Tamil Nadu Government Hospitals Excel in Health Insurance Claims under CMCHIS
Government hospitals in Tamil Nadu have achieved a remarkable feat by earning 50% of the total claims under the Chief Minister’s Comprehensive Health Insurance Scheme (CMCHIS) in the fiscal year 2023-24. According to data from the Tamil Nadu Health Systems Project (TNHSP), out of the total claims amounting to ₹723 crore this year, around ₹361 crore has been disbursed to government hospitals.
This success follows the trend from the previous fiscal year (2022-23) when 48% of the total claims, approximately ₹554 crore, were directed towards government hospitals, marking one of the highest claim amounts received by public hospitals in India. These funds have empowered government hospitals to continuously enhance their facilities, and infrastructure, and procure essential resources for patient care.
The efficient utilization of health insurance claims at government institutions earned Tamil Nadu the Best Practices Award from the Government of India for effective utilization of government funds under the integrated Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana (AB-PMJAY)-CMCHIS. The scheme covers 1.44 crore families at a premium of ₹849 per family per year, offering insurance coverage of ₹5 lakh per family annually and benefiting a substantial number of individuals across various medical procedures and treatments.
From July 23, 2009, to September 19, 2023, a total of 1,31,86,958 persons have benefited from ₹12,219 crore in claims approved under the CMCHIS. During the period from September 2018 to September 2023, 17,22,512 individuals benefited from the approval of ₹2,594 crore in claims under AB-PMJAY. The government has established a dedicated corpus to cover the costs of high-end medical procedures, including transplants and immunosuppressant therapy, cochlear implantation, auditory brainstem implantation, and stem cell transplantation.
A sum of ₹1,155.12 crore was approved for these advanced procedures, benefiting 13,934 beneficiaries from January 2012 to September 2023. Currently, the scheme encompasses 1,829 hospitals (854 government and 975 private) and covers 1,513 medical and surgical treatment procedures, including high-end and diagnostic procedures, ensuring comprehensive healthcare access to a wide range of beneficiaries.
