Lok Sabha Question No. 3177 (UNSTARRED), answered on 2024-08-09
Subject: Ayushman Bharat Card
Ministry: HEALTH AND FAMILY WELFARE
Asked by: Dr. Mohammad Jawed

## GOVERNMENTOFINDIA MINISTRYOF HEALTH AND FAMILYWELFARE DEPARTMENTOFHEALTH ANDFAMILYWELFARE

## LOK SABHA UNSTARRED QUESTION NO. 3177 TO BE ANSWERED ON 09 TH AUGUST, 2024

## AYUSHMAN BHARATCARD

## 3177. DR. MOHAMMAD JAWED:

Will the Minister of HEALTHAND FAMILYWELFARE be pleased to state:

(a) the details of the data on the utilization and outcomes of the Pradhan Mantri Jan Arogya Yojana (PMJAY) or Ayushman Bharat scheme in the State of Bihar including the number of beneficiaries covered/treatments availed and overall impact on healthcare accessibility and affordability in the State;

(b) whether it is true that critical diseases like cancer/thalassemia are not covered under Ayushman Bharat card and if so, the details thereof; and

(c) the steps taken/proposed to be taken by the Government to address the instances where empaneled hospitals refuse to accept Ayushman Bharat cards from beneficiaries in the State of Bihar and the manner in which the grievances related to such issues are likely to be resolved?

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

(a): In the State of Bihar, Ayushman Bharat - Pradhan Mantri Jan Arogya Yojana (ABPMJAY) is implemented in convergence with the State scheme Mukhya Mantri Jan Aarogya Yojna (MMJAY). A total of 2.03 crore families are eligible to avail healthcare benefits under the converged scheme. As on 30.06.2024, a total number of 2.94 crore Ayushman cards have been created and 11.30 lakh hospital admissions worth Rs. 1338.16 crore have been authorized, thus improving the affordability of healthcare in the State. To provide accessibility of services under the scheme, a total number of 972 hospitals including 387 private hospitals are empanelled in the State.

(b): Critical diseases like Cancer and Thalassemia are covered under AB-PMJAY. Cancerrelated treatments are included in specialties such as Medical Oncology, Radiation Oncology, Surgical Oncology and Palliative Care. Further, there are 12 packages for Thalassemia in General Medicine and Pediatric Medical Management. In the latest national master of the Health Benefit Package (HBP 2022), the scheme provides treatment corresponding to a total of 1,949 procedures under 27 different medical specialties including chronic diseases such as Diabetes, Heart Disease and other non-communicable diseases.

(c): The following grievance redressal mechanisms are in place to address instances where empaneled hospitals refuse to accept AB-PMJAY cards:

- i. District Level: The District Grievance Redressal Committee (DGRC) acts as the nodal authority for handling grievances at the District level.
- ii. State Level: The State Grievance Redressal Committee (SGRC) and the State Appellate Authority (SAA) are responsible for redressing grievances at the State level.
- iii. Final Appeal: The State Appellate Authority (SAA) serves as the final appellate authority for resolving all grievances, whether received directly or escalated from the SGRC.

Beneficiaries can file their grievance using different mediums including web-based portal Centralized Grievance Redressal Management System (CGRMS), Central & State call centers, email, letter to State Health Agencies (SHAs) etc. Grievances related to delay or denial of treatment are assigned priority. The district team examines the grievance and ensures that beneficiaries do not face any challenge in availing treatment. The status of the grievances filed and their resolution, is monitored by State government. Further, based on the findings of District Implementation Units, SHAs take penal action against erring hospitals including de-empanelment.

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