Lok Sabha Question No. 11 (STARRED), answered on 2024-02-02
Subject: Ayushman Bharat Scheme
Ministry: HEALTH AND FAMILY WELFARE
Asked by: Chandra Sekhar Sahu, Rahul Ramesh Shewale

## GOVERNMENT OFINDIA MINISTRY OF HEALTH AND FAMILY WELFARE DEPARTMENT OFHEALTH AND FAMILYWELFARE

## LOK SABHA STARRED QUESTION NO. 11 TO BE ANSWERED ON THE 2 ND FEBRUARY, 2024

## AYUSHMAN BHARAT SCHEME

## *11. SHRI CHANDRA SEKHAR SAHU: SHRI RAHULRAMESH SHEWALE:

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

- (a) whether the Government provides assistance to citizens under Ayushman Bharat Scheme in the country;
- (b) if so, the details of the funds incurred on treatment of citizens under Ayushman Bharat Scheme in various States particularly in Odisha during each of the last five years;
- (c) the number of citizens benefitted so far from such assistance under the said scheme, State/UTwise particularly in Odisha;
- (d) the number of Private Hospitals empanelled along with the details of funds reimbursed to various such Private Hospitals during the said period particularly in Odisha; and
- (e) the details of the criteria fixed for empanelment of Private Hospitals under the said scheme?

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

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

## STATEMENT REFERRED TO IN REPLY TO LOK SABHA STARRED QUESTION NO. 11 FOR 2 ND FEBRUARY, 2024

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 12 crore families. The scheme is implemented in 33 States/UTs except for Delhi, Odisha, and West Bengal.

As on 15.01.2024, approximately 6.22 crores hospital admission worth Rs. 79,174 crore have been authorized under the scheme. Out of this, 4.86 crore hospital admissions worth Rs. 59,785 crore have been authorized between FY 2018-19 to FY 2022-23. The State/UT-wise and Financial Year-wise details of authorized hospital admissions under the scheme are at Annexure .

As on 15.01.2024, a total number of 27,742 hospitals including 11,973 private hospitals have been empaneled under the scheme to provide healthcare benefits to scheme beneficiaries. Approximately 3.37 crore hospital admissions worth Rs. 52,207 crore have been authorized in private hospitals. AB-PMJAY is not being implemented in the State of Odisha, however, 26 hospitals, including 2 private hospitals, have been empaneled in the State to provide healthcare services to the scheme beneficiaries from other States under portability feature of the scheme.

Hospital Empanelment and Management (HEM) guidelines for empanelment of hospitals under AB-PMJAY mandates the State Health Agencies (SHAs) with the responsibility of empanelling hospitals under the scheme. SHAs have also been given flexibility to change hospital empanelment criteria for deficit regions.

The detailed HEM guidelines are available at the following link:

https://nha.gov.in/img/resources/Hospital-Empanelment-Guidelines-21-12-22.pdf

## State/UT-wise and Financial Year-wise details of authorized hospital admissions under the scheme

| State / UT                 | FY 2018-19   | FY 2018-19     | FY 2019-20   | FY 2019-20      | FY 2020-21   | FY 2020-21      | FY 2021-22   | FY 2021-22      | FY 2022-23   | FY 2022-23      | FY2023-24 (as on 15.01.2024)   | FY2023-24 (as on 15.01.2024)   |
|----------------------------|--------------|----------------|--------------|-----------------|--------------|-----------------|--------------|-----------------|--------------|-----------------|--------------------------------|--------------------------------|
| State / UT                 | Count        | Amount         | Count        | Amount          | Count        | Amount          | Count        | Amount          | Count        | Amount          | Count                          | Amount                         |
| Andaman AndNicobar Islands | 14           | 58,000         | 150          | 11,58,094       | 311          | 1,02,36,710     | 794          | 2,16,52,485     | 695          | 2,60,63,932     | 413                            | 1,53,45,111                    |
| Andhra Pradesh             | 1,39,925     | 4,15,94,11,741 | 5,76,991     | 14,09,63,00,000 | 7,56,406     | 19,08,02,00,000 | 11,60,904    | 27,15,68,00,000 | 15,42,183    | 33,38,22,00,000 | 12,62,734                      | 25,43,53,61,401                |
| Arunachal Pradesh          | 375          | 75,01,500      | 1,234        | 1,97,57,457     | 70           | 16,78,125       | 231          | 37,36,180       | 1,019        | 1,84,82,093     | 846                            | 1,70,18,394                    |
| Assam                      | 32,702       | 51,29,74,913   | 84,422       | 1,15,74,75,368  | 91,772       | 1,39,18,35,257  | 1,75,310     | 2,66,77,37,289  | 2,39,612     | 3,90,42,79,296  | 3,10,496                       | 5,32,53,97,278                 |
| Bihar                      | 18,462       | 16,70,27,926   | 1,50,567     | 1,38,22,39,421  | 84,812       | 76,55,02,124    | 1,14,882     | 1,35,00,47,086  | 2,12,504     | 2,29,17,53,024  | 1,97,009                       | 2,25,78,27,316                 |
| Chandigarh                 | 273          | 23,70,790      | 3,135        | 2,51,91,019     | 5,206        | 3,08,44,095     | 8,207        | 5,39,26,374     | 10,271       | 9,31,44,651     | 11,113                         | 10,62,52,939                   |
| Chhattisgarh               | 2,30,971     | 1,82,42,88,077 | 6,27,786     | 5,60,36,58,705  | 4,92,288     | 5,14,46,01,495  | 8,93,285     | 9,62,58,80,196  | 12,86,731    | 14,85,95,25,184 | 10,17,055                      | 13,86,67,07,137                |
| DNHandDD                   | 7,675        | 2,67,65,240    | 31,621       | 18,46,68,266    | 18,862       | 11,54,41,342    | 20,526       | 14,62,88,819    | 21,422       | 16,31,60,019    | 14,481                         | 10,82,37,486                   |
| Goa                        | 9,723        | 31,68,34,320   | 374          | 1,06,97,164     | 139          | 28,72,856       | 167          | 38,00,809       | 407          | 78,68,621       | 1,420                          | 85,04,614                      |
| Gujarat                    | 3,14,087     | 4,53,55,88,237 | 11,38,567    | 17,05,99,62,950 | 8,23,589     | 11,32,66,54,900 | 5,58,564     | 15,97,46,99,223 | 9,08,184     | 26,23,95,63,868 | 8,19,523                       | 23,01,79,20,827                |
| Haryana                    | 10,426       | 15,92,40,615   | 93,830       | 1,20,80,73,470  | 1,37,044     | 1,55,52,47,368  | 1,84,108     | 2,38,55,32,133  | 2,82,782     | 4,20,98,26,775  | 3,41,886                       | 5,22,34,34,538                 |
| Himachal Pradesh           | 8,238        | 8,61,00,051    | 45,089       | 41,71,41,240    | 28,394       | 35,24,67,427    | 46,548       | 69,43,69,380    | 62,142       | 79,69,65,530    | 41,316                         | 51,49,14,646                   |
| Jammu AndKashmir           | 6,278        | 5,27,86,575    | 65,762       | 33,92,22,548    | 62,519       | 57,20,07,889    | 2,46,823     | 4,46,38,33,680  | 3,79,759     | 6,97,46,07,643  | 2,69,539                       | 5,17,42,25,399                 |
| Jharkhand                  | 1,07,125     | 1,06,30,07,538 | 4,02,636     | 3,80,34,39,510  | 2,92,945     | 2,94,35,61,932  | 3,24,024     | 4,40,95,94,590  | 4,05,671     | 4,90,98,97,278  | 2,58,022                       | 3,50,53,07,277                 |
| Karnataka                  | 1,18,153     | 2,86,91,25,874 | 5,80,443     | 7,76,28,11,283  | 6,52,150     | 6,88,43,84,722  | 10,83,580    | 9,62,93,84,141  | 22,13,619    | 16,60,93,00,000 | 24,33,887                      | 15,58,78,01,566                |
| Kerala                     | -            | -              | 9,69,810     | 6,76,70,13,412  | 10,40,111    | 7,61,45,62,339  | 16,96,845    | 15,68,87,61,430 | 12,22,500    | 17,00,57,58,025 | 5,16,487                       | 8,25,65,76,750                 |
| Ladakh                     | -            | -              | -            | -               | -            | -               | 505          | 67,07,803       | 5,186        | 8,39,27,662     | 4,324                          | 6,70,42,926                    |
| Lakshadweep                | -            | -              | 1            | 1,800           | -            | -               | 64           | 19,40,020       | 401          | 1,17,19,130     | 322                            | 92,89,411                      |
| Madhya Pradesh             | 42,612       | 52,19,40,837   | 2,61,496     | 3,45,35,45,417  | 3,77,006     | 5,37,59,33,250  | 7,02,119     | 11,63,35,08,654 | 11,49,586    | 19,32,79,74,790 | 10,14,950                      | 11,93,51,47,691                |
| Maharashtra                | 1,08,062     | 2,77,28,97,464 | 2,03,957     | 4,93,39,50,420  | 1,42,631     | 3,90,33,32,609  | 1,29,700     | 3,46,16,57,858  | 3,17,164     | 7,90,19,77,518  | 3,02,664                       | 7,75,40,45,174                 |
| Manipur                    | 1,459        | 2,72,03,099    | 12,527       | 18,91,41,389    | 16,330       | 16,44,84,595    | 24,050       | 30,90,46,978    | 38,866       | 53,78,56,671    | 25,853                         | 36,39,42,076                   |
| Meghalaya                  | 1,122        | 71,15,011      | 1,24,358     | 93,36,72,884    | 1,23,680     | 95,44,41,138    | 1,45,224     | 1,17,33,12,963  | 1,85,112     | 1,72,73,02,809  | 1,28,454                       | 1,44,74,41,269                 |

## Annexure

(Amount is in Rupees)

| Mizoram       | 7,067     | 5,60,41,636     | 27,584    | 25,40,25,836    | 16,915    | 20,90,05,800    | 13,904      | 17,75,48,426      | 23,309      | 31,45,54,215      | 21,679      | 26,59,03,115      |
|---------------|-----------|-----------------|-----------|-----------------|-----------|-----------------|-------------|-------------------|-------------|-------------------|-------------|-------------------|
| Nagaland      | 262       | 33,27,272       | 10,096    | 13,65,14,683    | 7,344     | 10,71,67,010    | 5,650       | 11,26,28,183      | 12,456      | 26,90,13,037      | 21,227      | 45,43,34,586      |
| Puducherry    | -         | -               | 1,361     | 1,10,16,220     | 2,477     | 1,04,12,784     | 11,863      | 7,43,66,025       | 24,733      | 20,29,34,373      | 24,223      | 21,24,41,792      |
| Punjab        | -         | -               | 1,94,052  | 2,31,49,83,999  | 4,15,749  | 4,63,91,79,389  | 5,28,728    | 6,59,47,20,315    | 2,96,695    | 3,75,98,04,956    | 4,99,661    | 5,94,37,04,764    |
| Rajasthan     | -         | -               | 9,25,683  | 5,38,89,03,873  | 4,18,192  | 2,46,86,55,573  | 12,34,819   | 8,31,58,39,855    | 16,40,401   | 17,24,81,95,311   | 15,90,934   | 16,13,52,66,799   |
| Sikkim        | 9         | 1,36,100        | 1,205     | 1,57,86,780     | 1,937     | 1,56,62,360     | 2,753       | 1,89,63,767       | 4,792       | 4,34,43,238       | 4,837       | 4,62,90,617       |
| Tamil Nadu    | 8,05,291  | 10,24,51,58,363 | 8,15,775  | 10,12,87,32,387 | 18,94,989 | 8,64,29,39,095  | 44,94,343   | 16,29,64,58,376   | 14,19,371   | 13,49,88,48,486   | 7,90,670    | 10,06,46,52,579   |
| Telangana     | -         | -               | -         | -               | -         | -               | 2,71,016    | 6,28,78,44,173    | 5,59,443    | 11,55,68,83,812   | 4,85,617    | 10,19,28,38,763   |
| Tripura       | 7,763     | 3,93,08,890     | 50,950    | 29,77,58,847    | 30,075    | 24,05,89,648    | 45,892      | 40,44,19,915      | 76,522      | 79,10,33,687      | 68,434      | 74,25,70,531      |
| Uttar Pradesh | 65,920    | 75,09,32,516    | 2,81,158  | 3,07,67,43,585  | 3,14,580  | 2,97,67,00,084  | 4,94,345    | 5,68,31,01,349    | 8,22,346    | 12,45,84,57,823   | 8,57,219    | 15,34,88,11,970   |
| Uttarakhand   | 20,321    | 20,69,08,058    | 1,24,524  | 1,15,95,01,009  | 1,12,217  | 1,64,08,71,366  | 1,81,034    | 4,04,23,75,654    | 2,58,843    | 5,89,78,59,780    | 2,50,414    | 5,18,89,50,797    |
| Total         | 20,64,315 | 30,58,50,32,113 | 78,07,144 | 92,13,30,89,036 | 83,60,740 | 89,14,14,73,282 | 1,48,00,807 | 1,58,87,04,84,129 | 1,56,24,727 | 2,27,12,41,83,237 | 1,35,87,709 | 1,93,88,98,17,347 |