Overview

• IPHSA will unify access to AB-PMJAY, MJPJY, ESIC, RAN and the Health Minister’s Discretionary Grant to expand cashless coverage for eligible patients.
• The system is designed to integrate with hospital HMIS and external scheme portals for digital identification, eligibility checks, treatment authorization and end‑to‑end claims processing.
• Rollout will proceed zone by zone, covering KEM and Kasturba first, then Nair, LTMG and Cooper along with trauma centres, peripheral hospitals, dispensaries and Aapla Dawakhana clinics.
• Officials state eligible patients will make no upfront payments, including for emergency services, with real-time dashboards tracking claims and a complaints portal gating reimbursements.
• Procurement terms include Quality‑Based Selection, an initial two‑year contract extendable by three and a 3–5% commission tied to performance, with helplines and public outreach slated after initial deployment and alignment with recent MJPJY expansions.