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Core Purpose

Notification making the Cashless Treatment of Road Accident Victims Scheme, 2025 under section 162 read with sub-section (4) of section 215 of the Motor Vehicles Act, 1988.

Detailed Summary

The Ministry of Road Transport and Highways, in exercise of powers conferred by section 162 read with sub-section (4) of section 215 of the Motor Vehicles Act, 1988 (59 of 1988), hereby makes the Cashless Treatment of Road Accident Victims Scheme, 2025. This Scheme shall come into force with effect from the 5th May, 2025, as per S.O. 2015(E) dated 5th May, 2025. The Scheme defines terms such as 'Act' (Motor Vehicles Act, 1988), 'designated hospital', 'Fund' (Motor Vehicle Accident Fund as defined in sub-rule (b) of rule 2 of the Central Motor Vehicles (Motor Vehicle Accident Fund) Rules, 2022), 'guidelines', 'National Health Authority', 'portal', 'State Government', 'State Health Agency', 'State Road Safety Council', 'treatment package', and 'treatment package rate'. Any person victim of a road accident arising from the use of a motor vehicle on any road is eligible for cashless treatment at a designated hospital up to one lakh fifty thousand rupees (₹1,50,000) per victim for a maximum period of seven days from the date of the accident. Treatment at non-designated hospitals is for stabilisation only. The State Road Safety Council shall be the nodal agency for implementation, coordinating with the National Health Authority and State Health Agency. The Scheme mandates treatment through treatment packages with payment based on treatment package rates. Designated hospitals must commence treatment immediately and may refer victims to other designated hospitals if necessary. Hospitals raise claims on the portal, which are verified, approved/rejected by the State Health Agency, and paid from the Fund within ten days of receiving the approved payment. Detailed guidelines issued by the Central Government shall be read along with the Scheme, prevailing in case of inconsistency. A Steering Committee is constituted by the Central Government to monitor implementation, chaired by the Secretary, Ministry of Road Transport and Highways, with members including CEO, National Health Authority; Additional Secretary, Ministry of Road Transport and Highways-cum-Chairperson (Settlor), Motor Vehicle Accident Fund Trust; Joint Secretaries from Ministries of Home Affairs, Health and Family Welfare, Department of Financial Services (Ministry of Finance); Secretary General, General Insurance Council; Deputy Director General, National Informatics Centre; representatives of State Health Agencies; Director or Deputy Secretary, Ministry of Road Transport and Highways (Member-Convener); and representatives of Non-Governmental Agencies. The Steering Committee shall meet at least twice a year. Implementation is also monitored by the State Road Safety Council and the District Road Safety Committee constituted under sub-section (3) of section 215 of the Act. The Ministry of Road Transport and Highways is the Central Government's nodal authority for guidelines and addressing Scheme issues.

Full Text

REGD. No. D. L.-33004/99 The Gazette of India CG-DL-E-05052025-262912 EXTRAORDINARY PART II-Section 3-Sub-section (ii) PUBLISHED BY AUTHORITY No. 1971] NEW DELHI, MONDAY, MAY 5, 2025/VAISAKHA 15, 1947 2969 GI/2025 MINISTRY OF ROAD TRANSPORT AND HIGHWAYS NOTIFICATION New Delhi, the 5th May, 2025 S.O. 2015(E). In exercise of the powers conferred by section 162 read with sub-section (4) of section 215 of the Motor Vehicles Act, 1988 (59 of 1988), the Central Government hereby makes the following Scheme, namely:- 1. Short title and commencement. - (1) This Scheme may be called the Cashless Treatment of Road Accident Victims Scheme, 2025. (2) It shall come into force with effect from the 5th May, 2025. 2. Definitions.-(1) In this scheme, unless the context otherwise requires,- (a) "Act" means the Motor Vehicles Act, 1988 (59 of 1988); (b) "designated hospital" means the hospital or clinical establishment onboarded by the State Government with the National Health Authority for providing cashless treatment to victims of road accidents arising out of the use of motor vehicles; (c) "Fund" means the Motor Vehicle Accident Fund as defined in sub-rule (b) of rule 2of the Central Motor Vehicles (Motor Vehicle Accident Fund) Rules, 2022; (d) "guidelines" means the guidelines issued from time to time by the Central Government to guide the implementation of the Scheme to provide appropriate and timely treatment to victims of road accidents arising from the use of a motor vehicle and to ensure timely payment to hospitals where treatment to the victim is provided; (e) "National Health Authority" means the Authority established under the Ministry of Health and Family Welfare for implementation of the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana; (f) "portal" means an inter-linked web or electronic based system for implementation of the Scheme; (g) "State Government” means a State Government or Union Territory Administration, as the case may be; (h) "State Health Agency" shall mean the entity recognised by the National Health Authority for implementation of the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana; (i) "State Road Safety Council" means the Council for a State or Union Territory, as the case may be, constituted under sub-section (2) of section 215 of the Act; (j) "treatment package" means the treatment package as specified by the National Health Authority for providing cashless treatment under the Scheme; (k) "treatment package rate" means the acceptable limit of cost of treatment decided by the National Health Authority corresponding to the treatment package for which payment under the Scheme shall be made. (2) Words and expressions used in the Scheme and not defined herein, but defined in the Act, shall have the meanings respectively assigned to them in the Act. 3. Eligibility and coverage.- (1) Any person being a victim of road accident arising out of the use of motor vehicle (hereinafter referred to as the victim), occurring on any road, shall be entitled to cashless treatment in accordance with the provisions of this Scheme. (2) The victim shall be entitled to cashless treatment at any designated hospital for an amount up to one lakh fifty thousand rupees per victim for a maximum period of seven days from the date of such accident: (3) The treatment under this Scheme at a hospital other than a designated hospital shall be for stabilisation purposes only and shall be as specified by the guidelines: Provided that the State Government shall take all necessary steps to onboard all hospitals capable of providing trauma and polytrauma care to victims as designated hospitals for the implementation of the Scheme. 4. Nodal agency.-(1) The State Road Safety Council shall be the nodal agency for implementation of the Scheme for that State or Union Territory: Provided that the State Government may specify, with the prior approval of the Central Government, any other entity to be the nodal agency. (2) The nodal agency may specify implementation agencies for the implementation of the Scheme, in whole or any part thereof, as specified by the guidelines. 5. Functions of nodal agency. - (1) The nodal agency shall, for the purpose of implementation of the Scheme, perform such functions as may be specified by the guidelines. (2) Without prejudice to sub-clause (1), the nodal agency shall,- (i) coordinate with National Health Authority for adoption and utilisation of the portal for onboarding of designated hospitals, treatment of victims, payment to the designated hospital on treatment and related matters; (ii) coordinate with State Health Agency to designate hospitals under the Scheme for providing treatment, in addition to the hospitals empanelled under the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana, as specified by the National Health Authority; (iii) coordinate with State Health Agency to implement measures required for the detection and prevention of fraud or misuse of the Scheme or its benefits; (iv) develop, implement and maintain a mechanism for redressal of grievances arising from the implementation of the Scheme; (v) oversee the timely disbursement of payments due to the designated hospital on the portal; and (vi) perform such other functions or discharge any other responsibility entrusted to it, from time to time, by the Central Government, for the proper implementation of the Scheme. 6. Treatment packages.- (1) The medical treatment under the Scheme shall be administered through treatment packages. (2) The payment for the cost of treatment package to the designated hospital provided under the Scheme shall be based on the treatment package rate. 7. Medical treatment to a victim.- (1) The designated hospital shall commence and administer medical treatment to the victim immediately on the victim being brought to the hospital. (2) The procedure to be followed by designated hospital in pursuance of the Scheme, shall be as specified by the guidelines. (3) In case the designated hospital deems that the treatment facilities or the expertise necessary for the proper treatment of the victim are not available with it, such designated hospital may immediately refer the victim to another designated hospital and indicate the transfer on the portal and also make arrangements for the transportation of the victim to such designated hospital by an ambulance. 8. Payments to hospitals.- (1) After discharge of the victim under the Scheme, the designated hospital or such other hospital providing stabilization treatment, as the case may be, shall raise a claim for payment of the cost of treatment package on the portal, in such manner and along with such documents as specified by the State Health Agency. (2) The claim submitted under sub-clause (1) shall be verified by the State Health Agency: Provided that the State Health Agency may seek further information from other agencies or authorities as deemed necessary for payment of the claim amount for the cost of treatment package to the designated hospital. (3) The State Health Agency shall either approve, in full or in part, or reject the claim, in full or in part, for reasons to be recorded on the portal and make available to the designated hospital or such other hospital: (4) On approval of the claim by the State Health Agency, the approved payment for the cost of treatment package to the designated hospital shall be transferred on the portal to such agency or authority as specified in the guidelines. (5) The payment shall be made by such agency or authority from the concerned account of the Fund within a period of ten days from the date of receipt of the approved payment under sub-clause (4) from the State Health Agency. Explanation. - For the purpose of this clause, “approved payment” shall mean such claim amount which is approved for payment to the designated hospital or such other hospital by the State Health Agency for the treatment package administered to the victim in accordance with the treatment package rate. 9. Guidelines to the Scheme.- (1) For the effective implementation of the Scheme, the detailed guidelines issued by the Central Government from time to time, shall be read along with the Scheme. (2) In case of any inconsistency between the Scheme and the guidelines, the provisions of the Scheme shall prevail. 10. Scheme monitoring mechanism.- (1) A Steering Committee, having the following composition, shall be constituted by the Central Government to monitor the implementation of the Scheme, namely:- +-----+-----------------------------------------------------------+------------+ | S. No. | Committee Members | Role | +=====+===========================================================+============+ | (1) | (2) | (3) | +-----+-----------------------------------------------------------+------------+ | 1. | Secretary, Ministry of Road Transport and Highways | Chairperson| +-----+-----------------------------------------------------------+------------+ | 2. | CEO, National Health Authority | Member | +-----+-----------------------------------------------------------+------------+ | 3. | Additional Secretary, Ministry of Road Transport and | Member | | | Highways-cum-Chairperson (Settlor), Motor Vehicle Accident| | | | Fund Trust | | +-----+-----------------------------------------------------------+------------+ | 4. | Joint Secretary, Ministry of Home Affairs | Member | +-----+-----------------------------------------------------------+------------+ | 5. | Joint Secretary, Ministry of Health and Family Welfare | Member | +-----+-----------------------------------------------------------+------------+ | 6. | Joint Secretary, Department of Financial Services, Ministry| Member | | | of Finance | | +-----+-----------------------------------------------------------+------------+ | 7. | Secretary General, General Insurance Council | Member | +-----+-----------------------------------------------------------+------------+ | 8. | Deputy Director General, National Informatics Centre | Member | +-----+-----------------------------------------------------------+------------+ | 9. | Representatives of State Health Agencies of six States and| Member | | | Union Territories on rotation basis | | +-----+-----------------------------------------------------------+------------+ | 10. | Director or Deputy Secretary, Ministry of Road | Member - | | | Transport and Highways | Convener | +-----+-----------------------------------------------------------+------------+ | 11. | Representatives of three Non-Governmental Agencies working| Member. | | | in the area of road safety as may be nominated by the | | | | Central Government | | +-----+-----------------------------------------------------------+------------+ (2) The Steering Committee shall meet at least twice in a year, at such time, date and at such place as the Chairperson may, from time to time, specify in this behalf. (3) The Steering Committee may seek information from any State Road Safety Council or any entity or officer involved in the implementation of the Scheme for the purpose ofmonitoring the implementation of the Scheme. (4) The implementation of the Scheme in each State or Union Territory shall be monitored by the respective State Road Safety Council. (5) The implementation of the Scheme in each district shall be monitored by the District Road Safety Committee constituted under sub-section (3) of section 215 of the Act. (6) The Ministry of Road Transport and Highways shall be the nodal authority in the Central Government for notification of the guidelines and addressing issues related to the Scheme. [F. No. RT-11028/01/2024-MVL-Part (4)] MAHMOOD AHMED, Addl. Secy.

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