Lok Sabha Question No. 880 (UNSTARRED), answered on 2018-12-14
Subject: Ayushman Bharat National Health Protection Mission (AB-NHPM)
Ministry: HEALTH AND FAMILY WELFARE
Asked by: RAVINDRA VISHWANATH GAIKWAD, KONDA VISHWESHWAR REDDY, KONAKALLA NARAYANA RAO, PRALHAD VENKATESH JOSHI, M. B. RAJESH, C. MAHENDRAN, PRITAM GOPINATH MUNDE, PRASUN BANERJEE, RAM CHARITRA, ABHISHEK SINGH, GOPALAKRISHNAN CHINNARAJ, KIRIT SOMAIYA, A.P. JITHENDER REDDY, SUNIL KUMAR SINGH, RAMACHANDRAN MULLAPPALLY, R. PARTHIPAN, CHANDRAKANT BHAURAO KHAIRE, Tejpratap Singh,Yadav, Shrirang Appa Barne, ANANDRAO  ADSUL, SUSHIL KUMAR SINGH, (ADV.) JOICE GEORGE, VIJAY KUMAR S.R., DHARMENDRA YADAV, T. RADHAKRISHNAN, SHRIKANT EKNATH SHINDE, SHIVAJI ADHALRAO PATIL, SUDHEER GUPTA, T.G. VENKATESH BABU, S. RAJENDRAN, J. JAYASINGH THIYAGARAJ NATTERJEE, DUSHYANT CHAUTALA, RAVNEET SINGH, ASHOK SHANKARRAO CHAVAN, VINAYAK BHAURAO RAUT, KUNWAR HARIBANSH SINGH, KAUSHALENDRA KUMAR, RANGASWAMY DHRUVANARAYANA

## GOVERNMENT OF INDIA MINISTRY OF HEALTH AND FAMILY WELFARE

## DEPARTMENT OF HEALTH AND FAMILY WELFARE

## LOK SABHA UNSTARRED QUESTION NO. 880 TH

TO BE ANSWERED ON 14 DECEMBER, 2018

## AYUSHMAN BHARAT NATI ONAL HEALTH PROTECTION MISSION (AB - NHPM)

## 880. PROF. RAVINDRA VISHWANATH GAIKWAD:

SHRI KONDA VISHWESHWAR REDDY:

SHRI KONAKALLA NARAYANA RAO:

SHRI PRALHAD JOSHI:

SHRI M.B. RAJESH:

SHRI C. MAHENDRAN:

DR. PRITAM GOPINATH MUNDE:

SHRI PRASUN BANERJEE:

SHRI RAM CHARITRA NISHAD:

SHRI ABHISHEK SINGH:

DR. C. GOPALAKRISHNAN:

DR. KIRIT SOMAIYA:

SHRI A.P. JITHENDER REDDY:

SHRI SUNIL KUMAR SINGH:

SHRI MULLAPPALLY RAMACHANDRAN:

SHRI R. PARTHIPAN:

SHRI CHANDRAKANT KHAIRE:

SHRI TEJ PRATAP SINGH YADAV:

SHRI SHRIRANG APPA BARNE:

SHRI ANANDRAO ADSUL:

SHRI SUSHIL KUMAR SINGH:

ADV. JOICE GEORGE:

SHRI S.R. VIJAYAKUMAR:

SHRI DHARMENDRA YADAV:

SHRI T. RADHAKRISHNAN:

DR. SHRIKANT EKNATH SHINDE:

SHRI ADHALRAO PATIL SHIVAJIRAO:

SHRI SUDHEER GUPTA:

SHRI VENKATESH BABU T.G.:

SHRI S. RAJENDRAN:

SHRI J.J.T. NATTERJEE:

SHRI DUSHYANT CHAUTALA:

SHRI RAVNEET SINGH:

SHRI ASHOK SHANKARRAO CHAVAN:

SHRI VINAYAK BHAURAO RAUT:

KUNWAR HARIBANSH SINGH:

SHRI KAUSHALENDRA KUMAR:

SHRI R. DHRUVA NARAYANA:

Will the Minister of HEALTH AND FAMILY WELFARE be pleased to state:

- (a) the details and s lient features of the Ayushman Bharat - National Health Protection Mission (AB - NHPM) along with the funds allocated/released and the number of persons benefitted under theMission so far; State/UT/year -wise;
- (b)  whether  the  Government  plans  to rope  in  pri vate  hospitals  and  Ayushman Mitras  for providing quality healthcare under the Scheme, if so, the details thereof including the safeguards adopted to prevent profiteering by private hospitals/agencies;
- (c)  whether  some  private  hospitals have  requested  to  r evise  package  rates offered  under  the Mission, if so, the details thereof and steps taken in this regard;
- (d) the details of State/UTs that have signed MoUs with the Government for implementation of the Scheme;
- (e) whether the health cover under the sche me is not available to AYUSH System of medicine, if so, the details and reasons therefor; and
- (f)  whether  the  Government  has  also taken  note  of  fake  websites  and  mobile applications spreading false information about the Mission, if so, the corrective steps taken in this regard?

## ANSWER THE MINISTER OF STATE IN THE MINISTRY OF HEALTH AND FAMILY WELFARE (SMT. ANUPRIYA PATEL )

- (a): Pradhan  Mantri  Jan  Arogya  Yojana  (PMJAY),  earlier  known  as  Ayushman Bharat National Health Protection Mission, provides benefit coverage of upto Rs. 5 lakh per annu family  to  the  identified  poor  and  vulnerable  families  for  secondary  and  tertiar hospitalisation. Salient features of PMJAY are annexed as Annexure -I.

PMJAY was launched on 23.09.2018 and for the current Financial Year, at the Budge Estimate stage, Rs. 2000/ -crore were allocated for it. As on 10.12.2018, Rs. 817.73 crore ha been released to States/UTs. The details are attached as Annexure -II. As on 11.12.2018, the total number of hospital admissions were 4,92,073.

- (b): As PMJAY is implemented by the respective State Governments, the responsibility empanelment of hospitals rests with them. Private hospitals are empanelled under PMJAY ba on defined criteria and hospital empanelment guidelines.

For the hospitalization services rendered, empanelled hospitals can charge only as pre - defined package rates.

Under  PMJAY,  there  is  a  provision  of  having  Pradhan  Mantri  Arogya  Mitras  at  th e empanelled health care providers. Guidelines have been issued in this regard.

- (c): Some private health care providers have requested to increase the package rates. have the flexibility to decrease the rates, or increase up to 10%, or adopt rates as per the existing State Scheme depending on their suitability.
- ( d) : 33 States/UTs have signed MoUs except Odisha, Telangana & UT of Delhi.
- ( e) : PMJAY is still in its implementation stage and at present its benefit packages cover AYUSH System of Medicine.
- (f): Yes. Fake entities, (Websites, Mobile Applications, Videos) trying to spr misinformation about PMJAY, are being proactively mon itored. So far a list of 68 fake mobile applications and 54 websites on internet spreading false news about PMJAY has been compi and following steps have been taken:
- i. Issue  of  Public  Advisory  on  the  official  website  to  inform  citizens  about  such ent ities.
- ii. Sharing  the  list  with  the  concerned  authorities  including  Chief  Information  Sec Officer of India, Ministry of Home Affairs and Ministry of Electronics and Informa Technology, requesting them to take the necessary action against these entiti es.
- iii. Filed an FIR against such entities.

Consequently, 62 out of 68 Fake Mobile Applications have been closed and 23 out of fake websites have been either blocked or shut down.

## Annexure-I

## Salient features of PMJAY launched on 23.09.2018 for families belonging to poor, vulnerable and disadvantage sections of populations are as under:

1. Cashless and paperless access to services for the beneficiary at the point of service in any (both public and private) empanelled hospitals across India.
2. The benefit coverage of PMJAY is Rs. 5,00,000/- covering over 10 Crore beneficiary families (identified through SECC database). This cover of Rs. 5.00 lakh is able to take care of almost all secondary care and most of tertiary care procedures.
3. No family size, ensuring all members of designated families specifically girl child and senior citizens get coverage. It is suggested to preferably make woman as the head of family.
4. This Scheme is on entitlement basis. Every family figuring in defined SECC Database will be entitled to claim benefit under the scheme. The beneficiaries are encouraged to bring Aadhaar for the purpose of identification. However, no person is denied benefits under the scheme in the absence of Aadhaar.
5. Implementation Arrangement -States have the option to use an existing Trust/ Society/ Not for Profit Company [SNA] or set up a new Trust/ Society/ Not for Profit Company [State  Health  Protection  Mission  Agency]  to  implement  the  scheme. With  respect  to implementation, the States are free to choose the modalities for implementation. They can implement the scheme through insurance company or directly through the Trust/ Society or mixed model.
6. A well-defined Complaint and Public Grievance Redressal Mechanism, actively utilising electronic,  mobile  platform,  internet  as  well  as  social  media,  has  been  put  in  place through  which  complaints/  grievances  are  registered,  acknowledged,  escalated  for relevant action, resolved and monitored.
7. While ensuring user convenience, robust safeguards have been created to prevent misuse/  fraud/  abuse  by  providers  and  users.  Pre-Authorisation  has  been  made mandatory for all tertiary care and selected secondary care packages.

| Budget allcoated                                 | Budget allcoated                                 | 3125 crore                                       |                                                  |
|--------------------------------------------------|--------------------------------------------------|--------------------------------------------------|--------------------------------------------------|
| Statement of Release of Grant (As on 10.12.2018) | Statement of Release of Grant (As on 10.12.2018) | Statement of Release of Grant (As on 10.12.2018) | Statement of Release of Grant (As on 10.12.2018) |
| Sr. No.                                          | Name of State/UT                                 | No. Beneficiary                                  | Amount released to States/UTs (In Crore)         |
| 1                                                | Chhattisgarh                                     | 3729027                                          | 114.44                                           |
| 2                                                | Uttar Pradesh                                    | 11804647                                         | 32.71                                            |
| 3                                                | Himachal Pradesh                                 | 277005                                           | 7018                                             |
| 4                                                | Manipur                                          | 277016                                           | 7.18                                             |
| 5                                                | Tripura                                          | 494397                                           | 12.81                                            |
| 6                                                | Mizoram                                          | 194859                                           | 5.05                                             |
| 7                                                | Bihar                                            | 10895176                                         | 188.27                                           |
| 8                                                | Jharkhand                                        | 2805753                                          | 48.48                                            |
| 9                                                | Gujarat                                          | 4485227                                          | 77.50                                            |
| 10                                               | West Bengal                                      | 11189146                                         | 193.35                                           |
| 11                                               | Haryana                                          | 1551731                                          | 26.81                                            |
| 12                                               | Madhya Pradesh                                   | 8381782                                          | 27.57                                            |
| 13                                               | Dadra & Nagar Haveli                             | 32614                                            | 0.94                                             |
| 14                                               | Daman & Diu                                      | 10191                                            | 0.29                                             |
| 15                                               | Tamil Nadu                                       | 7770928                                          | 11.66                                            |
| 16                                               | Sikkim                                           | 39791                                            | 1.03                                             |
| 17                                               | Maharashtra                                      | 8363664                                          | 12.55                                            |
| 18                                               | Nagaland                                         | 233328                                           | 4.72                                             |
| 19                                               | Assam                                            | 2701763                                          | 21.08                                            |
| 20                                               | Jammu and Kashmir                                | 613648                                           | 20.64                                            |
| 21                                               | Arunachal Pradesh                                | 88928                                            | 2.31                                             |
| 22                                               | Lakshadweep                                      | 1465                                             | 0.00                                             |
| 23                                               | Chandigarh                                       | 71278                                            | 0.18                                             |
| 24                                               | Puducherry                                       | 103433                                           | 0.16                                             |
| 25                                               | Goa                                              | 36974                                            | 0.64                                             |
| 26                                               | Andaman Nicobar Islands                          | 21399                                            | 0.05                                             |
| 27                                               | Uttarakhand                                      | 142640                                           | 0.12                                             |
| Grand Total                                      | Grand Total                                      | Grand Total                                      | 817.73                                           |