Rashtriya Swasthya Bima Yojana (RSBY)

RSBY has been initiated and launched by the Ministry of Labour and Employment, Government of India to provide health insurance coverage for Below Poverty Line (BPL) families. The objective of RSBY is to provide protection to BPL households from financial liabilities arising out of health shocks that involve hospitalization. Beneficiaries under RSBY are entitled to hospitalization coverage up to Rs. 30,000/- for most of the diseases that require hospitalization. Coverage extends to five members of the family which includes the head of household, spouse and up to three dependents. Beneficiaries need to pay only Rs. 30/- as registration fee while Central and State Government pays the premium to the insurer selected by the State Government on the basis of a competitive bidding.

NRHM has been identified as the implementing agency in the State of Meghalaya and accordingly various government hospitals has been identified by the state for empanelment under the scheme. So far there are 19 public hospitals identified in East Khasi Hills, 6 in Jaintia Hills, 6 in Ri Bhoi, 29 in West Garo Hills and 5 in West Khasi Hills respectively. The State Nodal Agency (SNA)-NRHM is working on increasing the awareness level of the scheme in these empanelled hospitals and also in stressing on providing cashless treatment to the RSBY beneficiaries who are undergoing treatment on an IPD basis. Furthermore, training of the RKS committee on the functioning of the scheme is being conducted on a regular basis. It has also been decided that the remittances from the scheme towards these empanelled hospitals would be worked on an incentive cum infrastructure model whereby doctors, staff nurse, ANMs, ASHAs (for accompanying beneficiaries to empanelled hospitals), etc would be incentivized based on their involvement and participation in the scheme in order to better the service delivery of the overall functioning of the scheme. The RKS Committee through the guidance of the State Nodal Agency would accordingly appropriate the percentage of division between such incentives and infrastructure upgradation in respective public hospitals (60%- incentives; 40%- infrastructure upgrade).

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