National Health Authority (NHA) has revised the Ayushman Bharat Health Benefit Packages. NHA has added 237 new packages in the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY). The rates of 270 Health Benefit Packages (HBP) has been raised, 43 stratified packages have been adopted while there is no change in rates of 469 packages.
NHA said that the revision in the HBP packages will not affect the range of treatment covered under PM Jan Arogya Yojana. Without comprising range of treatment covered under AB-PMJAY scheme, around 554 packages would be discontinued while there is reduction in rate of 57 packages.
This reduction in Ayushman Bharat Health Benefit Packages will reduce abuses of packages by fraudsters at different level.
Ayushman Bharat Health Benefit Packages Revision
The revision of Health Benefit Packages (HBP) of Ayushman Bharat Scheme will motivate more private hospitals to join the PMJAY scheme. People can now check the HBP packages revision in the table below:-
|Rates After AB-HBP Revision||Number of Packages|
|Increase in Rates||270 Packages|
|No Change||469 Packages|
|Reduction in Rates||57 Packages|
|Newly Added||237 Packages|
NHA has made an attempt to keep prices of abuse prone packages at minimum level to minimize incentives for abuse. With revision in Ayushman Bharat health benefit packages, many new private hospitals will get empanelled with PMJAY scheme. This is going to improve the access to good quality healthcare and lakhs of vulnerable families will receive free treatment.
Packages under Ayushman Bharat
PMJAY health insurance scheme is offering 1,393 treatment packages for cashless and paperless treatment. Out of these, 1,083 packages are surgical, 309 medical and one unspecified package. These AB health benefit packages includes cost of diagnostics upto 3 days before hospitalization and medicines upto 15 days post-hospitalization. NHA is consistently receiving feedback on various aspects of PMJAY scheme which includes existing HBP and their rates.
Before finalizing the changes in Health Benefit Packages, feedback was also taken from the States and Union Territories. Their feedback was examined by the review committee setup for Ayushman Bharat – PM Jan Arogya Yojana.
All the states & UTs which are implementing AB-PMJAY scheme using insurance model or combination of trust and insurance model will have autonomy on this decision. They can continue implementing Ayushman Bharat Yojana using existing package master till their current contract period ends or can shift to the new version after making suitable amendments in their contract.
Cancer Care Revamp in Ayushman Bharat HBP Revision
The revised oncology packages of Ayushman Bharat Scheme will revamp cancer care for beneficiaries. This will align to reflect current best practices in the country. The revised HBP rates will further augment cancer care in the country with reduction in catastrophic expenses associated with its treatment.
After AB-HBP revision, oncology packages have been split to include multiple regimens of surgical and medical oncology complemented by radiotherapy regimens. This will standardize the nomenclature and definitions of packages. NHA in collaboration with World Health Organization (WHO) has started process of aligning HBP with International Classification of Health Interventions (ICHI) and International Classification of Diseases (ICD) coding of the WHO. On completion, India will become first country to use ICHI in HBP list.
Ayushman Bharat Scheme – Addressing Price Movement
NHA is also planning to configure the cost of implants / high-end consumables in its IT system separately at the backend. This would be useful in case there is a movement in the price of these significant components of a package cost.