Lok Sabha Question No. 4343 (UNSTARRED), answered on 2024-12-20
Subject: Salient features of AB-PMJAY
Ministry: HEALTH AND FAMILY WELFARE
Asked by: Shri Omprakash Bhupalsinh Alias Pavan Rajenimbalkar, Shri Sanjay Haribhau Jadhav

## GOVERNMENTOFINDIA MINISTRYOF HEALTH AND FAMILYWELFARE DEPARTMENTOFHEALTH AND FAMILYWELFARE

## LOK SABHA UNSTARRED QUESTION NO. 4343 TO BE ANSWERED ON 20 TH DECEMBER, 2024

## SALIENT FEATURES OF AB-PMJAY

## 4343. SHRI SANJAY HARIBHAU JADHAV: SHRI OMPRAKASH BHUPALSINH ALIAS PAVAN RAJENIMBALKAR:

Will the Minister of HEALTHAND FAMILYWELFARE be pleased to state:

- (a) the salient features of AB-PMJAY;
- (b) the details of the funds sanctioned, allocated and utilised under the said scheme along with the number of empanelled hospitals in the country particularly in Parbhani Parliamentary Constituency during the last five years and the current year, State/UT and year-wise;
- (c) the amount of expenditure incurred on OPD treatment and indoor treatment of the beneficiaries under the said yojana during the last five years;
- (d) the targets fixed for strengthening and expanding the said yojana in the country along with the necessary steps taken/proposed to be taken for the purpose;
- (e) the efforts being made for covering the remote and the rural areas across the country under the said yojana along with the details of the areas including Parbhani Parliamentary Constituency, State/UT/area-wise; and
- (f) the detail of the efforts being made by the Government for covering the remote and rural areas under the said yojana across the country including Parbhani Parliamentary Constituency where the scheme is being implemented, State/UT-wise?

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

(a): Ayushman Bharat - Pradhan Mantri-Jan Arogya Yojana (AB-PMJAY) provides health cover of Rs. 5 lakh per eligible beneficiary family per year for secondary and tertiary care hospitalizations corresponding to 1,961 treatment procedures across 27 specialties. The scheme is implemented across the country through a three-tier model - National Health Authority (NHA), State Health Agencies (SHAs) and District Implementation Units (DIUs) at National, State and district level respectively. AB-PMJAY is completely funded by the Government and the costs are shared between Central and State Governments.

The scheme is completely cashless and paperless. It is an entitlement-based scheme and all the eligible beneficiary families are covered from day one of the implementation of the scheme in the State/UT. The benefits under the scheme are portable across the country. Further, there is no cap on family size, age or gender. AB-PMJAY is being implemented in 33 States/UTs across the country except West Bengal, NCT of Delhi and Odisha. The States/UTs have been provided flexibility to implement the scheme in the operational model best suited to the local conditions, including the customization of Health Benefit Packages, operational activities such as hospital empanelment, mode of implementation and IEC strategies etc.

- (b): 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. The details of funds allocated under AB-PMJAY for release to States/UTs as Grant-In-Aid during the last five years and the current year are as under:

| Financial Year   |   Funds allocated for release to States/UTs as Grant-In-Aid (in crore of Rs.) |
|------------------|-------------------------------------------------------------------------------|
| 2019-20          |                                                                          5795 |
| 2020-21          |                                                                          5995 |
| 2021-22          |                                                                          5995 |
| 2022-23          |                                                                          6000 |
| 2023-24          |                                                                          6220 |
| 2024-25          |                                                                          6878 |

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. Central Government's share of Grant-in-Aid is based on the pre-defined sharing pattern ratio for the actual cost of treatment of scheme beneficiary families or maximum ceiling amount decided by Government of India (currently Rs. 1052 per family per year), whichever is less. As per the process defined, the State is required to furnish a Utilization Certificate of previously received funds prior to every new fund release. State/UT-wise and year-wise details of funds released under AB-PMJAY as GrantIn-Aid during the last five years and the current year are at Annexure-I . State/UT-wise and yearwise details of number of hospitals empaneled in the country during the last five years and the current year are at Annexure-II .

Further, 24 hospitals have been empaneled under AB-PMJAY in Parbhani district of Maharashtra, year-wise details of which are as under:

| Year    |   No. of hospitals empanelled |
|---------|-------------------------------|
| 2019-20 |                            10 |
| 2020-21 |                             0 |

| 2021-22                 |   0 |
|-------------------------|-----|
| 2022-23                 |   1 |
| 2023-24                 |   2 |
| 2024 (as on 16.12.2024) |  11 |
| Total                   |  24 |

(c): AB-PMJAY provides free in-patient care only i.e. hospitalization. OPD services are not covered under the scheme. The amount incurred on the in-patient treatment of beneficiaries under the scheme for the last five years (i.e. FY 2019-20 to FY 2023-24) is Rs. 88,499.91 crore.

(d): Targets are not fixed for AB-PMJAY as the scheme operates on the basis of beneficiary demand for healthcare services. All the eligible beneficiaries of the implementing States/UTs are entitled for healthcare services under the scheme.

(e) and (f): AB-PMJAY has a comprehensive media and outreach strategy to spread awareness and empower beneficiaries for their rights and entitlements, more prominently in rural areas. This includes intensive advertisement over traditional media platforms including newspapers, community radio, street plays, digital displays, radio campaigns, mass messaging, telecast of beneficiary testimonials via Doordarshan, etc. Further, State Health Agencies have also engaged the wide network frontline workers ASHAs, AWWs and VLEs (Village Level Entrepreneurs) who have been pivotal in creating mass awareness at the grassroot level. Further, various other initiatives have been undertaken including deployment of Ayushman Mitra, toll free helpline '14555', mechanism for feedback, etc with the objective to foster wider societal engagement and empower beneficiaries for availing healthcare services under the scheme. Further, eligible beneficiaries are distributed PVC Ayushman cards as a token of empowerment.

## Annexure-I

## State/UT-wise and year-wise details of funds released under AB-PMJAY as Grant-In-Aid during the last five years and the current year

(in crore of Rupees)

| State/UT                 |   FY 2019- 20 |   FY2020- 21 |   FY2021- 22 |   FY2022- 23 |   FY2023- 24 |   FY2024- 25 |
|--------------------------|---------------|--------------|--------------|--------------|--------------|--------------|
| Andaman &Nicobar Islands |          0.41 |         0.27 |         0.76 |         1    |         0.59 |         0.78 |
| Andhra Pradesh           |        374.07 |       261.23 |       223.95 |       480.89 |       451.45 |       203.24 |
| Arunachal Pradesh        |          0    |         0.67 |         0    |         3.8  |         3.47 |         3.76 |
| Assam                    |        133.23 |        12.1  |        87.91 |       209.33 |       292.06 |       289.68 |
| Bihar                    |         82.49 |         0    |        59.77 |       145.51 |       172.5  |       300    |
| Chandigarh               |          3.82 |         1.84 |         2.49 |         6.41 |         8.96 |         4.51 |
| Chhattisgarh             |        280.37 |       112.62 |        66    |       352.94 |       195.47 |       242.31 |
| DNH and DD               |          2.02 |         4.24 |         1.76 |         2.93 |         7.79 |         2.89 |
| Goa                      |          0.06 |         0.49 |         0.6  |         0.53 |         1.2  |         0    |
| Gujarat                  |        212.33 |        99.84 |       330.55 |       660.15 |       267.48 |         0    |
| Haryana                  |         58.69 |        71.92 |        89.95 |       143.5  |        95.17 |        51.19 |
| Himachal Pradesh         |         19.12 |        32.93 |        33.71 |        64.32 |        47.91 |        49.71 |
| Jammu and Kashmir        |         33.44 |        22.7  |        75.12 |        85.62 |        42.22 |        31.54 |
| Jharkhand                |        126.5  |       100.32 |         7.98 |         0    |        83.55 |       270.63 |
| Karnataka                |        254.13 |       160.85 |       414.11 |       647.74 |       320.59 |       371.74 |
| Kerala                   |         97.56 |       145.61 |       138.9  |       151.34 |       155.49 |       151.34 |
| Ladakh                   |          0    |         1.62 |         0.51 |         1.92 |         1.93 |         1.15 |
| Lakshadweep              |          0    |         0    |         0.31 |         0.15 |         0.07 |         0    |
| Madhya Pradesh           |        118.46 |       164.8  |       355.25 |       665.73 |       790.35 |       413.61 |
| Maharashtra              |        241.88 |       376.65 |       324.75 |       388.03 |       548.4  |       371.88 |
| Manipur                  |         17.1  |        11.45 |        22.5  |        38.55 |        29.17 |        14.58 |
| Meghalaya                |         18.07 |        49.52 |        22.28 |        47.31 |        49.74 |         3.65 |
| Mizoram                  |         12.41 |        14.97 |        16.58 |        26.3  |        23.35 |        11.66 |
| Nagaland                 |         10.89 |        12.27 |        14.09 |        21.69 |        28.6  |        11.05 |
| Puducherry               |          0    |         1.23 |         0.11 |         7.98 |         5.3  |         2.15 |
| Punjab                   |         55.55 |        46.85 |        80.5  |       111.38 |        57.96 |        43.91 |
| Rajasthan                |        200.07 |       258.31 |        96.39 |       416.96 |       606.04 |       209.48 |
| Sikkim                   |          0.09 |         1.85 |         1.04 |         2.3  |         6.01 |         2.95 |
| Tamil Nadu               |        441.77 |       359.81 |        75.14 |       578.67 |       681.74 |         0    |
| Telangana                |          0    |         0    |       150.26 |       173.54 |       135.75 |       170.48 |
| Tripura                  |         20.18 |         8.98 |        35.6  |        45.25 |        48.81 |        27.76 |
| Uttar Pradesh            |        147.49 |       167.63 |       157.56 |       501.78 |       841.11 |       933.5  |
| Uttarakhand              |         30.73 |        40.52 |        54.23 |        65.11 |        60.21 |        34.07 |

State/UT-wise and year-wise details of number of hospitals empaneled in the country during the last five years and the current year

| State/UT                   |   FY2019- 20 |   FY2020- 21 |   FY2021- 22 |   FY2022- 23 |   FY2023- 24 |   FY2024- 25 |
|----------------------------|--------------|--------------|--------------|--------------|--------------|--------------|
| Andaman AndNicobar Islands |            0 |            0 |            0 |            4 |            0 |            0 |
| Andhra Pradesh             |         1241 |           61 |          689 |          132 |          120 |           95 |
| Arunachal Pradesh          |            2 |           15 |           17 |            9 |            3 |            2 |
| Assam                      |          121 |           16 |           11 |           30 |           42 |           13 |
| Bihar                      |          120 |           32 |           36 |           70 |           81 |           81 |
| Chandigarh                 |            7 |            3 |            4 |            1 |            2 |            2 |
| Chhattisgarh               |          591 |          661 |          122 |          150 |           41 |           56 |
| DNH&DD                     |            0 |            0 |            0 |            0 |           13 |            0 |
| Goa                        |            4 |            1 |            2 |            0 |            0 |            0 |
| Gujarat                    |           78 |           99 |          148 |          255 |          214 |          119 |
| Haryana                    |          121 |           43 |           59 |          126 |          459 |           80 |
| Himachal Pradesh           |           11 |           12 |           24 |           26 |           31 |           11 |
| Jammu AndKashmir           |           15 |            3 |           33 |           32 |           40 |            4 |
| Jharkhand                  |           44 |           34 |           38 |           25 |           23 |            9 |
| Karnataka                  |         2504 |           73 |           40 |          136 |          161 |           37 |
| Kerala                     |          102 |          113 |           79 |           44 |            4 |           19 |
| Ladakh                     |            0 |            0 |            0 |            0 |            0 |            0 |
| Lakshadweep                |            0 |            4 |            0 |            0 |            0 |            0 |
| Madhya Pradesh             |          294 |          159 |          141 |          112 |           96 |           56 |
| Maharashtra                |          130 |          225 |           68 |           89 |           97 |           18 |
| Manipur                    |           11 |            8 |           12 |           11 |            8 |            3 |
| Meghalaya                  |           12 |            6 |            1 |            0 |            4 |            4 |
| Mizoram                    |            3 |            3 |            0 |            1 |            1 |            1 |
| Nagaland                   |           10 |            4 |            3 |            2 |           12 |            2 |
| NCTofDelhi                 |            9 |            9 |            8 |            2 |           16 |            6 |
| Odisha                     |            9 |            0 |            0 |            1 |            1 |            0 |
| PSU                        |            1 |            0 |            1 |            0 |            0 |            0 |
| Puducherry                 |           18 |            2 |            6 |            2 |            0 |            0 |
| Punjab                     |          464 |          104 |           64 |           28 |           67 |           40 |
| Rajasthan                  |           27 |         1020 |          463 |          269 |           95 |            0 |
| Sikkim                     |            0 |            0 |            6 |            1 |            2 |            4 |
| Tamil Nadu                 |          111 |           93 |          670 |           73 |          126 |           26 |
| Telangana                  |            4 |            3 |          388 |          878 |           58 |           19 |
| Tripura                    |            1 |           36 |            2 |            3 |            5 |            1 |
| Uttar Pradesh              |          867 |           83 |          270 |          591 |         2389 |          298 |
| Uttarakhand                |            7 |           14 |           20 |           25 |           49 |           28 |
| West Bengal                |           20 |            3 |            0 |            2 |            5 |            7 |

Note: Data as on 25.11.2024

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