Lok Sabha Question No. 94 (STARRED), answered on 2019-02-08
Subject: Ayushman Bharat Yojana
Ministry: HEALTH AND FAMILY WELFARE
Asked by: MALLIKARJUN  KHARGE, OM BIRLA

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

## LOK SABHA STARRED QUESTION NO. 94 TO BE ANSWERED ON THE 8 TH FEBRUARY ,2019 AYUSHMAN BHARAT YOJA NA

## *94. SHRI MALLIKARJUN KHARGE: SHRI OM BIRLA:

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

- (a)  whether  the  Government  is  implementing  the  Ayushman  Bharat  Yojana covering nearly half the population of the country, if so, the salient fea targets of the scheme;
- (b) the amount for which applications have been received under the said Yojana date and the quantum of amount released to beneficiaries, State - wise;
- (c)  whether the  Government  plans  to  include  economically  poor  persons  in addition to BPL Card holders under the said scheme and if so, the details along  with  the  number  of  persons  benefited  under  the  said  scheme  till State/UTwise;
- (d) whether the Gove rnment has identified adequate number of hospitals under th scheme and if so, the details thereof along with the number of hospitals c under the scheme currently, Statewise; and
- (e) the steps taken by the Government to meet the shortage of doctors , tap/infuse the  resources,  infrastructure  and  paramedics  into  the  system,  create  awa among the people and effectively implement the scheme?

## ANSWER THE MINISTER OF HEALTH AND FAMILY WELFARE (SHRI JAGAT PRAKASH NADDA)

(a) to ( e) : A Statement is laid on the Table of the House.

## STATEMENT REFERRED TO IN REPLY TO LOK SABHA STARRED QUESTION NO. 94* FOR 8 TH FEBRUARY , 20 19

(a) The  Government  has  launched  Ayushman  Bharat  Programme to  address access  to  health  holistically,  including  prevention,  health  promotion,  p secondary  and  tertiary  care.    Ayushman  Bharat  Yojana  comprises  of  tw components namely (i) Provision of Comprehensive Primary Healthcare (CPHC) through Health and Wellness Centers (HWCs) and (ii) Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PMJAY).

Health and Wellness Centres are envisaged to provide an expanded packag of  primary  healthcare  services  encompassing  reproductive  and  child  hea services, communi cable diseases, non - c mmunicable disease, palliative care and elderly care, oral health and ENT care, and basic emergency care in addit preventive  care  and  health  promotion,  provision  of  point  of  care  diagno regular refills of essential drugs e tc.

Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PMJAY) provides hospitalisation coverage up to Rs.5.00 lakh per family per year for seconda tertiary  care  procedures  including  certain  defined  pre  and  post  hospital expenses  to  families  eli gible  based  on  specified  deprivation  and  occupational criteria as per Socio Economic Caste Census (SECC) database. The salient fea of  Ayushman  Bharat - Pradhan  Mantri  Jan  Arogya  Yojana  (AB - PMJAY)  are provided at Annexure - I.

(b) to (d) AB - PMJAY  is  an  e ntitlement - based scheme under which coverage is linked to deprivation. Beneficiary families for PMJAY have been identified o basis  of  defined  criteria  using  the  SECC  data.  Beneficiaries  of  the  sche entitled  to  cashless  treatment  for  the  approved treatment  packages  in  the empanelled Government or Private hospitals for which claims are submitted by hospitals. State - wise  details  of  empanelled  hospitals,  beneficiaries  admitted, claims submitted by the hospitals are at annexure II.

(e)  For ef f ctive implementation of PMJAY, Government has set up a National Health Authority at national level. At the State level, State Health Agenci been set up by the implementing States/UTs. In order to spread awareness a AB - PMJAY,  a  comprehensive  me dia and outreach strategy has been developed, which,  inter  alia,  includes  use  of  print  media,  electronic  media,  socia platforms, traditional media, IEC materials and outdoor activities

The  steps  taken  by  the  Government  to increase  the  numbers of  doc tors, paramedics, and infrastructure are at annexure III.

## Annexure I

## Salient features of Prime Minister Jan Arogya Yojana [PMJAY]

1. Government of India has launched Ayushman Bharat Pradhan Mantri Jan Aro Yojana (PMJAY)  on  23.09.2018.  PMJAY  is  centrally  sponsored  scheme.  It entirely  funded  by  Government  and  the  funding  is  shared  between  Cent State governments as per prevailing guidelines of Ministry of Finance.
2. PMJAY  provides  health  coverage  up  to  Rs.  5 lakh  per  family  per  year  fo secondary  and  tertiary  hospitalization  to  around  10.74  crore  entitl (approx. 50 crore beneficiaries).
3. PMJAY is an entitlement based scheme. This scheme covers poor and vulnerable families based on deprivation and occupational criteria as per SECC data.
4. PMJAY provides cashless and paperless access to services for the benef the point of service in any (both public and private) empanelled hospi India.  In  other  words,  a  beneficiary  from  one  State can  avail  benefits  from  an empanelled Hospital anywhere in the Country.
5. Under PMAJY, the States are free to choose the modalities for impleme They can implement the scheme through insurance company or directly th the Trust/ Society or mixed m odel.
6. There is no restriction on family size, ensuring all members of designa specifically girl child and senior citizens get coverage.
7. At National level, National Health Authority (NHA) has been set up to i the scheme.
8. MoU  has  been signed  between  National  Health  Agency  (now  National Health Authority) and 33 States/UTs to implement PMJAY.
9. About  1393  treatment  packages  are  available  for  the  beneficiaries  u PMJAY.
10. The details of package, operational guidelines and key features are av ilable at www. pmjay.gov.in

| State                       | Beneficiary families covered (in lakhs)*   | Hospitals Empaneled   | Beneficiaries Admitted in Hospital   | Claims Submitted   | Claims Submitted Amount   |
|-----------------------------|--------------------------------------------|-----------------------|--------------------------------------|--------------------|---------------------------|
| Andaman And Nicobar Islands | 0.78                                       | 3                     | 8                                    | 6                  | 23000                     |
| Arunachal Pradesh           | 0.89                                       | 2                     | 164                                  | 49                 | 884300                    |
| Assam                       | 27.02                                      | 153                   | 15533                                | 8567               | 117679946                 |
| Bihar                       | 108.95                                     | 631                   | 10386                                | 8899               | 72573664                  |
| Chandigarh                  | 0.71                                       | 10                    | 243                                  | 205                | 3115135                   |
| Chhattisgarh                | 41.46                                      | 1323                  | 198447                               | 180762             | 1278106472                |
| Dadra And Nagar Haveli      | 3.4                                        | 4                     | 2726                                 | 2422               | 6770020                   |
| Daman And Diu               | 2.4                                        | 4                     | 899                                  | 775                | 2774200                   |
| Goa                         | 0.37                                       | 4                     | 2829                                 | 1818               | 65894655                  |
| Gujarat                     | 44.85                                      | 2676                  | 199128                               | 145228             | 2108200798                |
| Haryana                     | 15.51                                      | 357                   | 5228                                 | 4473               | 66436726                  |
| Himachal Pradesh            | 4.8                                        | 198                   | 4317                                 | 2250               | 24414494                  |
| Jammu And Kashmir           | 6.13                                       | 150                   | 1125                                 | 854                | 7986480                   |
| Jharkhand                   | 57                                         | 595                   | 50996                                | 45277              | 435197902                 |
| Karnataka                   | 115                                        | 880                   | 85299                                | 65172              | 1699590222                |
| Kerala (implementing RSBY)  | 34.84                                      | 446                   | 188193                               | 86630              | 338018759                 |
| Lakshadweep                 | 0.01                                       | 1                     | 0                                    | 0                  | 0                         |
| Madhya Pradesh              | 118                                        | 211                   | 25321                                | 19273              | 173805022                 |
| Maharashtra                 | 83.63                                      | 488                   | 65942                                | 57758              | 1368333707                |
| Manipur                     | 2.77                                       | 15                    | 931                                  | 667                | 11055183                  |
| Meghalaya                   | 8.37                                       | 152                   | 0                                    | 0                  | 0                         |
| Mizoram                     | 1.95                                       | 104                   | 3758                                 | 3125               | 22351474                  |
| Nagaland                    | 2.5                                        | 59                    | 126                                  | 116                | 1149680                   |
| NHA Empanelled Hospitals    | -                                          | 21                    | 968                                  | 593                | 23418837                  |
| Puducherry                  | 1.04                                       | 1                     | 0                                    | 0                  | 0                         |
| Punjab                      | 42                                         | -                     | 0                                    | 0                  | 0                         |
| Rajasthan                   |                                            | -                     | 0                                    | 0                  | 0                         |
| Sikkim                      | 0.4                                        | 7                     | 8                                    | 7                  | 111200                    |
| Tamil Nadu                  | 157                                        | 2180                  | 117490                               | 110835             | 1929602573                |
| Tripura                     | 4.9                                        | 64                    | 2987                                 | 2505               | 12510700                  |
| Uttar Pradesh               | 118.04                                     | 1618                  | 29532                                | 25592              | 266247262                 |
| Uttarakhand                 | 19.68                                      | 182                   | 4723                                 | 2822               | 23750270                  |
| West Bengal                 | 112                                        | 1240                  | 17636                                | 14777              | 141452393                 |
| Overall                     | 1,136                                      | 13,779                | 1,034,943                            | 791,457            | 10,201,455,074            |

1. Under Ayushman Bharat Programme 1.5 lakh Health Sub Centres and Primary Health Centres are to be transformed into Health and Wellness Centres (HWCs) by December, 202 in  order  to  expand  access  to  Comprehensive  Primary  Health  Care  (CPHC).    Sub ealth Centres (SHCs) and Primary Health Centres (PHCs) are being strengthened as Health a Wellness Centres (H&WCs). The H&WCs are to provide preventive, promotive, rehabilitative and curative care for an expanded range of services encompassing reprod tive and child health services, communicable diseases, non - communicable diseases, palliative care and elderly care, oral health, ENT care, and basic emergency care.

2. Approvals for over 21000 such HWCs were accorded in 2018 - 19  against the target of 15000  in  the  current  year.  Out  of  these,  8120  Health  &  Wellness  Centres  have  b operationalized so far.

3. National Health Mission(NHM) is being implemented to strengthen public health system in the States/UTs including providing support for health human resources and infrastructure.

4. For  HWCs,  at  the  level  of  sub - centres  under  Ayushman  Bharat,  mid - level  health providers are being engaged. These are usually B.Sc (Nursing)/GNM or Ayurveda doctor that  have  successfully  completed  six  months  certificate  co urse  on  primary  healthcare  and public health. B.Sc. (Community Health) pass students are also being engaged as mid - level health providers.

5. The  ratio  of  teachers  to  students  has  been  revised  from  1:1  to  1:2  for  all  M disciplines and 1:1 to 1:3 in subjects of Anaesthesiology, Forensic Medicine, Radioth Medical Oncology, Surgical Oncology and Psychiatry. Further, teacher: student ratio in public funded Government Medical Colleges for Professor has been increased from 1:2 to 1:3 in clinical subjects and for Asso. Prof. from 1:1 to 1:2 if the Asso. Prof. is a unit head has also been extended to the private medical colleges w ith certain conditions. This would result in increase in number of PG seats in the country.
6. DNB  qualification  has  been  recognized  for  appointment  as  faculty  to  take  care shortage of faculty.
7. Enhancement of maximum intake capacity at MBBS level from 1 50 to 250 per Medical College.
8. Relaxation in the norms of setting up of Medical College in terms of requirement faculty, staff, bed strength and other infrastructure.
9. Requirement  of  land  for  establishment  of  medical  college  in  metropolitan  citie notified under Article 243P(c) of the Constitution of India has been dispensed with.

10. Strengthening/upgradation of State Government Medical Colleges for starting new P courses/Increase of PG seats.

11. Establishment of New Medical Colleges by  upgrading dist rict/referral hospitals preferably in underserved districts of the country.
12. Strengthening/ upgradation of existing State Government/Central Government Medica Colleges to increase MBBS seats.
13. Enhancement of age limit for appointment/ extension/ re - employment  against  posts  of teachers/dean/principal/ director in medical colleges from 65 - 70 years.