Dinesh Arora is head of Joint Working Group (JWG)

The Insurance Regulatory and Development Authority of India (IRDAI) and the National Health Authority (NHA) have formed a Joint Working Group (JWG) to curb fraud in the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY). The 11-member group, with NHA Deputy CEO Dinesh Arora as the chair and lRDAl Executive Director Suresh Mathur as the co-chair, would submit a report within 6 months on how to detect and deter fraud through a common repository and capacity-building. The JWG will develop standards for field verifications and investigations besides guidelines to “name and shame” fraudsters. It will also take up a comparative study of packages and their rates, besides defining standards. Additionally, it will suggest common IT infrastructure for health insurance claims management to increase efficiency and transparency among stakeholders. The AB-PMJAY is the health insurance scheme for availing secondary and tertiary care, cashless treatment at empanelled private and public hospitals across the country to families listed in SECC (Socio-Economic Caste Census) 2011. Eligible families get Rs 5 lakh per year.

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