Lok Sabha Question No. 1015 (UNSTARRED), answered on 2020-02-07
Subject: Revision of Packages under ABY
Ministry: HEALTH AND FAMILY WELFARE
Asked by: Shobha Karandlaje

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

LOK SABHA UNSTARRED QUESTION NO. 1015 TO BE ANSWERED ON 7 th FEBRUARY, 2020

## REVISION OF PACKAGES UNDER ABY

## 1015. KUMARI SHOBHA KARANDLAJE:

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

- (a) whether the Government has objectively assessed the A yushman Bharat Yojana (ABY), if so, the details thereof ;
- (b) whether unviable rates and delayed payments hav  p ushed  some  privat e players away from participating the programme;
- (c) whether there is no actuarial database available to yield a probability distribution of the expected number of different health episodes requiring different treatments at varying costs under the Scheme;
- (d) if so, whether the Government proposes to revise the procedural rates,if so, the details thereof;
- (e) the number of private hospitals empanelled under ABY as on December 31, 2019; and
- (f) whether ABY is an entitlement based scheme and there is no requirement of registration or enrolment of beneficiaries?

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

- (a): The  implementation  of  Ayushman  Bharat - Health  & Wellness  Centres  has  been reviewed and States/UTs have been oriented by conducting four regional workshops in year  2019.  The  synthesis  report  of  these  workshops  is  available  in  public  domai https://nhm.gov.in/index1.php?lang=1& level=1&sublinkid=1 161&lid=649.

Continuous assessment and monitoring of the Ayushman Bharat -Pradhan Mantri Jan Arogya Yojana (AB - PMJAY) is undertaken on real - time basis. A dashboard with various key performance indicators has been designed to constantly monitor the schem e. The performance  of  the  scheme  is  objectively  evaluated  in  terms  of  cards  issued,  numbe hospitalization cases, quality of treatment provided, timely payment of claims etc. basis of this, suitable action in terms of changes in the process flow, IT syst m, guidelines for implementation of scheme are undertaken.

## (b): No.

As on 04.02.2020, total 21,789 hospitals have been empaneled under the AB - PMJAY including 10,032  hospitals  belonging  to  private  sector.  Services  for  51%  of  the  t hospital admissions, as on 05.02.2020, have been provided by the private service provide

(c) & (d) AB - PMJAY was launched with 1393 packages including one unspecified surgical package.  After  the  launch  of  Scheme,  feedback  from  various  stakeholders  on  diffe aspects  of  AB  PMJAY  including  Health  benefit  Packages  (HBPs)  was  received. Accordingly,  an  exercise  to  rationalise  the  benefit  packages  was  undertaken.  Eigh specialist committee were set up to provide their inputs and consultation meetings conduct ed with subject experts for rationalisation of health benefit package. Followi due procedure, recommendations were presented before the Governing Board of Nationa Health Authority for approval. The Governing Board has approved rationalized HBPs H BP 2.0 for the Scheme.

(e): As on 31.12.2019, total 9,112 private hospitals were empanelled under AB -PMJAY.

(f): Services at AB - HWCs are free and universal to all individuals residing in the servi area.

AB - PMJAY  is  an  entitlement - based  scheme  andthe re  is  no  requirement  of registration or enrolment of beneficiaries . Around 10.74 crore beneficiary families identified as per Socio - Economic  Caste  Census  (SECC)  database,  are  entitled for  benefits under th scheme.