IRDAI, NHA form joint working group on Ayushman Bharat

In order to improve insurance implementation, a Joint Working Group (JWG) which comprises senior officials from IRDA and National Health Authority (NHA) has been formed which would recommend measures to help and improve implementation of centres Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) or the health insurance scheme for the poor.

1. The group would have 11 members with NHA Deputy CEO and IRDAI Executive Director as the Co-Chair.
2. The group would submit a report on various aspects related to
   1. Network hospitals’ management
   2. Data standardization and exchange
   3. Fraud abuse and control and
   4. Common IT infrastructure for health insurance claims management
3. The Insurance Regulations and Development Authority of India (IRDA) revealed that under network hospitals management, the group had 12 months to submit its report on a national repository of empanelled hospitals.
4. The Joint Working Group would define the hospital infrastructure and facility audits to know more about hospitals’ capacity and availability of specialists and accordingly chalk out a roadmap for a single common list of accredited verified hospitals for the entire industry.
5. Under the fraud and abuse control component, the JWG would should make recommendations within a period of six months which would be helpful in
   1. Detecting and deterring frauds through a common repository and
   2. Building of overall capacity.