CHIEF MINISTER AROGYA ARUNACHAL YOJANA
Toll Free Number: 1800 233 5558

Committee

  • A. EMPANELMENT AND DISCIPLINARY COMMITTEE

    Scope of EDC: Will deal with empanelment of hospitals for the scheme, addition/deletion of specialties of hospital, Disciplinary action against Hospitals (suspension/De-empanelment), review of infrastructure and performance of hospitals, review grievances of the hospitals, other empanelment related matters. The EDC will consist of:

    • Representative from PMU
    • Representative from MSP
    • 3 Speciality expert (Surgical, Medical and Hospital Administration) from Arunachal Pradesh Health Services
    • Representative from National Health Agency, AB-PMJAY
  • B. CENTRAL CLAIMS COMMITTEE

    Scope of CCC: Will act as appellate authority and review of claims appealed by empanelled hospitals which were initially repudiated by MSP and subsequently by PMU, Review of hospital behaviour on utilization of various packages. The CCC will consist of:

    • Representative from PMU
    • Representative from MSP
    • Finance Manager of PMU
    • Representatives from Finance Department, Govt. of Arunachal Pradesh
    • Representative from National Health Agency, AB-PMJAY
  • C. GRIEVANCE COMMITTEE

    Conduct investigation into allegation of treatment lapses, Cash collections by hospitals, deficiency of MSP and PMU and redress the issue. The Grievance Committee will consist of: At State Level:

    • At State Level:

      • Commissioner/Secretary (Health &FW), Govt. of Arunachal Pradesh
      • Commissioner/Secretary (Law) or his representative, Govt. of Arunachal Pradesh
      • Commissioner/Secretary (Planning, Finance &Implementation) or his representative, Govt. of Arunachal Pradesh
      • Director of Health Services/Director of Family Welfare/Director of Medical Education, Training &Research Govt. of Arunachal Pradesh
      • Representative of Private Hospitals in Arunachal Pradesh
      • Registrar of Arunachal Pradesh Medical Council
      • Representative of IMA-Arunachal Pradesh Branch
    • At District Level:

      • Deputy Commissioner of the District
      • District Medical Officer
      • Representative of Private Hospitals in Arunachal Pradesh
      • District representative of IMA-Arunachal Pradesh Branch
  • D. MEDICAL AUDIT COMMITTEE

    Conduct medical audits on empanelled hospitals and MSP. Audits on pre-authorization, claims management and administration, and hospital network management etc with a mandate to carry out surprise audits at a regular frequency. The Society will also carry out audits on the performance of the 24*7 call center set up by the MSP. The Committee will consist of:

    • Representative from PMU
    • Representative from MSP
    • 3 Speciality expert (Surgical, Medical and Hospital Administration) from Arunachal Pradesh Health Services