RIMS warns scheme empanelled pharmacies
Source: Chronicle News Service

Imphal, July 25 2025: Regional Institute of Medical Sciences (RIMS), Imphal, has delivered cashless treatment to 35,390 beneficiaries under the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) since the scheme's rollout in September 2018, according to a press release issued by RIMS .

This achievement positions RIMS as one of the leading tertiary care centres in the Northeast under the flagship health programme.

On average, RIMS registers 38 patients per day under PMJAY, with approximately 25 undergoing package enhancement and 36 completing discharge formalities.

According to RIMS, each of these processes is completed within 10 to 30 minutes per patient.

The institute explained that, upon admission, beneficiaries or their relatives are required to report to the PMJAY office with their Ayushman Health Card.

Arogya Mitras - health workers appointed under the scheme - provide details of the benefits in Manipuri, Hindi, or English.

The treating medical team fills out a pre-authorisation form which is uploaded to the Transaction Management System (TMS) portal.

Once approved, medicines and devices are collected from empanelled pharmacies with the assistance of an on-duty pharmacist.

Beneficiaries receive SMS confirmation of the sanctioned package amount, which includes a 10 per cent institutional incentive for RIMS.

Discharge procedures are to be completed within 15 days of admission.

Beyond this window, approval from the State Health Agency (SHA) CEO is mandatory, RIMS explained.

As outlined by RIMS, the PMJAY scheme offers financial protection of up to Rs 5 lakh per eligible family annually.

This includes costs for hospitalisation, chemotherapy, haemodialysis, surgeries, implants, diagnostics, day care procedures, as well as pre- and post-hospitalisation expenses (up to 15 days) .

Additionally, charges for registration and patient meals are covered.

Excluded services include outpatient care, cosmetic or dental procedures not linked to trauma, fertility treatments, and aesthetic surgeries.

Claim revenues generated under PMJAY at RIMS are utilised in accordance with national guidelines: 15 per cent is allocated to staff incentives, 15 pc to PMJAY human resources, 40 pc to medicines and diagnostics, 20 pc to hospital upgrades, and 10 per cent to administrative costs.

However, some flexibility is allowed for addressing institutional priorities, RIMS clarified.

Eligible individuals - based on Socio-Economic Caste Census (SECC) data or SHA criteria - may verify their status and download their Ayushman Card at https://mera.pmjay.gov.in or visit a nearby PMJAY helpdesk.

The scheme is implemented at RIMS through a dedicated team of Arogya Mitras, ensuring efficient and transparent healthcare delivery.

However, RIMS has acknowledged receiving multiple complaints that certain empanelled pharmacies have charged patients amounts beyond the approved package rates.

This practice directly violates PMJAY's zero out-of-pocket expenditure policy, the institute stated.

As per Office Order No.CMHT-RlMS/RKS/0001/1219 dated December 16, 2019, pharmacies empanelled under the scheme are strictly prohibited from collecting any payment during the course of treatment and are required to offer a minimum 10% discount on medicines.

In light of the complaints, RIMS has issued a firm warning to all empanelled pharmacies, instructing strict compliance with scheme guidelines.

Ceiling prices for commonly prescribed medicines have been published.

The PMJAY nodal officer, along with the hospital pharmacist and in-charge, have been directed to thoroughly examine prescriptions and cash memos to prevent overcharging.

RIMS reaffirmed its commitment to providing affordable, high-quality, and transparent healthcare services under the Ayushman Bharat scheme and urged all stakeholders to adhere to its core principles.

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