Lok Sabha Question No. 1635 (UNSTARRED), answered on 2022-02-11
Subject: Ayushman Bharat–Pradhan Mantri Jan Aarogya Yojana
Ministry: HEALTH AND FAMILY WELFARE
Asked by: Anurag Sharma, Poonam (Mahajan) Vajendla Rao, Faizal P.P. Mohammed, Nishikant  Dubey, Ramcharan Bohra, Manoj Rajoria, D.K. Suresh

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

## LOK SABHA UNSTARRED QUESTION NO. 1635 TO BE ANSWERED ON 11 TH  FEBRUARY, 2022

## AYUSHMAN BHARAT-PRADHAN MANTRI JAN AAROGYA YOJANA

## 1635.  SHRI ANURAG SHARMA:

SHRIMATI POONAM MAHAJAN:

SHRI MOHAMMED FAIZAL P.P.:

DR. NISHIKANT DUBEY:

SHRI RAMCHARAN BOHRA:

DR. MANOJ RAJORIA:

SHRI D.K.SURESH:

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

- (a)  the  details  and  salient  features  of  AB-PMJAY  along  with  the  eligibility  conditions  and  the procedure laid down for availing of medical facilities by the patients thereunder;
- (b)  the  number  of  people  benefitted  under  Ayushman Bharat  Yojana  (AB-PMJAY) in the country since its inception, State/UT-wise;
- (c)  the  number  of  patients  registered  and  those  who  have  availed  medical  facilities  under  the  said Yojana along with the funds sanctioned and utilized so far during the last three years, State/UTwise and year wise;
- (d) the number of patients treated in private hospitals and also in government hospitals, sector-wise;
- (e) the budget allocated and utilized for treatment of COVID-19 patients and non-COVID-19 patients under the said Yojana, State/UT-wise;
- (f) whether the Government has empanelled adequate number of hospitals under the Yojana and if so, details thereof, State/UT-wise; and
- (g) the steps taken by the government to create awareness among  people and effective implementation of the Scheme?

## THE MINISTER OF STATE IN THE MINISTRY OF HEALTH AND

## ANSWER FAMILY WELFARE (DR. BHARATI PRAVIN PAWAR)

- (a) to (g): The details, salient features along with the eligibility conditions and the procedure laid down for availing of medical facilities by the patients under Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) are at Annexure-I.

State/UT-wise  details  of  number  of  authorized  hospital  admissions  since  the  inception  of  the scheme are at Annexure-II.

State/UT-wise details of number of Ayushman cards issued are at Annexure-III. State/UT-wise and  year-wise  details  of  funds  released  during  last  three  financial  years  are  at  Annexure-IV. Funds are released to States/UTs only after utilization certificate is submitted by them.

As  of  08 th February  2022,  a  total  of  2.99  crore  hospital  admissions  are  authorized  under  the scheme. Of these, public-private categorization is available for 2.27 crore hospital admissions, as in  case  of  a  few  States,  implementation  data  is  shared  through  Application  Programming Interface  (API)  or  through  offline  means  and  therefore,  in  respect  of  such  data,  public-private bifurcation is not fully available.  Of the 2.27 crore hospital admissions, approximately 1.29 crore are authorized in private hospitals and 0.98 crore in public hospitals.

The allocation of funds under AB-PMJAY is integrated both for COVID-19 and non-COVID-19 treatments. Funds are released to States/UTs as per their requirement. As of 07th February 2022, COVID-19 testing and treatment worth over Rs. 3,000 crore are authorized under the scheme. State/UT-wise details are at Annexure-V.

State/UT-wise details of number of empanelled hospitals are at Annexure-VI.

Details  of  steps  taken  by  the  Government  to  create  awareness  among  people  and  effective implementation of the scheme are at Annexure-VII.

1. Ayushman  Bharat,  a  flagship  scheme  of  Government  of  India,  was  launched  as recommended by the National Health Policy 2017, to achieve the vision of Universal Health  Coverage  (UHC).  This  initiative  has  been  designed  to  meet  Sustainable Development Goals (SDGs) and its underlining commitment, which is to "leave no one behind."
2. AB-PMJAY is the world's largest Government funded health assurance scheme.
3. AB-PMJAY provides  health  assurance  of  up  to  Rs.5  Lakh  per  family  per  year  for secondary and tertiary healthcare hospitalizations.
4. AB-PMJAY is a completely cashless and paperless scheme.
5. The benefits under AB-PMJAY are portable across the country.
6. There is no cap on family size, or age or gender.
7. The  beneficiary  families  under  Ayushman  Bharat  -  Pradhan  Mantri  Jan  Arogya Yojana  (AB-PMJAY)  have  been  identified  from  the  Socio-Economic  Caste  Census (SECC) of 2011 on the basis of select deprivation and occupational criteria across rural and urban areas. Details are as below:

## Detailed list of criteria for eligibility under AB-PMJAY as per SECC 2011

Automatically included:

1. Households without shelter
2. Destitute/ living on alms
3. Manual scavenger families
4. Primitive tribal groups
5. Legally released bonded labour

Deprivation criteria in rural area:

- D1: Only one room with kutcha walls and kutcha roof
- D2: No adult member between age 16 to 59
- D3: Female headed households with no adult male member between age 16 to 59
- D4: Disabled member and no able-bodied adult member
- D5: SC/ST households
- D7:  Landless  households  deriving  major  part  of  their  income  from  manual  casual

## labour

## Occupational criteria in urban area:

- 1)  Rag picker
- 2)  Beggar
- 3)  Domestic worker
- 4)  Street vendor/ Cobbler/hawker / Other service provider working on streets
- 5)  Construction worker/ Plumber/ Mason/ Labour/ Painter/ Welder/ Security guard/ Coolie and other head-load worker
- 6)  Sweeper/ Sanitation worker / Mali
- 7)  Home-based worker/ Artisan/ Handicrafts worker / Tailor
- 8)  Transport  worker/  Driver/  Conductor/  Helper  to  drivers  and  conductors/  Cart puller/ Rickshaw puller
- 9)  Shop worker/ Assistant/ Peon in small establishment/ Helper/ Delivery assistant / Attendant/ Waiter
- 10)  Electrician/ Mechanic/ Assembler/ Repair worker/Washer-man/ Chowkidar
8. The  number  of  eligible  beneficiaries  under  SECC  2011  is  10.74  crore  (50  crore people). 33 States/UTs implementing AB-PMJAY  have  further expanded  the coverage of the scheme to include 13.44 crore families (65 crore people).
9. AB-PMJAY is implemented in all States and UTs barring West Bengal, NCT of Delhi and Odisha.
10. The scheme is implemented across the country through a three-tier model. National Health Authority, an attached office of the Ministry of Health and Family Welfare with full  functional  autonomy,  is  the  apex  body  implementing  AB-PMJAY  across  the country. For effective implementation of AB-PMJAY at States/UTs level, State Health Agencies (SHAs) have been established. District Implementation Units (DIUs) have been set up for ensuring on-ground coordination between scheme stakeholders and for smooth implementation.
11. AB-PMJAY is completely funded by the Government and costs are shared between Central  and  State  Governments  in  the  ratio  as  per  the  extant  directives  issued  by Ministry of Finance.

State/UT-wise number of authorized hospital admissions under AB-PMJAY

| State / Union Territory     | Number of authorized hospital admissions   |
|-----------------------------|--------------------------------------------|
| Andaman and Nicobar Islands | 1,228                                      |
| Andhra Pradesh              | 24,54,370                                  |
| Arunachal Pradesh           | 1,836                                      |
| Assam                       | 3,59,857                                   |
| Bihar                       | 3,59,079                                   |
| Chandigarh                  | 16,190                                     |
| Chhattisgarh                | 21,08,600                                  |
| DNH and DD                  | 78,853                                     |
| Goa                         | 10,371                                     |
| Gujarat                     | 27,44,780                                  |
| Haryana                     | 3,99,707                                   |
| Himachal Pradesh            | 1,25,413                                   |
| Jammu and Kashmir           | 3,42,329                                   |
| Jharkhand                   | 10,74,910                                  |
| Karnataka                   | 23,06,822                                  |
| Kerala                      | 34,56,393                                  |
| Ladakh                      | 2,695                                      |
| Lakshadweep                 | 39                                         |
| Madhya Pradesh              | 12,80,090                                  |
| Maharashtra                 | 5,47,221                                   |
| Manipur                     | 50,461                                     |
| Meghalaya                   | 3,71,557                                   |
| Mizoram                     | 63,388                                     |
| Nagaland                    | 22,420                                     |
| Puducherry                  | 13,533                                     |
| Punjab                      | 10,91,924                                  |
| Rajasthan                   | 19,96,624                                  |
| Sikkim                      | 5,701                                      |
| Tamil Nadu                  | 67,54,484                                  |
| Telangana                   | 2,39,162                                   |
| Tripura                     | 1,28,075                                   |
| Uttar Pradesh               | 10,71,308                                  |
| Uttarakhand                 | 4,23,747                                   |
| West Bengal                 | 17,636                                     |

rd

Note: West Bengal was implementing AB PM-JAY from 23 September 2018. However, the State Government decided to withdraw the implementation of the scheme from 10 th January 2019.

## Ayushman cards issued under AB-PMJAY

| State / UT                  | Ayushman Cards Issued   |
|-----------------------------|-------------------------|
| Andaman and Nicobar Islands | 39,520                  |
| Arunachal Pradesh           | 35,271                  |
| Assam                       | 1,25,40,235             |
| Bihar                       | 73,26,809               |
| Chandigarh                  | 68,211                  |
| Chhattisgarh                | 1,51,22,991             |
| DNH and DD                  | 4,20,819                |
| Goa                         | 22,083                  |
| Gujarat                     | 1,15,12,421             |
| Haryana                     | 28,06,441               |
| Himachal Pradesh            | 11,06,734               |
| Ladakh                      | 1,03,469                |
| Jammu and Kashmir           | 61,36,242               |
| Jharkhand                   | 92,71,458               |
| Karnataka                   | 97,83,047               |
| Kerala                      | 67,84,871               |
| Lakshadweep                 | 17,735                  |
| Madhya Pradesh              | 2,58,36,350             |
| Maharashtra                 | 74,05,354               |
| Manipur                     | 3,91,338                |
| Meghalaya                   | 16,96,778               |
| Mizoram                     | 3,58,821                |
| Nagaland                    | 2,62,831                |
| Puducherry                  | 3,83,163                |
| Punjab                      | 77,62,440               |
| Sikkim                      | 42,355                  |
| Tamil Nadu                  | 2,47,27,709             |
| Tripura                     | 12,70,392               |
| Uttar Pradesh               | 1,77,06,653             |
| Uttarakhand                 | 41,02,341               |

Note: Beneficiary cards in Andhra Pradesh, Rajasthan and Telangana are issued at family level and therefore not counted among individual Ayushman cards.

## State/UT-wise and year-wise details of funds released during last three financial years under AB-PMJAY

(in crore of Rupees)

| Sr. No.   | State / UT                  | 2018-19   | 2019-20   | 2020-21   |
|-----------|-----------------------------|-----------|-----------|-----------|
| 1         | Andaman and Nicobar Islands | 0.15      | 0.41      | 0.27      |
| 2         | Andhra Pradesh              | 182.85    | 374.07    | 261.23    |
| 3         | Arunachal Pradesh           | 2.31      |           | 0.67      |
| 4         | Assam                       | 21.08     | 133.23    | 12.10     |
| 5         | Bihar                       | 88.27     | 82.49     |           |
| 6         | Chandigarh                  | 0.68      | 3.82      | 1.84      |
| 7         | Chhattisgarh                | 217.43    | 280.37    | 112.62    |
| 8         | DNH and DD                  | 4.27      | 2.02      | 4.24      |
| 9         | Goa                         | 0.64      | 0.06      | 0.49      |
| 10        | Gujarat                     | 77.50     | 212.33    | 99.84     |
| 11        | Haryana                     | 26.81     | 58.69     | 71.92     |
| 12        | Himachal Pradesh            | 17.18     | 19.12     | 32.93     |
| 13        | Jammu and Kashmir           | 20.64     | 33.44     | 22.70     |
| 14        | Jharkhand                   | 170.17    | 126.50    | 100.32    |
| 15        | Karnataka                   | 159.31    | 254.13    | 160.85    |
| 16        | Kerala                      | 25.00     | 97.56     | 145.61    |
| 17        | Ladakh                      |           |           | 1.62      |
| 18        | Lakshadweep                 | 0.00      |           |           |
| 19        | Madhya Pradesh              | 72.57     | 118.46    | 164.80    |
| 20        | Maharashtra                 | 266.32    | 241.88    | 376.65    |
| 21        | Manipur                     | 7.18      | 17.10     | 11.45     |
| 22        | Meghalaya                   | 15.57     | 18.07     | 49.52     |
| 23        | Mizoram                     | 17.48     | 12.41     | 14.97     |
| 24        | Nagaland                    | 4.72      | 10.89     | 12.27     |
| 25        | Puducherry                  | 1.52      |           | 1.23      |
| 26        | Punjab                      | 2.24      | 55.55     | 46.85     |
| 27        | Rajasthan                   | 0.00      | 200.07    | 258.31    |
| 28        | Sikkim                      | 1.03      | 0.09      | 1.85      |
| 29        | Tamil Nadu                  | 304.98    | 441.77    | 359.81    |
| 30        | Telangana                   |           |           |           |
| 31        | Tripura                     | 12.81     | 20.18     | 8.98      |
| 32        | Uttar Pradesh               | 85.01     | 147.49    | 167.63    |
| 33        | Uttarakhand                 | 12.54     | 30.73     | 40.52     |
| 34        | West Bengal                 | 31.28     |           |           |
|           | Grand Total                 | 1849.55   | 2992.94   | 2544.12   |

Note: West Bengal was implementing AB PM-JAY from 23 rd September 2018. However, the State Government decided to withdraw the implementation of the scheme from 10 th January 2019.

## Amount authorized for hospital admissions for treatment of COVID-19 under AB-PMJAY (in Rupees)

|   Sl No. | State / UT                  | Amount authorized for hospital admissions   |
|----------|-----------------------------|---------------------------------------------|
|        1 | Andaman and Nicobar Islands | 16,530                                      |
|        2 | Andhra Pradesh              | 7,39,34,00,000                              |
|        3 | Assam                       | 2,21,62,210                                 |
|        4 | Bihar                       | 3,05,772                                    |
|        5 | Chandigarh                  | 1,37,000                                    |
|        6 | Chhattisgarh                | 66,69,11,895                                |
|        7 | DNH and DD                  | 92,590                                      |
|        8 | Goa                         | 3,500                                       |
|        9 | Haryana                     | 1,71,47,098                                 |
|       10 | Himachal Pradesh            | 17,05,136                                   |
|       11 | Jammu and Kashmir           | 1,62,14,220                                 |
|       12 | Jharkhand                   | 3,58,99,698                                 |
|       13 | Kerala                      | 4,32,94,82,711                              |
|       14 | Karnataka                   | 8,96,91,00,360                              |
|       15 | Madhya Pradesh              | 39,17,93,452                                |
|       16 | Maharashtra                 | 4,48,53,80,152                              |
|       17 | Manipur                     | 3,40,97,131                                 |
|       18 | Meghalaya                   | 13,09,52,300                                |
|       19 | Mizoram                     | 1,36,23,210                                 |
|       20 | Nagaland                    | 2,60,340                                    |
|       21 | Puducherry                  | 52,97,940                                   |
|       22 | Sikkim                      | 9,93,000                                    |
|       23 | Rajasthan                   | 14,72,89,968                                |
|       24 | Tamil Nadu                  | 3,86,53,67,007                              |
|       25 | Tripura                     | 3,90,000                                    |
|       26 | Uttar Pradesh               | 1,38,99,902                                 |
|       27 | Uttarakhand                 | 28,42,50,582                                |

State/UT-wise details of number of empanelled hospitals under AB-PMJAY

| State / UT                  | Number of empanelled Hospitals   |
|-----------------------------|----------------------------------|
| Andaman and Nicobar Islands | 3                                |
| Andhra Pradesh              | 1,333                            |
| Arunachal Pradesh           | 52                               |
| Assam                       | 382                              |
| Bihar                       | 911                              |
| Chandigarh                  | 27                               |
| Chhattisgarh                | 1,528                            |
| DNH and DD                  | 7                                |
| Goa                         | 36                               |
| Gujarat                     | 2,544                            |
| Haryana                     | 608                              |
| Himachal Pradesh            | 238                              |
| Ladakh                      | 10                               |
| Jammu and Kashmir           | 245                              |
| Jharkhand                   | 823                              |
| Karnataka                   | 3,447                            |
| Kerala                      | 749                              |
| Lakshadweep                 | 6                                |
| Madhya Pradesh              | 988                              |
| Maharashtra                 | 970                              |
| Manipur                     | 80                               |
| Meghalaya                   | 182                              |
| Mizoram                     | 94                               |
| Nagaland                    | 99                               |
| Puducherry                  | 28                               |
| Punjab                      | 948                              |
| Rajasthan                   | 1,129                            |
| Sikkim                      | 17                               |
| Tamil Nadu                  | 3,627                            |
| Telangana                   | 433                              |
| Tripura                     | 143                              |
| Uttar Pradesh               | 2,895                            |
| Uttarakhand                 | 250                              |
| Delhi                       | 111                              |
| West Bengal                 | 67                               |
| Odisha                      | 29                               |
| Grand Total                 | 25,039                           |

Note: Delhi, Odisha and West Bengal are currently not implementing AB PM-JAY. However, hospitals are empanelled in these States/UTs to facilitate portability services for the scheme beneficiaries from other States.

## Details  of  steps  taken  by  the  Government  to  create  awareness  among  people  and effective implementation of the scheme:

-  'Aapke Dwar Ayushman' (ADA) is a key initiative of NHA that is implemented in mission mode across various States/UTs, including focus States such as Bihar, Chhattisgarh, Madhya Pradesh, and Uttar Pradesh. The campaign leveraged a grassroots  network  of  healthcare  workers  (HCWs),  frontline  workers  (FLWs), Panchayati  Raj  institutions  (PRIs),  village  level  entrepreneurs  (VLEs)  /  agents from CSC and UTIITSL to mobilize and verify nearly4 crore beneficiaries in 2021.
-  NHA  has  reached  out  to  Central  Government  Ministries  implementing  welfare schemes  using  SECC  2011  database.  This  was  done  with  the  intention  of leveraging the updated databases of such welfare schemes for better targeting of PM-JAY beneficiaries. Efforts are made to reach out to eligible individuals from this list to issue Ayushman cards to them.
-  NHA has taken steps to increase avenues for Ayushman card generation:
- o Four additional agencies are onboarded for generation of Ayushman cards across the country.
- o Eight additional agencies are onboarded to ensure approval of Ayushman card requests.
-  NHA  has  introduced  changes  to  the  technology  of  the  PMJAY  Beneficiary Identification System  (BIS) to liberalize and democratize  Ayushman  card generation:
- o An enhanced location hierarchy-based search option is enabled in SECC database. Village level beneficiary data has thus become accessible. This enables local Government officials, frontline workers and public representatives in identifying and mobilizing beneficiaries.
- o A revamped 'Self BIS' system is launched for self / assisted verification.
- o Crowd  sourced  approval  functionality  is  enabled  for  beneficiary  record approval.