CMAAY & AB PM-JAY impacting lives on ground

[ Bengia Ajum ]

ITANAGAR, 31 Jan: The Chief Minister’s Arogya Arunachal Yojana (CMAAY), which was launched on 15 August, 2018, has entered the fifth year of its implementation this year.

The CMAAY is considered to be one of the few government schemes which have truly impacted the lives of the people of Arunachal Pradesh. The scheme is implemented by the state health agency (SHA) under the aegis of the Chief Minister Arogya Arunachal Society (CMAAS).

Under the scheme, health assurance for up to Rs 5 lakhs per family per year for secondary and tertiary healthcare hospitalisation is provided to all APST persons, state government employees and non-APST RC holders.

At present, the total number of members enrolled in the state stands at 5,39,034.

Ninety-four hospitals, including 66 within the state and 28 outside it, have been empanelled under the scheme.

Altogether Rs 40.64 crore claims settlements have been submitted, out of which Rs 30.89 crore has been cleared till date. However, there are pending claims of Rs 9,41,45,174, which are yet to be paid.

The private hospitals contributed the most in the claim amount with 53 percent of the total with 34 percent of the beneficiary patients treated in private hospitals.

With each passing year, the CMAAY is growing in popularity, which can be seen from the data of utilisation of the scheme. In 2019, the number of patients that were treated under the scheme was 969, for which Rs 1.18 crore financial benefit was given. Within a period of three years, the scheme utilisation increased to more than five times, translating to 5,271 patients availing treatment in various hospitals both within and outside the state receiving financial benefit of more than Rs 15.51 crore.

In the state’s public hospitals, the volume of claim settlement has increased from Rs 0.54 crore in FY 2019-20 to Rs 9.77 crore in FY 2022 till 31 December, 2022.

The TRIHMS is the most preferred public hospital in the state for patients. The CMAAY has reached all the districts of the state. As per the latest report, in more than 19 districts, the beneficiary enrollment is more than 50 percent, of which six districts have saturated family enrollment. The base for beneficiary is currently the ePDS data.

Last year, 67,000 more beneficiaries were added under the scheme, which has increased the total beneficiaries under the scheme to 5,39,034, which takes the scheme coverage to 65 percent. The beneficiary sum also covers 21,540 state government employees and their dependants (94,284). This 17 percent of the state government employees includes employees of all categories, ie, regular, contractual, ad hoc and contingency.

Another health assurance scheme which is being implemented in the state is the AB PM-JAY, which is a central government scheme. Till now 24,454 families have been verified under this scheme in the state. More than 28,600 hospitals across India are empanelled under the AB PM-JAY. As of now, claims amounting to Rs 4.36 crore have been submitted by hospitals in Arunachal, and out of it, Rs 3.73 crore has been paid to the hospitals.

The CMAAY and the AB PM-JAY are implemented by the SHA under the aegis of the CMAAS.