Lok Sabha Question No. 833 (UNSTARRED), answered on 2025-02-07
Subject: Hospitals in North Eastern Region
Ministry: HEALTH AND FAMILY WELFARE
Asked by: Shri Joyanta Basumatary

## GOVERNMENTOFINDIA MINISTRYOF HEALTH AND FAMILYWELFARE DEPARTMENTOFHEALTH AND FAMILYWELFARE

## LOK SABHA UNSTARRED QUESTION NO. 833 TO BE ANSWERED ON 07 TH FEBRUARY, 2025

## HOSPITALS IN NORTH EASTERN REGION

## 833. SHRI JOYANTABASUMATARY:

Will the Minister of HEALTHAND FAMILYWELFARE be pleased to state:

(a) the details of public and private hospitals empanelled under Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) in North Eastern Region (NER), year-wise and Statewise;

(b) the details of public and private hospitals de-empanelled under (AB-PMJAY) due to irregularities in NER, year-wise and State-wise;

- (c) whether the Government is aware that such private hospitals in NER are refusing treatment under ABPMJAY due to delay in disbursement of funds, and if so, the details thereof; and
- (d) the measures taken by the Government to ensure the best treatment provided to the patients?

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

(a): State/UT-wise and year-wise details of public and private hospitals empanelled under Ayushman Bharat - Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) in North East Region are at Annexure-I .

(b): State/UT-wise and year-wise details of public and private hospitals de-empanelled under AB -PMJAY due to irregularities in North East Region are at Annexure-II .

(c): As per the terms and conditions of empanelment, hospitals are mandated to provide healthcare services to eligible beneficiaries under AB-PMJAY. In case of denial of services by the empanelled hospital, beneficiaries can lodge grievances. Under AB-PMJAY, 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. At each level, there is a dedicated nodal officer and Grievance Redressal Committees to address the grievances.

Beneficiaries can file their grievances using different mediums including web-based portal Centralized Grievance Redressal Management System (CGRMS), Central & State call centers (14555), email, letter to State Health Agencies (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.

Under AB-PMJAY, claims are settled by respective SHAs. Timely settlement of claims is one of the key parameters against which the scheme performance is measured. Therefore, the status of claim settlement under the scheme is constantly monitored to ensure that claims are settled within defined turnaround time. Necessary action is taken by the National Health Authority wherever there is a delay in claim payment.

(d): The scheme ensures quality treatment for the beneficiaries. For this, various incentives are provided to improve the quality of healthcare services. To encourage the participation of public, private and corporate healthcare providers, empaneled hospitals are additionally incentivized for accreditation. Incentive of 10% and 15% over and above the package rate is provided to the hospitals with entry level NABH accreditation and full NABH accreditation, respectively. Hospitals, which are imparting Post-Graduate education, are also incentivized at the rate of 10% over and above the base rate of HBP packaged master rates.

State/UT-wise and year-wise details of public and private hospitals empanelled under ABPMJAY in North East Region

| State             |   2018-19 | 2019-20   | 2020-21   | 2021-22   | 2022-23   |   2023-24 |   2024-25 |
|-------------------|-----------|-----------|-----------|-----------|-----------|-----------|-----------|
| Arunachal Pradesh |         2 | 2         | 15        | 17        | 9         |         3 |         3 |
| Assam             |       120 | 121       | 16        | 11        | 30        |        42 |        13 |
| Manipur           |        15 | 11        | 8         | 12        | 11        |         8 |         4 |
| Meghalaya         |       147 | 12        | 6         | 1         |           |         4 |         4 |
| Mizoram           |        79 | 3         | 3         |           | 1         |         1 |         1 |
| Nagaland          |        43 | 10        | 4         | 3         | 2         |        12 |         3 |
| Sikkim            |         6 |           |           | 6         | 1         |         2 |         4 |
| Tripura           |        90 | 1         | 36        | 2         | 3         |         5 |         1 |

Note: Data as on 01.02.2025

State/UT-wise and year-wise details of public and private hospitals de-empanelled under ABPMJAY due to irregularities in North East Region

| State     | 2018-19   | 2019-20   | 2020-21   | 2021-22   | 2022-23   | 2023-24   |
|-----------|-----------|-----------|-----------|-----------|-----------|-----------|
| Assam     | 44        | 42        | 9         | 3         | 1         | 1         |
| Manipur   |           |           |           | 1         |           |           |
| Meghalaya | 7         | 1         |           | 1         |           |           |
| Nagaland  | 15        | 5         | 5         |           |           |           |
| Sikkim    | 1         |           |           |           |           |           |

Note: Data as on 01.02.2025

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