Soon, free cashless medical treatment will be provided to all road-crash victims at Ayushman Bharat-empanelled hospitals across India, with treatment expenses capped at Rs 1.5 lakh and covering hospitalisation for up to seven days.
The move is driven by the National Health Authority (NHA), which has collaborated with the Ministry of Road Transport and Highways (MoRTH), to provide cashless trauma and polytrauma care services to the victims of road accidents caused by the use of motor vehicles on any category of road.
NHA is the governing body that executes the world’s largest publicly funded health insurance scheme, Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY). The scheme has recently expanded its base to include senior citizens above the age of 70 years.
Apart from providing care to the elderly and mapping their treatment, the software managed by NHA will also map the IDs of accident victims against the patient registration ID to facilitate the smooth exchange of data across the platform to ensure that every victim of road accident gets treatment.
Hospitals to provide free treatment to Indians, NRIs & foreigners
According to a letter issued by NHA to all participating states and Union Territories, the cashless scheme will be provided to all Indian citizens, non-resident Indians (NRIs) and foreigners. “The treatment to victims of road accidents shall be provided through hospitals empanelled under AB-PMJAY,” said the letter seen by News18.
The cashless scheme shall provide victims of road accident trauma and polytrauma care treatment for an amount up to Rs 1.50 lakh per accident per person for a maximum period of seven days from the date of the accident.
“In case the victim of a road accident is a beneficiary of other scheme(s) of central or state/UT government for providing similar benefits, the treatment under this programme shall be exhausted before the other schemes,” said the letter written by Dr Akshay Jain, joint director of NHA.
The hospitals, which are empanelled under the scheme, will provide treatment to eligible victims as per the packages related to trauma and polytrauma care which have been specifically designed for this scheme by NHA using health benefit packages, 2022.
“Pre-authorisation and claim processing shall be done by SHAs or the insurance company (in case of insurance/hybrid mode of implementation). The payment of approved claims shall be settled from MoRTH-owned escrow accounts.”
All states and UTs have been asked to inform all the empanelled hospitals in the Ayushman Bharat ecosystem to provide cashless trauma care healthcare services to the victims of road accidents under the scheme.
“The unique identifier of a road accident victim in eDAR i.e., accident (victim) ID shall be mapped against the treatment/patient registration ID of TMS to facilitate smooth exchange of data across the platform and ensure that only victims of road accident avail treatment,” the letter said.
Ayushman Bharat, introduced in 2018, is touted as a landmark health initiative designed to provide universal health coverage, particularly for rural and vulnerable populations.
The programme aims to comprehensively meet health needs across primary, secondary and tertiary care levels, driven by the central government’s commitment to improving healthcare access.
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