Maharashtra govt raises concerns about adopting Modicare

The BJP-ruled Maharashtra government has expressed its reservations on joining the National Health Protection Scheme (NHPS) or Modicare in the present format, citing procedural and financial issues. The state government in its recent representation to the Centre has strongly argued that its own Mahatma Jyotiba Phule Jan Arogya Yojana (MJPJAY) entails around 971 surgeries, therapies and procedures, along with 121 follow-up packages in 30 identified specialized categories compared with NHPS.

During 2016-17, the state's outgo on MJPJAY was Rs 1,000 crore, which is expected to surge to Rs 1,200 crore by 2017-18 end.

The government has highlighted two major issues, one with regard to fixing criterias to decide beneficiaries, and the other is monitoring.

An officer from the state health department told DNA: "Families belonging to any of the 36 districts holding yellow ration card, Antyodaya Anna Yojana Card (AAY), Annapurna Card and orange ration card, along with farmers from 14 agriculturally-distressed districts will be eligible. However, the NHPS will be applicable to those covered under the Social Economic Caste Census (SECC) conducted by the government of India in 2011. There is a vast difference between the two... The second issue is related to monitoring. The state government's software covers eligible families, but the Centre's software is prepared to cover eligible families as per the SECC census." However, the Centre has indicated that it will allow monitoring as per the state's software, which will have interface with the Centre's software.

State public health minister Deepak Sawant told DNA, "The government has made various suggestions to the Centre and expects a reply."

MJPJAY provides coverage for meeting all expenses relating to hospitalization of beneficiary up to Rs 1.50 lakh per family per year in any of the empanelled hospitals, subject to package rates on cashless basis through valid ration card. "Hardly 30 to 40 lakh beneficiaries who spend more than Rs 1.50 lakh may benefit under the NHPS and for that the state government will have to shell out 40%. But there is a possibility that the empanelled hospitals may demand a rise in package rates, which will put an additional financial burden. The government may have to pump in additional Rs 100 crore and it may not be possible to do so due to financial crunch," the officer said.