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Government to rename medical insurance scheme after Mahatma Phule

Rules regarding empanelment of hospitals have been relaxed to benefit people in rural, hilly and tribal areas, where hospitals have lesser number of beds. This will hike the coverage of the scheme from just 470 hospitals empanelled now.

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In what may snowball into a political controversy, the BJP-Shiv Sena led Maharashtra government has decided to rechristen the Rajiv Gandhi Jeevandayee Yojana (RGJAY) cashless medical insurance scheme after social reformer Mahatma Phule. The state Cabinet has also approved a new scheme named after late Shiv Sena chief Bal Thackeray to provide free medical care to accident victims for three days subject to a Rs30,000 ceiling.

The PPP-based cashless mediclaim covers beneficiaries from BPL, APL and indigent categories, and its limit has been enhanced from an annual Rs1.50 lakh per family on floater basis to Rs2 lakh in empanelled hospitals with the premium being paid by the state government. The number of procedures has also been increased to 1,100 surgeries and therapies from the previous 971 with geriatric and paediatric care being added in the new Mahatma Phule Jana Arogya Yojana.

Rules regarding empanelment of hospitals have been relaxed to benefit people in rural, hilly and tribal areas, where hospitals have lesser number of beds. This will hike the coverage of the scheme from just 470 hospitals empanelled now.

"The state government has decided to keep the scheme functional under the name of Mahatma Phule," said health minister Dr Deepak Sawant, adding that this would take effect after the tenure of the existing scheme ends in October.

"The tenure of the scheme named after Rajiv Gandhi would get over in October... Since its MoU will come to an end, the scheme too will be over," averred Sawant on questions regarding the change in the nomenclature. The Congress was quick to react with party MLC and general secretary Sanjay Dutt saying this proved that the government's "mental bankruptcy".

Sawant said that apart from increasing the floater coverage for beneficiary families, the coverage for kidney transplants would be Rs3 lakh. Kidney donors would also be covered.

"The new scheme will cover 1,100 medical and surgical procedures including those regarding cancer, paediatric care and geriatric care. It will also include students from ashramshalas and anganwadis... and haematology procedures which were not included earlier," he added, stating that hip and knee replacement, sickle cell anaemia, dengue and swine flu would be included in the new scheme. The total number of follow up packages is 127.

The state will also provide 24X7 call centre support to beneficiaries with outbound call facilities. Empanelled hospitals who flout the norms stand to face fines.

For accident victims

"Victims of accidents on roads usually face hurdles in medical treatment as they have no money," said Dr Deepak Sawant, adding that a new scheme — the Balasaheb Thackeray accident insurance scheme — would grant them to three days of free treatment in empanelled hospitals. This would be subject to a Rs30,000 ceiling. Subsequently, the patients can pay for their treatment or choose to be shifted to other hospitals. "We will also empanel 200 trauma care hospitals in Maharashtra," he added.

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