every learning to improve the scheme. Every year, we are learning something and are trying to improve the service of the CMAAY,” added Dr Peter.
He said people can log on to www.cmaay.com to register themselves.