Chandigarh, February 11 Authorities in Haryana have given the go-ahead for the surgery of a woman beneficiary of the Ayushman Bharat scheme, whose critical jaw reconstruction procedure had been delayed for two months due to "technical issues."
The woman from Faridabad, whose husband is a daily wage earner, had to undergo the surgery at the All India Institute of Medical Sciences (AIIMS), Delhi.
The authority to approve the procedure for the beneficiary from the state rests with the Haryana government.
Ayushman Bharat Haryana CEO Dr. Manoj Kumar said that the woman required a temporomandibular joint replacement, for which packages are already available under the scheme.
The procedure is listed under two packages – one for jaw reconstruction and another for an implant – but instead, approval was sought for an "unspecified new package."
According to a Times of India report, the woman suffered from ameloblastoma of the right mandible, a rare but locally aggressive jaw tumor that destroys bone and can lead to infection and facial deformity if not treated in time.
The report said that doctors in the department of oral and maxillofacial surgery at AIIMS advised an extended total temporomandibular joint replacement (one unit, right side) to remove the diseased portion of her jaw and reconstruct it.
The procedure, estimated to cost Rs 2.5 lakh, including implants, was flagged as medically urgent.
It further said that the pre-authorization procedure was filed under an unspecified surgical package, as extended temporomandibular joint replacement is not listed under the 2022 health benefit package, requiring special clearance from the state health authority.
The report also highlighted that the beneficiary was in severe pain, unable to eat solid food, and her condition had worsened. Her husband had stayed back in Delhi to care for her.
CEO Kumar highlighted that the National Health Authority discourages unspecified packages. It was earlier conveyed that the surgery should be booked "under the right package," he added.
However, keeping in view this specific procedure, which involves a poor woman beneficiary, "we have approved her case in the unspecified package on humanitarian grounds."
When asked to comment on the delay in approvals, he pointed to the "technical issue" involved.
“Though suitable packages are available for this treatment, they were clubbed together in an unspecified package and forwarded to us. But as soon as the nature of this particular case came to our notice, it was immediately approved,” he said.
