Lok Sabha Question No. 2217 (UNSTARRED), answered on 2023-12-15
Subject: Treatment under Ayushman Bharat Yojana
Ministry: HEALTH AND FAMILY WELFARE
Asked by: Queen Oja

## GOVERNMENT OFINDIA MINISTRY OF HEALTH AND FAMILY WELFARE DEPARTMENTOFHEALTHAND FAMILYWELFARE

## LOK SABHA UNSTARRED QUESTION NO. 2217 TO BE ANSWERED ON 15 TH DECEMBER, 2023

## TREATMENTUNDER AYUSHMAN BHARAT YOJANA

## 2217. SHRIMATI QUEEN OJA:

Will the Minister of HEALTHAND FAMILYWELFARE be pleased to state:

(a) whether it is fact that the Ayushman Bharat Yojana is a flagship scheme for unprivileged person launched by the Government and if so, the details thereof;

(b) whether the Government has any data about the beneficiary under the Ayushman Bharat Yojana and if so, the details thereof during last three years, State/UT-wise;

(c) whether the Government has received any complaints regarding the misbehaviour with patients and denial of treatment by private hospitals for treatment under Ayushman Bharat Yojana; and

(d) if so, the details thereof along with action taken against such hospitals?

## ANSWER THE MINISTER OFSTATE IN THE MINISTRY OF HEALTH AND FAMILY WELFARE (PROF. S. P. SINGH BAGHEL)

(a) to (d): Ayushman Bharat - Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) is the world ' s largest publicly funded health assurance scheme which aims to provide health cover of Rs. 5 lakh per family per year for secondary and tertiary care hospitalization to approximately 55 crore beneficiaries corresponding to 12 crore families which constitutes the bottom 40% of India ' s population. State/UT-wise details of authorized hospital admissions under the scheme during the last three years are at Annexure.

Hospitals empanelled under AB-PMJAY are bound to offer cashless treatment to eligible beneficiaries for the specialities for which it has been empanelled. Failure to do so may result in action, including de-empanelment. In case beneficiaries are denied treatment, grievance can be lodged online or at national call centre 14555 or through mail, letter, fax etc. which is acknowledged, recorded, escalated & resolved as per well-defined process. All grievances of scheme beneficiaries are resolved in an efficient, transparent and time bound manner through a three-tier grievance redressal structure. As on 05.12.2023, out of 4,198 such grievances received from across the country against different empanelled hospitals, 4,117 have been resolved, ensuring that beneficiaries receive their rightful entitlement under the scheme.

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Annexure State/UT-wise details of authorized hospital admissions under the scheme during the last three

years (during FY 2020-21 and FY 2022-23)

| State / UT                  | Authorized hospital admissions (Count)   | Authorized hospital admissions (Amount in Rupees)   |
|-----------------------------|------------------------------------------|-----------------------------------------------------|
| Andaman And Nicobar Islands | 1,800                                    | 5,79,53,127                                         |
| Andhra Pradesh              | 34,59,493                                | 79,61,92,00,000                                     |
| Arunachal Pradesh           | 1,320                                    | 2,38,96,398                                         |
| Assam                       | 5,06,694                                 | 7,96,38,51,842                                      |
| Bihar                       | 4,12,198                                 | 4,40,73,02,234                                      |
| Chandigarh                  | 23,684                                   | 17,79,15,120                                        |
| Chhattisgarh                | 26,72,304                                | 29,63,00,06,875                                     |
| DNH and DD                  | 60,810                                   | 42,48,90,180                                        |
| Goa                         | 713                                      | 1,45,42,286                                         |
| Gujarat                     | 22,90,337                                | 53,54,09,17,991                                     |
| Haryana                     | 6,03,934                                 | 8,15,06,06,276                                      |
| Himachal Pradesh            | 1,37,084                                 | 1,84,38,02,337                                      |
| Jammu And Kashmir           | 6,89,101                                 | 12,01,04,49,212                                     |
| Jharkhand                   | 10,22,640                                | 12,26,30,53,800                                     |
| Karnataka                   | 39,49,349                                | 33,12,30,68,863                                     |
| Kerala                      | 39,59,456                                | 40,30,90,81,794                                     |
| Ladakh                      | 5,691                                    | 9,06,35,465                                         |
| Lakshadweep                 | 465                                      | 1,36,59,150                                         |
| Madhya Pradesh              | 22,28,711                                | 36,33,74,16,694                                     |
| Maharashtra                 | 5,89,495                                 | 15,26,69,67,985                                     |
| Manipur                     | 79,246                                   | 1,01,13,88,244                                      |
| Meghalaya                   | 4,54,016                                 | 3,85,50,56,910                                      |
| Mizoram                     | 54,128                                   | 70,11,08,441                                        |
| Nagaland                    | 25,450                                   | 48,88,08,230                                        |
| Puducherry                  | 39,073                                   | 28,77,13,182                                        |
| Punjab                      | 12,41,172                                | 14,99,37,04,660                                     |
| Rajasthan                   | 32,93,412                                | 28,03,26,90,739                                     |
| Sikkim                      | 9,482                                    | 7,80,69,365                                         |
| Tamil Nadu                  | 78,08,703                                | 38,43,82,45,957                                     |
| Telangana                   | 8,30,459                                 | 17,84,47,27,985                                     |
| Tripura                     | 1,52,489                                 | 1,43,60,43,250                                      |
| Uttar Pradesh               | 16,31,271                                | 21,11,82,59,256                                     |
| Uttarakhand                 | 5,52,094                                 | 11,58,11,06,800                                     |

Note: States/UT of Odisha, West Bengal and Delhi are not implementing AB-PMJAY.