Jaipur: In a bid to
enhance the financial stability of government hospitals, the
Rajasthan government has directed health officials to ensure the efficient
implementation of the Mukhyamantri Ayushman Arogya (MAA) Yojana and the
Rajasthan Government Health Scheme (RGHS). The move aims to streamline the medical claim process and prevent revenue losses due to insurance claim
rejections.Also Read:Rajasthan Medical Services Corporation under Scrutiny for Rs 343 Crore TenderThe state health
authorities have issued clear instructions to Chief Medical Health Officers
(CMHOs), Principal Medical Officers (PMOs), and hospital administrators to
actively monitor and rectify deficiencies in claims filed under the MAA Yojana.

The RGHS provides cashless treatment to a wide range of beneficiaries, including ministers, MLAs, ex-MLAs, All India Services officers, as well as current and retired employees of the state government and its autonomous institutions. Treatments are offered based on Central Government Health Scheme (CGHS) package rates, as per medical rules applicable to their respective categories.

Medical dialogues had
previously reported that Rajasthan Chief Minister Bhajanlal Sharma reiterated
that the state government’s top priority is to ensure affordable, accessible,
and quality healthcare for the people. The chief minister said that free
treatment is being provided to the general public under the Chief Minister
Ayushman Arogya Yojana. The government has decided to include pediatric
packages under this scheme and rationalise the rates of some packages.

According to the Times of India, a state
government official stated, “The scheme ensures reimbursement for each OPD
consultation under RGHS, while IPD cases receive compensation for actual
expenses incurred, thereby creating a revenue stream for the hospitals. The
funds generated will be utilised by the hospitals for improving their
infrastructure and facilities.”Also Read:Rajasthan Govt focuses on affordable healthcare, directs implementation of Health schemesSpeaking about MAA Yojana
to TOI, the official said, “Directions have been issued to ensure that the
deficiencies in the claims filed under the MAA scheme are completed by having
them monitored properly. This will also increase the revenue of health
institutions. If a claim is rejected, the insurance company benefits, and your
hospital’s financial situation does not strengthen,” he said.

The Mukhyamantri Ayushman
Arogya Yojana, aligned with the broader Ayushman Bharat initiative, provides
cashless treatment at both government and empanelled private hospitals. Patients
can avail treatment at a wide range of facilities, including community health
centres, satellite hospitals, sub-divisional hospitals, district hospitals,
hospitals affiliated with medical colleges, and hospitals of the Government of
India located in the state, and private hospitals associated with the scheme.
The task of empaneling hospitals with the scheme will be undertaken by the
Rajasthan State Health Assurance Agency.