Bhubaneswar: The State Health Assurance Society (SHAS) will intensify field inspections and strengthen monitoring to detect fraud under Odisha’s universal healthcare scheme, while expediting grievance redressal, officials said after a review meeting Saturday.
At the meeting held here, the newly appointed Chief Executive Officer directed senior officials to step up field visits and sensitise hospitals about the PM-RAHAT scheme, which provides accident victims free treatment up to Rs 1.5 lakh for seven days, irrespective of their economic status, provided they are registered within 24-48 hours of the accident.
Even hospitals not empanelled under Ayushman Bharat PM-JAY can treat eligible accident victims through Hospital Empanelment Module (HEM) Lite portal, where applications are auto-approved. According to SHAS data, around 3.46 crore people have been covered under the AB PM-JAY-GJAY universal healthcare scheme.
While 3.45 lakh cards have been generated online, 1.79 crore physical co-branded cards have been distributed. Odisha ranks first nationally in physical card distribution. A total of 774 private hospitals in the state have been empanelled, while steps are underway to include government hospitals.
Beneficiaries without physical co-branded cards can also access treatment at empanelled hospitals using their ration or Aadhaar cards. During the 18 months from April 2025 to September 2026, SHAS processed and settled 22.13 lakh treatment claims worth `6,081.05 crore.
Odisha has also recorded strong performance in pre-authorisation, claim settlement and portability claims, facilitating treatment for beneficiaries seeking specialised care outside the state.
