Lok Sabha Question No. 1284 (UNSTARRED), answered on 2019-06-28
Subject: Cashless Health Insurance Schemes
Ministry: HEALTH AND FAMILY WELFARE
Asked by: Bhartruhari Mahtab

## GOVERNMENT OF INDIA MINISTRY OF HEALTH AND FAMILY WELFARE DEPARTMENT OF HEALTH AND FAMILY WELFARE

## LOK SABHA UNSTARRED QUESTION NO. 1284 TO BE ANSWERED ON 28 TH JUNE, 2019

## CASHLESS HEALTH INSU RANCE SCHEMES

## 1284. SHRI BHARTRUHARI MAHTAB:

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

(a)  whether  the  Government  has  taken note  of  the  fact  that  the  private  hospitals have  been charging  between  25  to  60 percent  more  from  the  patients  who  pay  in cash  than  those  with cashles s health insurance schemes for the same procedure;

(b) if so, the details thereof and the reasons therefor along with the number of such complaints received by the Government during each of the last three years and the current year, hospital -wise;

(c)whether the Government has conducted or proposes to conduct any enquiry in this regard keeping in view that 80 to 85 percent population of the country do not have any health insurance cover;

(d) if so, the details thereof and if not, the reasons therefor; and

(e) the other corrective steps taken/ being taken by the Government in this direction?

## ANSWER THE MINISTER OF STATE IN THE MINISTRY OF HEALTH AND FAMILY WELFARE (SHRI ASHWINI KUMAR CHOUBEY)

(a) & (b): As  per  Constitutional  provisions, 'Health' is  a State  subject.    It  is  the responsibility of the respective State Government to take cognizance of such instances take action to prevent and control such practices.  Therefore, such complaints, if recei referred to the concerned State for appro priate action. Details in this regard are not maintained by the Ministry of Health & Family Welfare.

(c)  & (d): Ministry of Health and Family Welfare has no information of any enquiry in t regard.

(e): The  Government  of  India  has  enacted  the  Clinical Establishments  (Registration  and Regulation)  Act,  2010  for  registration  and  regulation  of  all  clinical  establishments Government  and  Private)  in  the  country.  Under  the  Clinical  Establishments  (Centr Government) Rules, 2012 notified under this Act, the clinical establishments (in the States / Union  Territories  where  the  said  Act  is  applicable)  are  required  to  display  their  rat conspicuous place and charge the rates for each type of procedures and services within range of rates determined from time to time in consultation with the State Governments.  The implementation  and  enforcement  of  the  said  Act  is  within  the  purview  of  the  State/ Governments.

The  Ministry  of  Health  &  Family  Welfare  has  launched  Ayushman  Bharat - Pradhan Mantri Jan A rogya Yojana (PMJAY) on 23.09.2018. This scheme provides coverage of up to Rs. 5 lakh per family per year for secondary and tertiary hospitalisation to over 10 crore vulnerable  families  covering  around  50  crore  population.  This  scheme  covers  poor and vulnerable families based on deprivation and occupational criteria as per Socio Economi Caste  Census,  2011  (SECC,  2011)  data.  PMJAY  provides  cashless  and  paperless  access  t services for the beneficiary at the point of service in any empanelled ho spital (both public and private) across India.