Bhubaneswar: Mandarin Administrative Officer Dr Gavali Parag Harshad, after assuming charges of Chief Executive Officer, State Health assurance Society (SHAS) functioning under Health & Family Welfare Department undertook review of the performances of SHAS in a high-level meeting held at SHAS conference hall in Toshali Bhawan today.
Looking into details of the progress made so far, Dr Parag Gavali advised senior officers of the Society to intensify field visits for fraud detection and quick redressal of grievances. He also directed to sensitize the hospitals to provide immediate treatment to motor accident victims under PM-RAHAT wherein an accident victim, irrespective of economic status is entitled to get free treatment up to Rs.1.5 lakh for 7 days if registered under the scheme within 24 to 48 hours of the accident.
Even if a hospital is not under AB PM-JAY, still it can provide treatment to accident victims by logging on to HEM Lite portal. The applications are auto-approved, enabling these hospitals to admit eligible road accident victims under the PM-RAHAT scheme.
Available data show that so far of 3.46 cr persons have been brought under the umbrella of universal health care scheme of ABPMJAY-GJAY. Against them 3.45 lakh cards have been generated through online web portal of ABPMJAY, and 1.79 cr physical cards were distributed to the beneficiaries. Odisha occupies 1st position at national level in distribution of physical co-branded cards to the beneficiaries.
Along with distribution of physical cards, co-branded individual cards are also being generated and distributed though Aadhaar based e-KYC in Common Service Centres (CSCs) with support of ASHA workers. Beneficiaries not having physical co-branded cards are also availing health services in empanelled hospitals with their ration and Aadhaar card. So far, 774 private hospitals operating within Odisha have been empanelled, and steps are being expediated to empanel Government hospitals of the State.
Odisha has also been a lead performer in (i) pre-authorisation processing, (ii) settlement of claims against the treatment of beneficiaries, and (iii) portability claim settlement. Quick portability claim settlement helps the beneficiary patients staying outside Odisha or preferring critical tertiary care outside the State. During last 18 months (April, 2025 to September, 2026) a total number of 22,13,702 claims against treatment of beneficiaries amounting to Rs.6081.05 Cr have been processed and settled.
Additional Secretary and Joint CEO SHAS Ratnakar Sahoo, Joint CEO Finance Arupananda Pradhan, Additional Director SHAS Dr Rashmi Ranjan Satpathy, Dy CEO Admn Dr Sambit Behera, along with senior doctors of State Anti-Fraud Unit ( SAFU), Medical Audit Committee ( MAC) participated in deliberations of the meeting.
