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About National Health Claim Exchange (NHCX)


The National Health Authority (NHA) and the Insurance Regulatory and Development Authority of India (IRDAI) have joined hands to operationalize the National Health Claim Exchange (NHCX).


GS II: Health

Dimensions of the Article:

  1. National Health Claim Exchange (NHCX)
  2. National Health Authority (NHA)

National Health Claim Exchange (NHCX):

Development and Purpose:

  • Digital health claims platform developed by the National Health Authority.
  • Serves as a gateway for exchanging claims-related information among stakeholders in the healthcare and health insurance ecosystem.

Key Features:

  • Designed to be interoperable, ensuring compatibility with various systems.
  • Machine-readable for efficient data processing.
  • Auditable and verifiable to maintain accuracy and trustworthiness of exchanged information.

National Health Authority (NHA):

  • Responsibilities:
    • Apex body implementing Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY).
    • Tasked with designing strategy, building technological infrastructure, and implementing the “National Digital Health Mission” to create a National Digital Health Eco-system.
  • Evolution and Autonomy:
    • Successor of the National Health Agency, reconstituted as the National Health Authority in January 2019.
    • Originally functioned as a registered society and transitioned to full functional autonomy.
  • Structure and Governance:
    • Attached office of the Ministry of Health and Family Welfare.
    • Governed by a Governing Board chaired by the Union Minister for Health and Family Welfare.
    • Headed by a Chief Executive Officer (CEO), holding the rank of Secretary to the Government of India.
    • CEO serves as the Ex-Officio Member Secretary of the Governing Board.
  • State-Level Implementation:
    • Implementation at the State level involves the establishment of State Health Agencies (SHAs) as societies/trusts.
    • SHAs are set up by respective States to execute the scheme locally.

December 2023