Maharashtra Introduces App to Enhance Transparency, Accountability in MJPJAY Health Scheme

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The Maharashtra government will soon introduce a new mobile app to improve transparency and accountability in the Mahatma Jyotiba Phule Jan Arogya Yojana (MJPJAY), the state-run flagship health insurance scheme. Health Minister Prakash Abitkar revealed that the app will enable patients and their relatives to directly inform hospital malpractices and view real-time information, a huge change in the scheme's monitoring and grievance redressal system.

Brief Introduction

MJPJAY offers universal, cashless medical care to all families of Maharashtra, with cover for treatment recently raised to ₹5 lakh per annum per family. Although its reach is extensive, the scheme has had constant complaints regarding irregularities and unethical practices in empanelled hospitals. The new app is meant to rectify these issues by facilitating direct communication between beneficiaries and the health department, thereby allowing for immediate action and better delivery of services.

App Features and Purpose

The app will enable patients and their relatives to lodge complaints regarding malpractice or unethical practices by hospitals with the health department directly.
The app will give real-time information regarding the availability of beds in hospitals, enabling patients to make informed choices regarding where to receive treatment.
Complaints lodged through the app will be tracked for prompt action, ensuring that hospitals are held accountable for any scheme norm violations.

Government's Commitment to Reform

Health Minister Prakash Abitkar stressed a radical overhaul of MJPJAY to introduce greater transparency and accountability into the system.
The government intends to overhaul treatment packages and rates under the scheme, ensuring fairer and more efficient healthcare delivery.
Hospitals found taking advantage of patients or defying scheme guidelines will be taken to task severely, including possible legal action.

Background and Recent Changes to MJPJAY

MJPJAY was overhauled in 2023 to make it a statewide scheme, providing coverage to all families in the state and raising the one-year treatment limit to ₹5 lakh per family.
The scheme now covers 1,359 private and 672 government hospitals in the state.
Since the last five years, the state government received 1,007 complaints against hospital malpractices, primarily relating to illegal exactions for money in spite of the cashless nature of the scheme.

Addressing Persistent Issues

Most grievances in the past have been dismissed or handled poorly by district coordinators, and therefore, it was a necessity that a direct, online grievance system be established.
The application is to make the grievance mechanism more user-friendly, open, and effective, minimizing the chances of malpractice.

Further Action Measures

The department of health has also directed the officials to conduct an audit of all private hospitals across the state so that they comply with government standards and make their rates public.
Hospitals failing to comply with regulations after notice will face follow-up inspections and possible legal action.

Relevant Sources: Hindustan Times, Jeevandayee.gov.in, Times of India, UNI India