Maha to fund high cost transplants above Rs5 lakh via corpus fund

Nagpur: Maharashtra govt has removed the biggest financial barrier to life-saving organ transplants, announcing that costs beyond Rs5 lakh will now be fully covered by the state through a dedicated corpus fund. Backed by a govt resolution (GR) dated April 10, the move sharply expands the reach of the Mahatma Jyotirao Phule Jan Arogya Yojana and Ayushman Bharat Pradhan Mantri Jan Arogya Yojana, bringing high-cost, rare transplants within reach of ordinary patients. Under the revised framework, the treatment cap has been standardised at Rs5 lakh across both schemes. However, recognising that organ transplants can cost anywhere between Rs10-20 lakh, the govt has created a special reserve corpus fund to cover expenses exceeding this limit. Notably, 20% of claim funds received by public hospitals since the 2023 expansion have been earmarked to build this fund, which will support nine categories of rare organ and artificial transplants. The scheme now covers major procedures such as heart, lung, liver, pancreas, kidney, bone marrow and corneal transplants, along with combined heart-lung and small intestine transplants. All procedures must comply with the Transplantation of Human Organ and Tissue Act, ensuring legal and ethical standards in organ allocation and surgery. To streamline approvals, a three-tier governance mechanism has been established. A scrutiny committee will verify applications, followed by a medical and corpus fund approval committee led by the State Health Assurance Society CEO, with experts from Directorate of Medical Education and Research, State Organ and Tissue Transplant Organisation and All India Institute of Medical Sciences. This committee will meet weekly to grant both medical and financial approvals. A third panel will monitor fund utilisation and provide post-treatment clearances. Eligibility criteria remain focused on inclusivity — beneficiaries must be Maharashtra residents and possess valid documentation such as Aadhaar card, ration card, domicile certificate and medical reports, along with transplant-specific approvals like organ allocation letters. Patients must undergo treatment at empanelled hospitals, which are required to maintain cost transparency and adhere strictly to transplant regulations.The application process involves approaching an empanelled hospital and consulting an ‘Arogya Mitra'. After a doctor recommends the transplant, the hospital submits the proposal — currently offline, with an online system in development — to the State Health Assurance Society. Once approved, funds are directly transferred to the hospital, ensuring seamless treatment without financial burden on patients. Nagpur Civil Surgeon Dr Nivrutti Rathod said that no patient should lose their life due to the inability to afford expensive surgeries, and the Rs5 lakh cap will no longer be a barrier. He added that efforts are being made to simplify the system so that more patients can benefit from the scheme.
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