MHIS phase-III ends, Govt to roll out fourth phase in convergence with Ayushman Bharat

Shillong, Sept 25: The Meghalaya government will roll out the fourth phase Megha Health Insurance Scheme (MHIS) soon after the policy period of the third phase of the health insurance scheme ended on Tuesday.

Health Minister AL Hek said that though the phase-IV of MHIS was to launched on October 1, but it could not be done due to technical reasons.

Earlier opposition MLA from Mawsynram, HM Shangpliang demanded that the scheme be extended, to which Hek assured that only patients already admitted in hospitals would be accepted.

Hek informed that the state government had sent a letter to the Centre and is waiting for its response before deciding on the new date for rolling out of the fourth phase of MHIS in convergence with the central scheme – Ayushman Bharat – Pradhan Mantri Jan Arogya (AB-PMJA) that aimed at providing health insurance coverage upto Rs 5 lakh per family.

He said that the new scheme will not have a cap on family size as done previously, and any number of beneficiaries can be included in one household.

With regards to payment of premium under the MHIS phase-IV, the minister informed that upon selection of insurance company, 45 per cent premium will need to be paid immediately after the start of the policy period.

Stating that the MHIS is one of the first successfully implemented universal health insurance in India, he said, “We expect that the new scheme will also do better than the previous phases for the benefit of the people of the state particularly the poor and the needed.”

“We want the participation of all stakeholders, the MLAs, the dorbar shnongs, MDCs, churches and religious institutions for increasing the enrolment under MHIS,” he added.

Hek said that the implementation of MHIS in the state has been improving since the start of the scheme.

In the first phase, the number of households enrolled under the scheme was 1,99,815 (46%) which increased to 3,46,548 (50.5%) in the second phase and further increased to 4,36,788 (54.8%) in the third phase, he added.

The minister further informed that in terms of utilization by beneficiaries, a total of 146486 beneficiaries claimed an amount of Rs 94.81 crore under the third phase of the scheme as on September 15.

A total number of 41874 enrolled beneficiaries have benefited from the scheme amounting to Rs 16.6 crore under the first phase, while 79042 beneficiaries claimed an amount of Rs 53.16 crore in the second phase.

Under the Ayushman Bharat, he said, “We have special category population (mainly families under below poverty line) and we have covered 3.47 lakh households in Meghalaya. Under this, all expenditures will be covered by the government of India while the rest will be covered under the MHIS.”

Shangpliang asked the department to set up proper monitoring cell besides help desk in all hospital to assist people especially from rural areas.

“There could be tendency of manipulation by the hospitals and the amount credited to the card will be finished. If this card has five lakh rupees, we would like to see that it will be meaningfully utilized. Therefore, the department should set up a proper monitoring cell where hospitals would submit the bills immediately after the treatment,” he said.

Stressing the need to identify and classify surgeries to be covered under the scheme, Shangpliang also asked the minister to address cases where hospitals reject on ground of typical error with regards to gender of the beneficiary in the MHIS card.