Lok Sabha Question No. 3029 (UNSTARRED), answered on 2024-12-13
Subject: Ayushman Cards
Ministry: HEALTH AND FAMILY WELFARE
Asked by: Shri Utkarsh Verma Madhur

## GOVERNMENTOFINDIA MINISTRYOF HEALTH AND FAMILYWELFARE DEPARTMENTOFHEALTH AND FAMILYWELFARE

## LOK SABHA UNSTARRED QUESTION NO. 3029 TO BE ANSWERED ON 13 TH DECEMBER, 2024

## AYUSHMAN CARDS

## 3029. SHRI UTKARSH VERMAMADHUR:

Will the Minister of HEALTHAND FAMILYWELFARE be pleased to state:

- (a) whether Ayushman Card is valid in Government hospitals, if so, the details thereof;
- (b) whether private hospitals are refusing to accept these cards and not giving admission to the patients with said card, if so, the details thereof;
- (c) whether there is any provision to take punitive action against such identified hospitals; and
- (d) if so, the details thereof, State-wise?

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

(a) & (b): All public hospitals with inpatient facilities are deemed empaneled under Ayushman Bharat - Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) without any physical verification. Ayushman card is valid in such empaneled government hospitals at tertiary and secondary level.

Under AB-PMJAY, the hospitals are empaneled by the State Health Agency (SHA) and are bound to provide cashless treatment to the scheme beneficiaries as per the MoU signed at the time of empanelment. Eligible beneficiaries cannot be denied treatment in the absence of an Ayushman card.

AB-PMJAYis an entitlement-based scheme, all the eligible beneficiary families are covered from day one of the implementation of the scheme in the State/UT. AB-PMJAY does not require enrolment, however, a beneficiary verification process is undertaken to verify the genuineness of the beneficiary. Further, verified beneficiaries are issued Ayushman card, as a token of entitlement and empowerment.

Under the scheme, a three-tier grievance redressal system at District, State and National level has been created to resolve the issues faced by beneficiaries in utilizing healthcare services. In case of denial of treatment by the empaneled hospital, beneficiaries can file their grievance using different mediums including web-based portal Centralized Grievance Redressal Management System (CGRMS), Central & State call centers (14555), email, letter to SHAs etc. Based on the nature of grievance, necessary action including providing of support to the beneficiaries in availing treatment under the scheme, is taken.

- (c) & (d): Appropriate actions including suspension, show cause notice, warning letter, deempanelment of hospitals, de-activation of e-cards, levying penalty on errant hospitals and lodging of FIRs are taken against fraudulent entities.

State/UT-wise details of private hospitals against which punitive action like suspension of hospital, issuance of warning letter and de-empanelment of hospital, have been taken, are as under:

| State/UT          |   Number of hospitals |
|-------------------|-----------------------|
| Andhra Pradesh    |                    39 |
| Assam             |                     1 |
| Bihar             |                     1 |
| Chandigarh        |                     2 |
| Chhattisgarh      |                     4 |
| Goa               |                     1 |
| Gujarat           |                     5 |
| Haryana           |                     7 |
| Jammu And Kashmir |                    42 |
| Jharkhand         |                     6 |
| Karnataka         |                    49 |
| Kerala            |                     8 |
| Madhya Pradesh    |                   127 |
| Punjab            |                    11 |
| Rajasthan         |                    10 |
| Tamil Nadu        |                    25 |
| Uttar Pradesh     |                   542 |

Note: Data as on 30.11.2024

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