September 29, 2025

Why in news?

  • Introduced by: National Health Authority (NHA)
  • GCP aims to expedite insurance claim adjustments for empaneled hospitals treating AB PM-JAY beneficiaries.
  • Under it, Hospitals with good records will be instantly reimbursed 50% of the bill for any treatment under scheme through this channel.
  • Currently, the empanelled hospital receives payment once its claim is approved and paid by the State Health Agency (SHA) which is 15 days for non-portability claims and 30 days for portability claims.
  • Significance of GCP
  • Timely and judicious adjustments of claims raised by hospitals, which is key to the effective implementation of AB PM-JAY scheme.
  • Encourage greater participation of hospitals in providing treatment to AB PM-JAY beneficiaries.

 About AB PM-JAY:

  • It is an insurance scheme that offers cashless and paperless annual healthcare services benefits of up to Rs. 5 lakh per family for secondary and tertiary care hospitalization.
  • It is the world’s largest Government funded health assurance scheme. > Beneficiary families under AB-PMJAY are identified from the Socio Economic Caste Census (SECC) 2011
  • Launched in 2018, it is implemented by NHA (attached office of Ministry of Health and Family Welfare).
  • It is implemented in all States and UTs barring West Bengal, NCT of Delhi and Odisha.

 

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