In a first of its kind in the State of Nagaland, the Chief Minister’s Health Insurance Scheme (CMHIS) was launched on 14th October 2022 at the Chief Minister’s State Banquet Hall, CMRC, Kohima, with CEO, National Health Authority, Ministry of Health & Family Welfare, Dr. R. S. Sharma as the guest of honour, and Chief Minister, Nagaland, Neiphiu Rio as the special guest.
Delivering the keynote address, Chief Secretary, Nagaland, J. Alam IAS informed that the Oriental Insurance Company Limited will be the insurance partner with whom the Government has already signed the agreement. With the Nagaland Sustainable Development Goal Vision 2030 launched in August 2021, envisaging that by 2030, Nagaland will provide equitable, affordable and quality healthcare services to the people of the State, the CS stated that CMHIS is a major step towards fulfilling this vision.
He informed that the Government held multiple consultations with various stakeholders in the State as well as outside the State, and inputs from experts across the country, and came up with a Health Benefit Package that they hope will ensure a balanced and equitable access to quality healthcare for all. J. Alam further stated that CMHIS can only be a success if all the stakeholders, including the district administration, hospitals both public and private in the State, insurance partner and the people implementing the scheme through the Nagaland Health Protection Society and the Department of Health & Family Welfare, work collaboratively and hand in hand, to bring the benefit to all the citizens in the State.
Terming the launch of the CMHIS as a significant milestone, and acknowledging/lauding the leadership of Chief Minister Neiphiu Rio, guest of honour, CEO, National Health Authority, Ministry of Health & Family Welfare, Dr. R. S. Sharma, who delivered his address live from Delhi, stated that with the launch of CMHIS, Nagaland will become the second state in North-east to have universal health coverage, taking India forward to realising its Sustainable Development Goal of universal health access. Informing that around 12,000 hospitalisations were recorded in NHA-IT platform, and with the CMHIS scheme to be launched in the NHA-IT platform, he assured that it is robust, scalable and can record millions of processes of the healthcare system.
Chief Minister, Neiphiu Rio addressing the launching programme, stated that the CMHIS covering the entire population of the State, will expand the coverage of insurance benefits, over and above those being covered under Prime Minister’s Ayushman Bharat scheme. Under the scheme, the CM stated that the people of the State will have an assurance of better access to healthcare services than they had ever before. Pointing out that for any illness that requires hospitalisation resulting in substantial expenditure, which may not be within the means of the family, Rio expressed hope that the scheme will help prevent such hardships.
He stated that government servants on regular employment and serving legislators and their families will not have to go through the tedious and long process of medical reimbursement as they can avail treatment in a cashless manner.
Rio stated that it will be an opportunity for the private hospitals in the State to treat the patients and get assured payments, adding that there is tremendous interest generated amongst the private hospitals. He informed that consultations have been held with the private hospitals and the package rates have been revised to provide the best possible rates in the country, and that all the Government Hospitals in the State will also be empanelled to provide in-patient treatment under the scheme.
Rio further appealed to all the beneficiaries to enroll themselves on the online enrollment portal which is open now. In case they are not able to self-enroll, they should avail the free assistance that is being provided during the next fortnight all over the State at designated locations for e-verification. He also appealed to all hospitals to immediately enroll on the online portal so that they are able to provide services immediately.
Stating that a remarkable achievement has been made in the history of Nagaland by launching the CMHIS, Minister, Health & Family Welfare, Pangnyu Phom said that people with the least means not only have greater health problems but are less accessible to health care due to unaffordability of hospitalization expenses. There are two schemes being implemented in the State covering specific population segments - Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY) scheme for the pre-identified deprived categories and Medical Reimbursement Scheme (MR Scheme) for the government employees and their dependent family members. In addition, government employees and pensioners their dependents are provided with a monthly fixed medical allowance to cover their out-patient treatment expenses, he added.
Pangnyu also pointed out that there is a substantial section of the society who neither belong to government employee family nor eligible for AB PM-JAY. The government of the
day is responsive to these concerns of the people and have come up with a scheme
which aims to reduce their financial burden, knowing that medical expenditure is a
leading cause of impoverishment. He expressed hope that CMHIS will be an important stepping stone to achieve positive health and wellbeing, and a driver of economic prosperity for the State of Nagaland.
During the programme, Chief Minister, Neiphiu Rio released the CMHIS Policy Document, and also launched the CMHIS Beneficiary Registration Portal, thereby, initiating the Beneficiary Enrolment Drive. The Chief Minister also handed over the Ayushman – CMHIS Card to the beneficiaries, namely, Yinshom SS Konyak from the General Population Category, Neikholhoulie Belho from the Pensioners Category, and Solo Kent from the Government Employees Category. Empanelment Certificates were also handed over to Oking Hospital Kohima, CIHSR Dimapur, Olive Hospital Dimapur, District Hospital Mon and District Hospital, Longleng by the Chief Minister.
The State Government initiated the Chief Minister's Health Insurance Scheme (CMHIS) with the aim to alleviate financial hardships due to hospitalization expenses and to prevent inaccessibility to medical care on account of unaffordability. It is implemented in convergence with the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY). For beneficiary of CMHIS (GEN) Category, all indigenous and/or permanent residents of the State who are not beneficiaries under the AB PM-JAY or any other public funded insurance scheme of the government and who are not covered under CMHIS (EP) category are included. It also includes non-dependant family members of CMHIS (EP) categories, employees without PIMS number, contractual, adhoc, fixed pay employees of the State Government and contractual employees under various CSS, and their household members.
For beneficiary of CMHIS (EP) Category, State Government employees who are eligible for monthly Medical Allowance (MA) and or reimbursement of medical expenses under Medical Reimbursement scheme viz. Regular employees; Pensioners; Serving Legislators/Ex-Legislators;
Employees of State Public Sector Undertakings, Corporations and Autonomous Bodies; Work Charge employees (on Scale Pay), and their dependent family members are included.
For CMHIS (GEN) beneficiary families, the sum insured is Rs. 5,00,000/- (Rupees Five Lakhs Only) per family per annum on a family floater basis, similar to AB PM-JAY.
For CMHIS (EP) beneficiary families, the sum insured is Rs. 20,00,000/- (Rupees Twenty Lakhs Only) per family per annum on a family floater basis. Further, for government employees, any additional expenses beyond the sum insured shall be reimbursed on a case to case basis by the State Government on recommendation of the State Medical Board.
All beneficiaries of the scheme are entitled to free and cashless hospitalization care for various ailments including pre-existing conditions/diseases, which can be availed from any empanelled hospital across the country. The treatment will include both surgical and medical procedures and limited day-care packages. However, OPD services and standalone diagnostics investigations will not be covered.
CMHIS (GEN) beneficiaries will be entitled to more than 1950 medical and surgical packages across 27 major clinical specialties as well as entitlement to General Ward, similar to AB PM-JAY. CMHIS (EP) beneficiaries will be entitled similar to that available for Central Government employees under the Central Government Health Scheme (CGHS) as well as differential room entitlement as per their employee grade.
(Mhonlumi APRO)
