Speaking on the Workshop on the Chief Minister’s Health Insurance Scheme (CMHIS) at The Lily Hotel, Guwahati on 16th June 2023, Commissioner & Secretary, Health & Family Welfare, Y. Kikheto Sema, IAS, stated that it is the desire of the State Government to provide accessible, affordable, and universal healthcare services to all its citizen. Accordingly, the CMHIS was launched in Oct 2022 to provide health insurance to all citizens who are not covered under Ayushman Bharat PM-JAY making Nagaland the 1st State in the country to provide Cashless Universal Health Coverage. Thereby the MR Scheme for government employees has been discontinued wef 1st November 2022 with the launching of the CMHIS. However, Kikheto stated that there are numerous teething problems for the last few months, which are now almost settled.
Sema stated that under CMHIS, Employees and Pensioners with insured amount of Rs. 20.00 lakhs per family per year and the general category with insured amount of Rs. 5.00 lakhs per family per year. Kikheto also clarified that CMHIS (General) category is implemented in convergence with Ayushman Bharat PMJAY platform while the CMHIS (EP) category is implemented in convergence with Central Government Health Scheme platform.
The Commissioner stated that initially 1,444 hospitals were empanelled under CGHS, however, only few hospitals were frequented by patients from Nagaland. In addition, since the CGHS package rate is very low many hospitals refused to provide treatment. In order to solve this problem the team of Nagaland Health Protection Society and officials of H&FW department has now worked out revised rates and enhanced incentives ranging from 30% to 60% above the CGHS rates.
Sema stated that the State has decided to limit the number of empanelled hospitals who are willing to be on board and provide the best services to our patients. He further stated that the relationship between the people of Nagaland and Assam is from time immemorial and in view of proximity; relationship more than 50% of patients from Nagaland comes to Guwahati for treatment. Therefore, the empanellement of Guwahati-based hospital will be prioritised. As most of the patients seeking treatment from hospitals outside the State are of serious and complicated cases, Kikheto requested hospitals to provide best quality services as well as support facilities whenever required by our patients.
Kikheto also stated that the Nagaland Government has never defaulted payment of debt servicing to any financial institutions and assured that the payment of Hospital bills/claims will be paid within the Turn-Around-Time of 1 month. Hence he requested the hospitals to treat/ heal our Naga patients on priority. On a lighter note he told them to feel that their money is kept in bank account without interest for a month.
The workshop was attended by more than 20 Hospitals including several reputed Hospitals in Guwahati. The welcome and keynote address was given by Joint Director, H&FW and SNO, NHPS, Dr. Kika Longkumer while vote of thanks was delivered by Medical Officer, Guwahati, Dr. Chenjei Konyak.
1. Categories of Beneficiaries covered under CMHIS:
a. CMHIS (EP) category comprising of Employees and Pensioners with insured amount of Rs. 20.00 lakhs per family per year.
b. CMHIS (General) category comprising of citizens who are not covered under any public health insurance schemes with insured amount ofRs. 5.00 lakhs per family per year.
2. CMHIS (General) category is implemented in convergence with Ayushman Bharat PMJAY platform and CMHIS (EP) category is implemented in convergence with Central Government Health Scheme platform.
3. Accordingly, 1444 hospitals empanelled under CGHS will available to Employees and Pensioners. But out of which only few hospitals were frequented by patients from Nagaland.
4. Further, CGHS package rates were not popular among hospitals as the rate is very low (2014) and therefore many hospitals refuse to provide treatment. In view of this, there was numerous teething problems for the last few months.
5. To solve the problem, a dedicated team of Nagaland Health Protection Society were continuously working to rationalise and design a competitive rate, incentives were build-in so that hospital will get incentive ranging from 30% to 60% above the CGHS rates.
6. The State Government is now in the process of signing bilateral MOU with Hospitals and awaiting from NHA to provided Hospital Empanelment Portal to enable hospitals to apply for Empanelment.
7. Initially limited hospitals will be empanelled, wherein Guwahati in view of proximity, relationship and more than 50% of patients from Nagaland comes to Guwahati. Therefore, priority will be given Guwahati based hospital will be empanelled. As most of the patients seeking treatment from hospitals out the State are of serious and complicated cases, is requested that hospitals provided best quality services as well as support facilities such as ambulance services, lodging facility for patients’ relatives etc.
8. The Nagaland Government has never defaulted payment debt servicing to any financial institutions,therefore, it assured of prompt payment of Hospital claims within the Turn-Around-Time of 1 month. Hence you are requested to treat/ heal our patients on priority, on a lighter mode feel your money in bank account without interest for a month.
9. On the other hand, the Government will be serious with zero tolerance on fraud as it will defeat the objectives of this noble schemes.
(DIPR)
