Lok Sabha Question No. 879 (UNSTARRED), answered on 2024-11-29
Subject: Standardisation of Hospital Billing  Processes
Ministry: HEALTH AND FAMILY WELFARE
Asked by: Shri Haribhai Patel

## GOVERNMENTOFINDIA MINISTRYOF HEALTH AND FAMILY WELFARE DEPARTMENTOFHEALTH AND FAMILY WELFARE

## LOK SABHA UNSTARRED QUESTION NO. 879 TO BE ANSWERED ON 29 TH NOVEMBER, 2024

## STANDARDISATION OF HOSPITALBILLING PROCESSES

## 879: SHRI HARIBHAI PATEL:

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

- (a) whether the Bureau of Indian Standards has initiated efforts to standardize hospital billing processes and if so, the details thereof;
- (b) the details of consultations held with industry bodies and stakeholders on hospital billing standardization;
- (c) the steps taken/proposed to be taken by the Government to reduce out-of-pocket healthcare expenses, especially for medicines;
- (d) the measures taken/proposed to be taken by the Government to prevent people from being pushed into poverty due to exorbitant health expenses; and
- (e) whether the Government has any plan to conduct a comprehensive study on the impact of medical inflation on healthcare costs and if so, the details thereof?

## ANSWER

## THE MINISTER OF STATE IN THE MINISTRY OF HEALTH AND FAMILY WELFARE

## (SHRIMATIANUPRIYAPATEL)

(a) and (b) : Yes Sir , the Bureau of Indian Standards constituted a Working Group of experts to prepare preliminary draft Indian Standard. The industry bodies are also part of the Working Group.

(c) and (d) : As per National Health Accounts Estimates 2021-22, the Out-of-pocket expenditure (OOPE) as percentage of Total Health Expenditure (THE) is 39.4%. OOPE on health as percentage of THE in the country for the year 2017-18, 2018-19, 2019-20, 2020-21 and 2021-22 are 48.8%, 48.2%, 47.1%, 44.4% and 39.4% respectively and therefore there is declining trend in OOPE as percentage of THE.

Further, the Central Government has taken several initiatives for supplementing the efforts of the State for providing quality and affordable healthcare services to the people and reduce the OOPE. Under National Health Mission, the Government has taken many steps towards universal health coverage, by supporting the State Governments in providing accessible & affordable healthcare to people. The National Health Mission provides support for improvement in health infrastructure, availability of adequate human resources to man health facilities, to improve availability and accessibility to quality health care especially for the underserved and marginalized groups in rural areas. National Free Drugs Service Initiative and National Free Diagnostic Service has been rolled out to ensure the availability of essential drugs and diagnostic facilities and reduce the Out-of-Pocket Expenditure (OOPE) of the patients visiting the public health facilities.

The Government has launched mission mode projects, namely Pradhan Mantri -Ayushman Bharat Health Infrastructure Mission (PM-ABHIM), Ayushman Aarogya Mandir (erstwhile AB-HWC) and Pradhan Mantri Jan Arogya Yojana (PMJAY).

PM-ABHIM was launched as a mission to develop the capacities of primary, secondary and tertiary health care systems; strengthen existing national institutions and create new institutions to cater to detection and cure of new and emerging diseases. PM-ABHIM is a Centrally Sponsored Scheme with some Central Sector components with an outlay of Rs 64,180 crore.

A total of 1,75,180 Ayushman Arogya Mandirs (AAMs) have been established and operationalized till 22nd November 2024 by transforming existing Sub-Health Centres (SHC) and Primary Health Centres (PHC) in rural and urban areas. The purpose of AAMs are to deliver the expanded range of comprehensive primary healthcare services that includes preventive, promotive, curative, palliative and rehabilitative services encompassing Reproductive and Child care services, Communicable diseases, Non-communicable diseases and all health issues, which are universal, free and closer to the community.

Ayushman Bharat - Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) provides health cover of Rs. 5 lakh per family per year for secondary and tertiary care hospitalization to approximately 55 crore beneficiaries corresponding to 12.37 crore families, constituting the bottom 40% of India's population. The Central Government has also recently approved health coverage for all senior citizens of the age 70 years and above irrespective of their income under PM JAY.

Besides, quality generic medicines are made available at affordable prices to all under Pradhan Mantri Bhartiya Janaushadhi Pariyojana (PMBJP) in collaboration with the State Governments. Affordable Medicines and Reliable Implants for Treatment (AMRIT) Pharmacy stores have been set up in some hospitals/institutions.

(e) : No, Sir. No such study is under consideration of this Ministry.