NEW DELHI — The government Feb. 16 formed six working groups to finalize the structure and functioning of the National Health Protection Scheme, popularly called "Modicare," an official said.
The Ministry of Health and Family Welfare, at the end of a two-day deliberations with 31 states and union territories, said six working groups were formed to "finalize the contours of the scheme."
"The objective of this consultation was to discuss with the states further details about the scheme, assess their preparedness, and to learn from the states which have good experience in implementing their own health insurance or assurance schemes," said the ministry in a statement.
The scheme, announced in the Union Budget Feb. 1, plans to cover 10 crore poor families, about 40 percent of India's population, with medical coverage of up to Rs. 5 lakh per family per year.
The six working groups will manage processes, information technology, fraud detection and grievances, awareness generation, institutional arrangement and continuum of care.
The group on processes will make recommendations on the details of various processes that will be incorporated in the broad operational guidelines for implementing the NHPS, said the Health Ministry.
Similarly, the working group on information technology will make recommendations for the IT system or platform that will be used for effective implementation of the scheme, it added.
"The groups had detailed deliberations based on the experiences of Rashtra Swasthya Bima Yojana (the government-run health insurance program for India’s poor population) implementation, implementation of the states' own schemes and global experiences," it added.
Best practices for each of the process related to beneficiary identification, hospital empanelment, hospitalization services, grievance redressal mechanisms, information, education and communication activities and other aspects of the NHPS were identified for each state.
"States also shared the current challenges being faced, and potential solutions were shared with them," said the ministry.
As well, five groups of states were formed based on the implementation status of health insurance schemes. These are states with only RSBY, states with RSBY and their own schemes, states with only their own schemes in insurance mode, states with only their own schemes in trust mode and states with no health insurance or assurance schemes.
The two-day consultations were attended by more than 200 participants from the Ministry of Health and Family Welfare, the Ministry of Finance, NITI Aayog and other stakeholders from states.