Lok Sabha Question No. 439 (STARRED), answered on 2023-03-31
Subject: Medical treatment in AB-PMJAY Empanelled Hospitals
Ministry: HEALTH AND FAMILY WELFARE
Asked by: Dhal Singh Bisen

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

## LOK SABHA STARRED QUESTION NO. 439 TO BE ANSWERED ON THE 31 ST  MARCH, 2023

## MEDICAL TREATMENT IN AB-PMJAY EMPANELLED HOSPITALS

## †*439. DR. DHAL SINGH BISEN:

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

- (a)  the  details  of  private  hospitals  empanelled  under  Ayushman  Bharat-Pradhan Mantri Jan Aarogya Yojana in Madhya Pradesh and Maharashtra including Nagpur and Gondia;
- (b)  the  disease-wise  details  of  hospitals  specialized  for  treatment  under  the  ABPMJAY in Madhya Pradesh and Maharashtra;
- (c) whether the hospitals empanelled under AB-PMJAY are bound to offer treatment and if so, the details thereof; and
- (d)  whether there is a provision to take action against the empanelled hospitals for refusing treatment under AB-PMJAY and if so, the details thereof?

## ANSWER THE MINISTER OF HEALTH AND FAMILY WELFARE (DR MANSUKH MANDAVIYA)

- (a) to (d) A Statement is laid on the Table of the House.

## STATEMENT REFERRED TO IN REPLY TO LOK SABHA STARRED QUESTION NO. 439 FOR 31 ST     MARCH, 2023

(a)  to  (d)  Ayushman  Bharat  -  Pradhan  Mantri  Jan  Arogya  Yojana  (AB-PMJAY) launched on 23.09.2018 is the largest publicly funded health protection scheme in the world which provides health cover of Rs. 5 lakh per family per year for secondary and tertiary care hospitalization to 60 crore beneficiaries through a network of 26,892 hospitals  empanelled  in  the  country.  This  includes  more  than  11,700  private hospitals.

As of 27th March 2023, a total of 513 private hospitals are empanelled in the State of Madhya Pradesh under the scheme. With respect to the State of Maharashtra, a  total  of  807  private  hospitals  are  empanelled  in  the  State  including  6  private hospitals in Gondia and 37 private hospitals in the district of Nagpur.

Speciality-wise details of empanelled hospitals in Madhya  Pradesh  are available at the following link: https://acrobat.adobe.com/link/review?uri=urn:aaid:scds:US:64cef893-dc40-320fb3f2-4c0345d35444

Speciality-wise details of empanelled hospitals in Maharashtra are available at the following link: https://acrobat.adobe.com/link/review?uri=urn:aaid:scds:US:4bfb5b91-50db-34b38501-a5da4bb1369c

As  per  the  terms  and  conditions  of  empanelment,  hospitals  cannot  deny treatment to genuine beneficiaries of the scheme. It may result in penal action which may  include,  de-empanelment.  In  case  of  denial  of  treatment  by  the  empanelled hospital,  beneficiaries  can  lodge  grievances  on  the  designated  web-based  portal  or mobile-based  application  of  Central  Grievance  Redressal  Management  System (CGRMS). Alternatively, beneficiaries can reach out to NHA's National Call Centre through  24x7  helpline  14555  and  register  their  grievances.  Such  grievances  are resolved  in  an  efficient  and  transparent  manner  through  a  three-tier  grievance redressal structure.

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