BHUBANESWAR: The Odisha government has directed all empanelled hospitals under the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) and Gopabandhu Jan Arogya Yojana (GJAY) not to charge beneficiaries for pre- and post-hospitalisation services covered under the scheme package.
It also warned that any violation of the guidelines will be viewed seriously.
In an advisory issued by the State Health Assurance Society, the Health and Family Welfare Department said it had come to notice that several empanelled hospitals were collecting money from beneficiaries for pre-hospitalisation and post-hospitalisation diagnostic services despite such expenses being covered under the scheme.
According to the advisory, costs incurred by beneficiaries for consultations, diagnostic tests, and medicines up to three days before hospital admission are included in the package cost, provided the expenses are incurred at the same hospital where treatment under AB-PMJAY-GJAY is initiated.
The department further clarified that expenses for consultations, medicines, diagnostics, and post-operative care from the date of discharge for up to 15 days are also included in the package cost. Hospitals have been instructed to procure and provide the required medicines to beneficiaries and ensure that any diagnostic evaluations or follow-up visits needed within 15 days of discharge are provided free of charge.
The advisory stated that beneficiaries should not be charged for any pre-or post-hospitalisation services covered under the package. It also noted that in cases involving surgery, post-operative complications and readmissions linked to the treatment must be covered under the original package cost.
Dr. Brundha D, Chief Executive Officer of the State Health Assurance Society, urged all empanelled hospitals to strictly adhere to the scheme guidelines and refrain from charging beneficiaries for services included in the package cost.
The advisory has also been forwarded to the Commissioner-cum-Secretary of the Health and Family Welfare Department, all Chief District Medical and Public Health Officers, nodal officers, district coordinators, and other concerned officials for necessary action.
