GUWAHATI: Assam has introduced the Mukhya Mantri Lok Sevak Arogya Yojana (MMLSAY). This initiative, comprising three modules, aims to streamline the medical reimbursement process, ensuring easy access and efficient handling of claims.
Key Features of MMLSAY:
1. Eligibility: All government employees and pensioners receiving salaries or pensions from the state exchequer can register under the scheme.
2. Integrated Database: The scheme incorporates existing databases from the Director of Pension, AG office, and Pension Seva Kendras. API integration ensures real-time updates for government employees.
3. Subscription Model: Employees will be automatically enrolled, and monthly subscription deductions will be based on their grade. Pensioners have the option for annual or lifetime contributions.
4. Hospital Eligibility: Approved hospitals with IPD facilities, ICU/OT capabilities, and adequate medical professionals can participate.
5. Online Reimbursement: The scheme facilitates the online submission of medical reimbursement claims using an IT portal, eliminating the need for manual processes.
Process Flow:
1. Employees and pensioners register through an online portal, with data auto-populated through API integration and manual validation by Drawing and Disbursing Officers (DDOs).
2. A unique ID and MMLSAY e-card are generated upon successful registration.
3. Medical reimbursement claims are submitted online, with an advance/part reimbursement option for critical diseases and emergency conditions.
4. Claims are validated by DDOs, checked by the Implementation Support Agency and Project Management Unit, and finally approved by the Admissibility Board.
5. Reimbursement is made within 3 months, and the scheme allows for reconsideration of rejected claims.
For Advisory and Grievance Redressal:
1. An Advisory Board, chaired by the Minister of Medical Education & Research, will oversee the scheme's smooth functioning.
2. Toll-free numbers and email IDs will be available for raising queries or grievances.
3. Rejected claims can be reconsidered within one month of intimation.
