Lok Sabha Question No. 3077 (UNSTARRED), answered on 2024-12-13
Subject: Implementation of AB-PMJAY  in Kerala
Ministry: HEALTH AND FAMILY WELFARE
Asked by: Adv Dean Kuriakose

## GOVERNMENTOFINDIA MINISTRYOF HEALTH AND FAMILYWELFARE DEPARTMENTOFHEALTH AND FAMILYWELFARE

## LOK SABHA UNSTARRED QUESTION NO. 3077 TO BE ANSWERED ON 13 TH DECEMBER, 2024

## IMPLEMENTATION OF AB-PMJAYIN KERALA

## 3077. ADVDEAN KURIAKOSE:

Will the Minister of HEALTHAND FAMILYWELFARE be pleased to state:

(a) whether the Government is considering an increase in the premium of AB-PMJAY for eligible family considering the morbidity and demographic profile in Kerala, if so, the details thereof;

(b) the details of amount of funds allocated and expenditure incurred by the Union Government and State Government under the said scheme since the inception of the program, year-wise;

(c) the details of claims overdue/pending payments of the PMJAY program implementation in Kerala; and

(d) whether the Government is considering any additional assistance to the State taking into account the high utilisation of the program, if so, the details thereof?

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

(a) to (d): Ayushman Bharat - Pradhan Mantri-Jan Arogya Yojana (AB-PMJAY) is completely funded by the Government and the costs are shared between Central and State Governments as per the existing policy of the scheme. The ratio of Central share to State share in the State of Kerala is 60:40. Central Government's share of Grant-in-Aid is based on the above sharing pattern ratio for the actual cost of treatment of the scheme beneficiary families or maximum ceiling amount decided by Government of India (presently Rs. 1052 per family per year), whichever is less. As of now, any additional expenditure over and above the maximum ceiling amount has to be borne by the State Government as per the current applicable guidelines.

The funding of AB-PMJAY is entirely demand driven. Funds are released to the States/UTs on the basis of the actual demand received from them. There is no State/UT-wise allocation of funds. As per the defined process, States/UTs are required to furnish the Utilization Certificate of previously received funds prior to every new fund release.

In the State of Kerala, AB-PMJAY is implemented in convergence with the State's own health assurance scheme. The total number of eligible families overall is 41.83 lakh. Out of these, 23.97 lakh families are supported by both Central and State government. The remaining families are supported under the State scheme and the treatment cost for these families is borne by the State government. The details of Central share of funds released to the State of Kerala under ABPMJAYsince inception of scheme are at Annexure .

Under AB-PMJAY, claims are settled by respective State Health Agencies under the State Government.

## Details of Central share of funds released to the State of Kerala under AB-PMJAY since inception of scheme

(in crore of Rupees)

| Financial Year   |   Central share of funds released for AB-PMJAYfamilies |
|------------------|--------------------------------------------------------|
| 2018-19          |                                                  25    |
| 2019-20          |                                                  97.56 |
| 2020-21          |                                                 145.61 |
| 2021-22          |                                                 138.9  |
| 2022-23          |                                                 151.34 |
| 2023-24          |                                                 155.49 |
| 2024-25          |                                                 151.34 |

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