 bill no  64 of  2017 the health insurance scheme bill, 2017 by shri ashwini kumar choubey, mp a billto provide for framing of a comprehensive health insurance scheme in the country and for matters connected therewith be it enacted by parliament in the sixty-eighth year of the republic of  india as follows:—1  (1) this act may be called the health insurance scheme act, 2017(2) it extends to the whole of indiashort title, extent and commencement5(3) it shall come into force on such date as the central government may, by notificationin the official gazette, appointdefinitions2  in this act, unless the context otherwise requires,—(a) "corporation" means the health insurance corporation of india established under section 3;(b) "doctor" means a physician practicing in any recognised system of medicine;5(c) "family" means husband, wife, minor sons and daughters, dependent brother, sister and parents;10(d) "hospital" means any clinic, dispensary, medical first-aid centre, hospital, nursing home, medical consultancy centre, indoor treatment centre or a research centre, where patients are treated and includes a place where medical consultation is offered to a patient;(e) "medicine" means any drug or medicine, whether used internally or exterenally, or any life saving support system or any medicine required for physical and mental well being and includes all systems of medicine;(f) "prescribed" means prescribed by rules made under the act; and15(g) "treatment" means consultation, prescription, any investigation leading to diagnosis of disease, any type of treatment provided by any hospital and includes replacement of human organs and any treatment for physical and mental well being of the patient203 (1) the central government shall, by notification in the official gazette, establish a corporation to be known as health insurance corporation of india for carrying out the purposes of this actestablishment of health insurance corporation of india(2) the corporation shall consist of—(i) a chairperson; (ii) one representative of the union ministry of finance, as member;25(iii) one representative of the union ministry of health and family welfare, as member;31 of 1956(iv) one representative of the life insurance corporation of india established under the life insurance corporation act, 1956, as member;(v) one representative of medical profession, as member;30(vi) one representative of banking service, as member; (vii) one representative of distinguished social workers, as member; and(viii) one representative of legal profession, as member, to be appointed by the central government in such manner as may be prescribed(3) the headquarter of the corporation shall be at new delhi35(4) the corporation may set up regional offices at every state capital and at such other places as it may deem fit(5) the corporation shall set up a branch office in every city having a population of more than one million and in every district:40provided that the corporation may set up more than one branch in a district keeping in view the population and requirement of that district(6) the salary and allowances payable to and other terms and conditions of service of chairperson and members of the corporation shall be such as may be prescribed4 (1) the central government shall appoint such number of officers and other employees, as it may deem appropriate, for efficient functioning of the corporation(2) the salary and allowances payable to and other terms and conditions of service of officers and other employees of the corporation shall be such as may be prescribed55 the corporation shall frame an insurance scheme for providing medical and healthcare to all citizens of the countryappointment of officers and employees to the corporation formation of insurance scheme issuing of identity cards6 every family shall be given an identity card, containing the details of more members of the family who shall be entitled to benefits under this act including specialized treatment and such other particulars as may be prescribed10payment ofpremium7 (1) every family shall pay such amount as premium as may be prescribed to avail thebenefits under this act(2) while fixing the premium under sub-section (1), the following factors shall be taken into consideration, namely:—(i) the number of members in the family;15(ii) the annual income of the family; (iii) any previous history of disease or any medical problem to any member ofthe family; and(iv) the number of average visits to a hospital during the previous year8 the premium shall be payable at,—20(i) any branch of the corporation; orplaces for payment for premium(ii) the nearest commercial or cooperative bank; or (iii) mobile outlets of the corporation; or(iv) such other place as may be fixed by the corporation259 no family shall be entitled to benefits under this act unless the full amount of premium has been paidnonavailability of benefits for non-payment of premium benefits10 every family shall be entitled to the following benefits, namely:—(a) treatment from any hospital or a doctor; and(b) medicine from any medical shop:30provided that the corporation may, allow a person for specialised treatmenton payment of such further permium, as it may determine11 subject to the provisions of this act, a person availing of the benefits under this act shall not be required to pay any extra money, other than the premium, for treatment or cost of medicines or services availed in a hospitalno payment for treatment of medicines or other services3512 any hospital or doctor or a medical shop shall make an application to the nearest office of the corporation for reimbursement of expenses in connection with the treatment or for the cost of medicines, in such manner as may be prescribedreimbursement of expenditure for treatment medicine, etc13 the corporation shall, as soon as possible, but not later than ten days from thedate of receipt of an application under section 12, make the payment to the hospital, doctor or medical shop, as the case may betime limit for making payment by corporationpunishment14 whoever violates the provisions of section 13 shall be punished with a fine ofrupees one thousand15 the provisions of this act shall have effect notwithstanding anything contrary contained in any other law for the time being in forceoverriding effect of the act power to make rules516 (1) the central government may, by notification in the official gazette, make rulesfor carrying out purposes of this act10(2) every rule made under this section shall be laid, as soon as may be after it is made, before each house of parliament, while it is in session, for a total period of thirty days which may be comprised in one session or in two or more successive sessions, and if, before the expiry of the session immediately following the session or the successive sessions aforesaid, both houses agree in making any modification in the rule or both the houses agree that the rule should not be made, the rule shall thereafter have effect only in such modified form or be of no effect, as the case may be; so, however, that any such modification or annulment shall be without prejudice to the validity of anything previously done under that rule statement of objects and reasonsin our country, millions of people are living below poverty line and without any proper medical and healthcare medical care in our country is not upto the standard only very few people have access to good and specialized treatmentthough number of hospitals have increased over the years, yet they are not adequate to meet healthcare needs of the increasing population with the scarce resources available, the government cannot take upon itself to provide best healthcare to its citizensat present, some insurance companies provide for health insurance however, such schemes are not comprehensive in nature and cover only a small section of society and are limited to a few diseases only moreover, insurance companies are not exclusively connected with health insurancetherefore, it is proposed to set up an insurance corporation exclusively for providing best healthcare to citizens the beneficiaries will be required to make payment of premium depending upon number of members in the family, income, etc however, they will be entitled to comprehensive healthcarethe bill seeks to achieve the above objective financial memorandumclause 3 of the bill provides for the establishment of health insurance corporation of india it further provides for setting up of regional offices and branches of the corporation it also provides for appointment of chairperson and members of the corporation who shall manage the corporation clause 4 provides for appointment of the officers and employees of the corporation clause 6 provides for issuance of identity cards to beneficiaries clause 10 provides for free treatment and medicines to beneficiaries clause 13 provides that the corporation shall reimburse the expenditure to hospitals, doctors and medical shops in connection with the treatment of patients the bill, therefore, if enacted, will involve expenditure from the consolidated fund of india it is estimated that an annual recurring expenditure of about rupees five thousand crore would be involved from the consolidated fund of indiaa non-recurring expenditure of about rupees five hundred crore is also likely to be involved memorandum regarding delegated legislationclause 16 of the bill empowers the central government to make rules for carrying out the provisions of the act as the rules will relate to matters of detail only, the delegation of legislative power is of a normal character lok  sabha———— a billto provide for framing of a comprehensive health insurance scheme in the country and for matters connected therewith————(shri ashwini kumar choubey, mp)gmgipmrnd—5287ls(s3)—27-03-2017