According to a NITI Aayog source, World Bank is likely to submit a report on health insurance mechanisms
The NITI Aayog has sought World Bank's assistance to provide it with information and expertise on fraud detection and prevention to ensure no embezzlement of funds takes place in the Centre's ambitious Ayushman Bharat National Health Protection Mission (AB-NHPM).
The World Bank assistance is being taken as it has expertise from its international experience.
According to a source in the NITI Aayog, the World Bank is likely to submit a report by May 15 on how other countries, where similar health insurance mechanisms are in place, ensures that there is no fraud or corruption under the scheme.
"We will very carefully review the recommendations from the World bank, assess their applicability or relevance in Indian context and implement them to ensure there is no misuse and fraud under the Ayushman Bharat National Health Protection Mission (AB-NHPM) which will provide a coverage of Rs 5 lakh to 10 crore poorest families of the country," AB-NHPM Chief Executive Officer Indu Bhushan said.
Besides, the health ministry has also proposed that insurance companies will have to mandatorily refund excess premium if the claim ratio turns out to be less than 85 per cent under the scheme to ensure that insurance agencies do not have windfall gain which aims at supporting the poor on health treatment.
Touted as the world's largest government-funded healthcare insurance programme, 'AB-NHPM' will provide a coverage of Rs 5 lakh per family annually and benefit more than 10 crore families belonging to the poor and vulnerable sections of the society.
The centrally-sponsored scheme will target deprived rural families and identified occupational category of urban workers' families, who constitute 8.03 crore in rural and 2.33 crore in urban areas, respectively, as per the latest Socio Economic and Caste Census (SECC) 2011 data, and will cover around 50 crore people.
The health ministry has prepared a detailed timeline to ensure completion of all steps to enable rolling out of the scheme anytime after July, while allocating around Rs 10,000 crore for the project.