Nagaland Health Protection Society (NHPS), Department of Health & Family Welfare, has announced that as per the approval of the state government, the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) and the Chief Minister Health Insurance Scheme (CMHIS) schemes would be implemented in “Trust Mode” from 1st April 2025.

In a circular, the NHPS informed all empanelled hospitals that it will “directly manage the scheme’s financial liabilities without engaging an Insurance Company.”

The key changes effective from 1st April 2025 will include:

1. Direct Management by NHPS: All claims and financial liabilities under PM-JAY & CMHIS will be handled by NHPS through a Third Party Administrator.
2. Claims Processing: Empanelled hospitals will continue to submit claims through the existing IT platform, which will now be managed by NHPS.
3. Payments & Reimbursements: The State Government will be solely responsible for processing and disbursing claim payments.
4. Operational Guidelines: Further details on revised operational protocols, claim processing timelines, and grievance redressal mechanisms will be issued in due course.

Read more: NPDA to suspend AB-PMJAY and CMHIS services until settlement of pending claims

Gauhati High Court directs continued implementation of AB-PMJAY and CMHIS in Nagaland