PET-CT scans brought under Phule Jan Arogya and Ayushman Bharat schemes in Maharashtra
Maharashtra has covered PET-CT scans under two health schemes, including as a standalone test for 13 types of cancer, to cut patients' out-of-pocket costs.
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PET-CT scans are considered important for correctly identifying cancer, determining the stage of the disease and checking the effect of treatment. The test is expensive. The Maharashtra government has now decided to provide it under the Mahatma Jyotirao Phule Jan Arogya Yojana and the Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana. For 13 selected types of cancer, PET-CT has also been included as a standalone or regular primary test. The decision will reduce the burden on cancer patients of paying for the test out of their own pockets.
The Public Health Department has issued a government resolution to this effect. According to the order, the PET-CT test has been added as an "Add-on Diagnostic Procedure" to the packages for 63 cancer treatments. It has also been approved as a "standalone diagnostic procedure" for 13 types of cancer treatment. Earlier, the facility was available in 44 treatment packages, so the number of such add-on packages has been increased.
It has been stated that because of the high cost, patients often put off PET-CT or did not get it done at all. As a result, there were delays in understanding the nature of the disease and planning treatment on time. In view of this problem, members of the public and hospitals empanelled under the scheme had been demanding that the test be included in the scheme. On the instructions of Public Health and Family Welfare Minister Prakash Abitkar, a separate study committee was formed on this demand. The government took the decision after considering the committee's recommendations.
The health minister said cancer treatment would become easier and could be carried out at the right time. According to him, the financial burden of the expensive test on patients would also come down.
Rates have been fixed for PET-CT tests. They are Rs 20,400 for a whole-body scan, Rs 14,650 for the brain, Rs 15,000 for Gallium 68 and Rs 9,400 for cardiac. Hospitals will have to follow strictly the conditions laid down in the government resolution.
Under the conditions, the concerned specialist doctor must certify the medical need for the test. A hospital empanelled under the scheme must have the necessary technical facilities, equipment, qualified staff and its own in-house PET-CT centre. Obtaining prior approval before the test and submitting the required medical documents will also be mandatory. To implement the decision effectively, the State Health Assurance Society has been directed to make the necessary changes in the National Health Authority's TMS 2.0 system.
The health minister expressed confidence that with PET-CT facilities reaching the needy through both schemes, cancer patients could be diagnosed at the correct stage and treatment could be planned in time. He said that including the test in the expanded Mahatma Phule and Jan Arogya schemes would prove an important step in the state government's fight against cancer.
