The Employees’ State Insurance Corporation (ESIC) converged scheme has been expanded to 113 districts across four states of Madhya Pradesh except Indore district, Maharashtra (except South Mumbai area, Pune, and Kolhapur districts), and Chhattisgarh (except Raipur and Korba districts) and four districts of Karnataka namely Bidar, Chikballapur, Chikmagalur and Kodagu districts.
The National Health Authority and the ESIC has entered into an agreement to extend cashless treatment to ESIC beneficiaries through the Pradhan Mantri Jan Arogya Yojana (PM-JAY) network hospitals and provide increased accessibility to better quality healthcare services and larger choice. The project was launched in a pilot phase in two districts, Bidar in Karnataka & Ahmednagar in Maharashtra.
Under the scheme, 32 beneficiaries availed the in-patient treatment services at PM-JAY hospitals. Based on the learning and experience in the pilot phase, the PM-JAY – ESIC converged scheme has been expanded for beneficiaries residing across 113 districts of 4 states of Chhattisgarh, Madhya Pradesh, Maharashtra and Karnataka.
After successfully completing a pilot in Bidar in Karnataka & Ahmednagar in Maharashtra, the Ayushman Bharat PM-JAY will now have 28 lakh ESIC beneficiary families in these districts who will be able to avail cashless treatment at any of hospitals empanelled under Ayushman Bharat Pradhan Mantri Jan Arogya Yojana across the country.
Lauding the move was Karnataka Minister for Labour A Shivaram Hebbar, who said that this will help scores of employees and is much needed. Contending the state government, was deputy labour commissioner Vinutha who said that in the current scenario the cashless treatment comes in as a big help.
According to Dr. Indu Bhushan, chief executive officer, National Health Authority (NHA), “We have been working with ESIC continuously with a common goal to provide social security benefits in the form of cashless healthcare to its insured beneficiaries. We have jointly decided to expand the inpatient services under Ayushman Bharat PM-JAY to all ESIC beneficiaries located in 113 districts across Madhya Pradesh, Maharashtra, Chhattisgarh and Karnataka at any empaneled hospital anywhere across the country. I am pleased to share with you that on the first day of its expanded operations, 10 beneficiaries have already been admitted and receiving treatment under Ayushman Bharat PM-JAY.”
To ensure seamless services to ESIC beneficiaries, NHA has made the necessary changes in the PM-JAY IT platform to enable seamless hospitalization and claims payment. It has also sensitized the Empanelled Health Care Providers (EHCPs) and different stakeholders to ensure smooth implementation. As under the current process, all the payments for the treatments will be done by the National Health Authority to the hospitals against their claims. A dedicated call centre toll-free helpline 14588 has been setup by National Health Authority to take up all queries and grievances from the general public.