Lok Sabha Question No. 731 (UNSTARRED), answered on 2024-07-26
Subject: Implementation of  AB-PMJAY in Maharashtra
Ministry: HEALTH AND FAMILY WELFARE
Asked by: Shri Sanjay Dina Patil

## GOVERNMENTOFINDIA MINISTRYOF HEALTH AND FAMILYWELFARE DEPARTMENTOFHEALTH ANDFAMILYWELFARE

## LOK SABHA UNSTARRED QUESTION NO. 731 TO BE ANSWERED ON 26 TH JULY, 2024

## IMPLEMENTATION OF AB-PMJAYIN MAHARASHTRA

## 731. SHRI SANJAY DINA PATIL:

Will the Minister of HEALTHAND FAMILYWELFARE be pleased to state:

- (a) whether the Government is implementing Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) in the country and if so, the details thereof;
- (b) the challenges faced by the Government while implementing AB-PMJAY;
- (c) the number of Ayushman cards that have been created during each of the last three years in the State of Maharashtra, district-wise;
- (d) the number of persons benefited under AB-PMJAY during each of the last three years in the State of Maharashtra;
- (e) the details of expenditure incurred on OPD treatment and hospital admission of the beneficiaries;
- (f) the details of the eligibility criteria and procedure for providing benefits to the patients under the said Yojana; and
- (g) whether many SC/ST/OBC households from rural and remote areas have not been enrolled under AB-PMJAY thereby being deprived of the benefits therein and if so, the details thereof, State/UT-wise and corrective steps taken by the Government in this regard?

## ANSWER THE MINISTER OF STATE IN THE MINISTRY OF HEALTH AND FAMILY WELFARE (SHRI PRATAPRAO JADHAV)

(a) and (b): Ayushman Bharat - Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) is the world's largest publicly funded health assurance scheme which provides health cover of Rs. 5 lakh per family per year for secondary and tertiary care hospitalization to 12.34 crore families. The scheme is being implemented in 33 States/UTs except NCT of Delhi, West Bengal and Odisha. Implementing States/UTs have expanded the beneficiary base under the scheme beyond centrally sponsored numbers. As on 20.07.2024, approximately 34.7 crore Ayushman cards have been created across the country and 7.37 crore hospital admissions worth over Rs. 1,00,634 crore have been authorized under the scheme.

Some of the challenges faced in the implementation of the scheme are non-availability of, adequate and effective personnel at the grass root level, appropriate infrastructure, last mile connectivity, empanelment of good hospitals and to ensure the fidelity of their service delivery etc.

In order to reap full potential of the scheme, the Government has taken the following key initiatives:

- i. Support various categories of frontline workers under Panchayati Raj, ASHA workers, Self Help Groups under the National Rural Livelihood Mission (NRLM), through payment of incentives.
- ii. Campaign through radio, television, mass messaging through SMS, print media advertisement, announcements at railway stations, radio & television interviews, branding and advertisement etc.
- iii. Ayushman Bhava campaign and Viksit Bharat Sankalp Yatra were launched to expedite the Ayushman card creation process.

(c) and (d): The District-wise details of Ayushman cards created during each of the last three years in the State of Maharashtra are at Annexure-I . The details of the number of persons benefited under the scheme during each of the last three years in the State of Maharashtra are as under:

| FY 2021-22   | FY 2021-22   | FY 2022-23   | FY 2022-23   | FY 2023-24   | FY 2023-24   |
|--------------|--------------|--------------|--------------|--------------|--------------|
| Count        | Amount       | Count        | Amount       | Count        | Amount       |
| 3.2 lakhs    | 736 crore    | 3.26 lakh    | 770 crore    | 3.94 lakh    | 918 crore    |

(e): AB-PMJAY provides free in-patient care only i.e. hospitalization. OPD services are not covered under the scheme. As on 20.07.2024, 7.37 crore hospital admissions worth over Rs. 100,634 crore have been authorized under the scheme.

(f): Initially, 10.74 crore beneficiary families under AB PM-JAY were identified on the basis of the Socio-economic Caste Census (SECC) of 2011 using select deprivation and occupational criteria separately for rural and urban areas. In January 2022, the beneficiary base was expanded to 12.34 crore families and States/UTs have been given the flexibility to use other digitized databases of similar socio-economic conditions for identification of beneficiaries under the scheme. Accordingly, States/UTs have provided Aadhaar-seeded databases of poor and vulnerable families for verification under the scheme. The beneficiary may directly visit any empaneled hospital (public or private) across the country to avail cashless treatment benefits. Based on the diagnosis done by the hospital, eligible beneficiaries are provided treatment free of cost. Post treatment, beneficiary is discharged and hospital submits the claim for reimbursement.

(g): Reaching out to all eligible beneficiaries (including SC/ST/OBC households) and ensuring their Ayushman card creation is an important activity under the scheme. Beneficiaries can avail services by directly walking into the empanelled hospitals. Massive Ayushman card creation drive across the country is undertaken in tandem with the States. State/UT-wise details of Ayushman cards created under the scheme are at Annexure-II . The details of different initiatives taken under the scheme to saturate Ayushman card are as follows:

- i. Ayushman card creation process has been revamped with the launch of Ayushman App which enabled self-verifcation and Ayushman card creation, thus enabling individual beneficiaries to create their own Ayushman card.
- ii. Ayushman Bhava campaign and Viksit Bharat Sankalp Yatra have been undertaken to expedite the Ayushman card creation process.

*****

## District-wise details of Ayushman cards created during each of the last three years in the

## State of Maharashtra

| S.No.   | District        | Number of Ayushman cards created   | Number of Ayushman cards created   | Number of Ayushman cards created   |
|---------|-----------------|------------------------------------|------------------------------------|------------------------------------|
| S.No.   | District        | FY 2021-22                         | FY 2022-23                         | FY 2023-24                         |
| 1       | Ahmednagar      | 14,870                             | 45,508                             | 1,245,260                          |
| 2       | Akola           | 3,377                              | 21,341                             | 302,502                            |
| 3       | Amravati        | 17,928                             | 50,613                             | 493,542                            |
| 4       | Aurangabad      | 2,648                              | 19,318                             | 606,363                            |
| 5       | Beed            | 5,026                              | 23,435                             | 462,175                            |
| 6       | Bhandara        | 2,197                              | 25,221                             | 296,715                            |
| 7       | Buldhana        | 8,825                              | 23,932                             | 388,111                            |
| 8       | Chandrapur      | 4,488                              | 144,206                            | 334,154                            |
| 9       | Dhule           | 6,566                              | 23,664                             | 438,028                            |
| 10      | Gadchiroli      | 19,851                             | 25,423                             | 276,777                            |
| 11      | Gondia          | 4,608                              | 35,228                             | 252,367                            |
| 12      | Hingoli         | 10,074                             | 27,495                             | 262,014                            |
| 13      | Jalgaon         | 32,835                             | 63,014                             | 528,924                            |
| 14      | Jalna           | 11,171                             | 102,943                            | 432,293                            |
| 15      | Kolhapur        | 9,267                              | 57,254                             | 1,153,228                          |
| 16      | Latur           | 3,622                              | 48,604                             | 331,495                            |
| 17      | Mumbai          | 1,439                              | 6,227                              | 151,111                            |
| 18      | Mumbai Suburban | 23,364                             | 8,978                              | 626,422                            |
| 19      | Nagpur          | 7,657                              | 42,089                             | 1,039,165                          |
| 20      | Nanded          | 15,088                             | 44,218                             | 729,760                            |
| 21      | Nandurbar       | 6,396                              | 22,688                             | 294,168                            |
| 22      | Nashik          | 15,614                             | 239,938                            | 983,705                            |
| 23      | Osmanabad       | 8,022                              | 92,585                             | 363,714                            |
| 24      | Palghar         | 1,060                              | 9,720                              | 319,488                            |
| 25      | Parbhani        | 3,593                              | 26,821                             | 348,780                            |
| 26      | Pune            | 72,508                             | 50,860                             | 878,122                            |
| 27      | Raigad          | 1,247                              | 12,567                             | 333,248                            |
| 28      | Ratnagiri       | 924                                | 25,972                             | 366,706                            |
| 29      | Sangli          | 10,727                             | 61,501                             | 770,900                            |
| 30      | Satara          | 3,132                              | 67,250                             | 679,682                            |
| 31      | Sindhudurg      | 1,518                              | 12,210                             | 315,270                            |
| 32      | Solapur         | 11,082                             | 52,519                             | 638,251                            |
| 33      | Thane           | 11,072                             | 61,857                             | 530,806                            |
| 34      | Wardha          | 744                                | 50,224                             | 226,089                            |
| 35      | Washim          | 3,129                              | 29,230                             | 338,279                            |
| 36      | Yavatmal        | 7,021                              | 98,696                             | 267,792                            |

## State/UT-wise details of Ayushman cards created under the scheme

| State/UT                             | Number of Ayushman cards   |
|--------------------------------------|----------------------------|
| Andaman And Nicobar Islands          | 72 thousand                |
| Andhra Pradesh                       | 1.56 crore                 |
| Arunachal Pradesh                    | 1.41 lakh                  |
| Assam                                | 1.74 crore                 |
| Bihar                                | 2.96 crore                 |
| Chandigarh                           | 1.89 lakh                  |
| Chhattisgarh                         | 2.22 crore                 |
| Dadra And Nagar Haveli Daman And Diu | 4.45 lakh                  |
| Goa                                  | 81.6 thousand              |
| Gujarat                              | 2.56 crore                 |
| Haryana                              | 1.2 crore                  |
| Himachal Pradesh                     | 13.2 lakh                  |
| Jammu And Kashmir                    | 85.9 lakh                  |
| Jharkhand                            | 1.22 crore                 |
| Karnataka                            | 1.72 crore                 |
| Kerala                               | 76.7 lakh                  |
| Ladakh                               | 1.9 lakh                   |
| Lakshadweep                          | 34.6 thousand              |
| Madhya Pradesh                       | 4 crore                    |
| Maharashtra                          | 2.8 crore                  |
| Manipur                              | 6.13 lakh                  |
| Meghalaya                            | 19.76 lakh                 |
| Mizoram                              | 5.63 lakh                  |
| Nagaland                             | 7.16 lakh                  |
| Puducherry                           | 5 lakh                     |
| Punjab                               | 88 lakh                    |
| Rajasthan                            | 2.17 crore                 |
| Sikkim                               | 77 thousand                |
| Tamil Nadu                           | 73.64 lakh                 |
| Telangana                            | 82.5 thousand              |
| Tripura                              | 19.6 lakh                  |
| Uttar Pradesh                        | 5.1 crore                  |
| Uttarakhand                          | 57 lakh                    |