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The Insurance Regulatory and Development Authority of India (IRDAI) and the National Health Authority (NHA) have formed a working group on the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY).
The joint working group, to be chaired by Dinesh Arora, Deputy CEO of NHA, will have 10 members from both the organisations.
In six months, it will submit a report on how to detect and deter fraud through a common repository and capacity-building.
It will develop standards for field verifications and investigations besides guidelines to “name and shame” fraudsters.
As part of Network Hospitals Management, the working group will define hospital infrastructure and facility audits, and develop a roadmap to get a common list of accredited hospitals for the industry.
It will also take up a comparative study of packages and their rates, besides defining standards. Additionally, it will suggest common IT infrastructure for health insurance claims management to increase efficiency and transparency among stakeholders.
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