Lok Sabha Question No. 872 (UNSTARRED), answered on 2024-11-29
Subject: Empanelled Hospitals under AB-PMJAY
Ministry: HEALTH AND FAMILY WELFARE
Asked by: Shri Vijay Kumar Hansdak, Shri Benny Behanan, Shri Hibi Eden

## GOVERNMENTOFINDIA MINISTRYOF HEALTH AND FAMILYWELFARE DEPARTMENTOFHEALTH AND FAMILYWELFARE

## LOK SABHA UNSTARRED QUESTION NO. 872 TO BE ANSWERED ON 29 TH NOVEMBER, 2024

## EMPANELLED HOSPITALS UNDER AB-PMJAY

## 872. SHRI BENNY BEHANAN: SHRI VIJAY KUMAR HANSDAK: SHRI HIBI EDEN:

Will the Minister of HEALTHAND FAMILYWELFARE be pleased to state:

- (a) the details of public/private hospitals empanelled/de-empanelled under Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY), State/year-wise;
- (b) whether the Government is aware of the fact that private hospitals are refusing treatment under AB-PMJAY due to delays in fund disbursement and if so, the details thereof;
- (c) the measures implemented to monitor and address complaints related to empaneled hospitals under AB-PMJAY particularly regarding refusal of service or denial of benefits to eligible beneficiaries; and
- (d) the steps taken/proposed to be taken by the Government to increase the number of hospitals under AB-PMJAY?

## 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 number of Public and Private hospitals empaneled and de-empaneled under Ayushman Bharat - Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) are at Annexure-l and Annexure-II respectively.
- (b) and (c): Under AB-PMJAY, claims are settled by respective State Health Agencies under the State Government. Timely settlement of claims is one of the key parameters against which scheme performance is measured. The status of claim settlement under the scheme is constantly monitored and review meetings are organized regularly to take stock of the progress with regards to the claims.

Further, a three-tier grievance redressal system at District, State, and National level have been created to resolve the issues faced by beneficiaries whilst utilizing healthcare services under the scheme. Beneficiaries may file their grievance using different media including web-based portal Centralized Grievance Redressal Management System (CGRMS), central & state call centers, email, letter to SHAs etc. Based on the nature of grievance, necessary action, including providing support to the beneficiaries in availing treatment under the scheme, and resolution of grievances are taken.

(d): In order to improve the participation of hospitals, following actions have been taken:

- i. NHA has released a revised health benefit package with increased number of procedures (1961). Further, rates have been increased for 350 packages and new packages have been added.
- ii. Claim settlement is monitored at the highest level and it is ensured that claim is settled within defined turnaround time.
- iii. Virtual and physical capacity building of hospitals are undertaken.
- iv. Ahospital-specific call center (14413) has been set-up to address their concern on a real-time basis.
- v. District Implementation Units (DIU) have been set-up to regularly visit empaneled hospitals to understand the issues faced by beneficiaries and hospitals.

Annexure-I State/UT-wise and year-wise details of number of Public and Private hospitals empaneled under the scheme

|                     | 2018-2019           | 2018-2019           | 2019-2020           | 2019-2020           | 2020-2021           | 2020-2021           | 2021-2022           | 2021-2022           | 2022-2023           | 2022-2023           | 2023-2024           | 2023-2024           | 2024-2025*          | 2024-2025*          |
|---------------------|---------------------|---------------------|---------------------|---------------------|---------------------|---------------------|---------------------|---------------------|---------------------|---------------------|---------------------|---------------------|---------------------|---------------------|
| State/UT            | Public              | Private             | Public              | Private             | Public              | Private             | Public              | Private             | Public              | Private             | Public              | Private             | Public              | Private             |
| Andaman And Nicobar | Andaman And Nicobar | Andaman And Nicobar | Andaman And Nicobar | Andaman And Nicobar | Andaman And Nicobar | Andaman And Nicobar | Andaman And Nicobar | Andaman And Nicobar | Andaman And Nicobar | Andaman And Nicobar | Andaman And Nicobar | Andaman And Nicobar | Andaman And Nicobar | Andaman And Nicobar |
| Islands             | 3                   | 0                   | 0                   | 0                   | 0                   | 0                   | 0                   | 0                   | 4                   | 0                   | 0                   | 0                   | 0                   | 0                   |
| Andhra Pradesh      | 45                  | 84                  | 671                 | 570                 | 1                   | 60                  | 590                 | 99                  | 44                  | 88                  | 33                  | 87                  | 30                  | 65                  |
| Arunachal Pradesh   | 2                   | 0                   | 2                   | 0                   | 14                  | 1                   | 17                  | 0                   | 9                   | 0                   | 2                   | 1                   | 0                   | 2                   |
| Assam               | 35                  | 85                  | 119                 | 2                   | 5                   | 11                  | 0                   | 11                  | 2                   | 28                  | 16                  | 26                  | 6                   | 7                   |
| Bihar               | 558                 | 61                  | 22                  | 98                  | 1                   | 31                  | 2                   | 34                  | 1                   | 69                  | 1                   | 80                  | 2                   | 79                  |
| Chandigarh          | 6                   | 6                   | 1                   | 6                   | 0                   | 3                   | 0                   | 4                   | 0                   | 1                   | 0                   | 2                   | 0                   | 2                   |
| Chhattisgarh        | 2                   | 0                   | 591                 | 0                   | 361                 | 300                 | 28                  | 94                  | 28                  | 122                 | 22                  | 19                  | 6                   | 50                  |
| DNH&DD              | 7                   | 0                   | 0                   | 0                   | 0                   | 0                   | 0                   | 0                   | 0                   | 0                   | 8                   | 5                   | 0                   | 0                   |
| Goa                 | 9                   | 0                   | 2                   | 2                   | 1                   | 0                   | 2                   | 0                   | 0                   | 0                   | 0                   | 0                   | 0                   | 0                   |
| Gujarat             | 1450                | 312                 | 25                  | 53                  | 69                  | 30                  | 13                  | 135                 | 97                  | 158                 | 80                  | 134                 | 18                  | 101                 |
| Haryana             | 144                 | 207                 | 11                  | 110                 | 6                   | 37                  | 2                   | 57                  | 0                   | 126                 | 338                 | 121                 | 1                   | 79                  |
| Himachal Pradesh    | 133                 | 34                  | 2                   | 9                   | 0                   | 12                  | 0                   | 24                  | 2                   | 24                  | 1                   | 30                  | 0                   | 11                  |
| Jammu And Kashmir   | 111                 | 17                  | 1                   | 14                  | 0                   | 3                   | 1                   | 32                  | 2                   | 30                  | 3                   | 37                  | 4                   | 0                   |
| Jharkhand           | 220                 | 168                 | 13                  | 31                  | 0                   | 34                  | 4                   | 34                  | 1                   | 24                  | 1                   | 22                  | 1                   | 8                   |
| Karnataka           | 395                 | 206                 | 2420                | 84                  | 26                  | 47                  | 16                  | 24                  | 49                  | 87                  | 58                  | 103                 | 7                   | 30                  |
| Kerala              | 147                 | 80                  | 39                  | 63                  | 4                   | 109                 | 7                   | 72                  | 1                   | 43                  | 3                   | 1                   | 1                   | 18                  |
| Ladakh              | 9                   | 0                   | 0                   | 0                   | 0                   | 0                   | 0                   | 0                   | 0                   | 0                   | 0                   | 0                   | 0                   | 0                   |
| Lakshadweep         | 1                   | 0                   | 0                   | 0                   | 4                   | 0                   | 0                   | 0                   | 0                   | 0                   | 0                   | 0                   | 0                   | 0                   |

| Madhya Pradesh   |   146 |   56 |   259 |   35 |   30 |   129 |   25 |   116 |   21 |   91 |    9 |   87 |   7 |   49 |
|------------------|-------|------|-------|------|------|-------|------|-------|------|------|------|------|-----|------|
| Maharashtra      |    82 |  310 |    92 |   38 |   19 |   206 |    5 |    63 |    3 |   86 |    5 |   92 |   2 |   16 |
| Manipur          |     9 |    6 |     9 |    2 |    7 |     1 |    9 |     3 |    0 |   11 |    0 |    8 |   0 |    3 |
| Meghalaya        |   145 |    2 |     1 |   11 |    2 |     4 |    1 |     0 |    0 |    0 |    4 |    0 |   2 |    2 |
| Mizoram          |    77 |    2 |     0 |    3 |    1 |     2 |    0 |     0 |    1 |    0 |    0 |    1 |   1 |    0 |
| Nagaland         |    39 |    4 |     4 |    6 |    1 |     3 |    3 |     0 |    0 |    2 |    1 |   11 |   2 |    0 |
| NCTofDelhi       |     7 |   10 |     3 |    6 |    0 |     9 |    1 |     7 |    0 |    2 |    0 |   16 |   0 |    6 |
| Odisha           |     1 |    0 |     9 |    0 |    0 |     0 |    0 |     0 |    0 |    1 |    1 |    0 |   0 |    0 |
| PSU              |     0 |    0 |     1 |    0 |    0 |     0 |    1 |     0 |    0 |    0 |    0 |    0 |   0 |    0 |
| Puducherry       |     2 |    0 |    10 |    8 |    0 |     2 |    0 |     6 |    0 |    2 |    0 |    0 |   0 |    0 |
| Punjab           |     2 |    0 |   204 |  260 |    1 |   103 |    1 |    63 |    3 |   25 |    2 |   65 |   5 |   35 |
| Rajasthan        |    13 |    9 |    27 |    0 |  749 |   271 |   42 |   421 |   60 |  209 |   31 |   64 |   0 |    0 |
| Sikkim           |     5 |    1 |     0 |    0 |    0 |     0 |    6 |     0 |    0 |    1 |    1 |    1 |   2 |    2 |
| Tamil Nadu       |   326 |  789 |    27 |   84 |   12 |    81 |  524 |   146 |   22 |   51 |   86 |   40 |   9 |   17 |
| Telangana        |    38 |    1 |     4 |    0 |    2 |     1 |  142 |   246 |  826 |   52 |    2 |   56 |   1 |   18 |
| Tripura          |    88 |    2 |     1 |    0 |   36 |     0 |    2 |     0 |    2 |    1 |    3 |    2 |   1 |    0 |
| Uttar Pradesh    |   427 |  912 |   631 |  236 |    3 |    80 |    3 |   267 |   12 |  579 | 1810 |  579 |  62 |  236 |
| Uttarakhand      |    97 |   48 |     6 |    1 |    0 |    14 |    0 |    20 |    0 |   25 |    1 |   48 |   1 |   27 |
| West Bengal      |     5 |    0 |    20 |    0 |    0 |     3 |    0 |     0 |    2 |    0 |    0 |    5 |   0 |    7 |

* Data as on 25.11.2024

## State/UT-wise and year-wise details of number of Public and Private hospitals deempanelled under the scheme

|                             | 2018-201 9   | 2018-201 9   | 2019-202 0   | 2019-202 0   | 2020-202 1   | 2020-202 1   | 2021-202 2   | 2021-202 2   | 2022-202 3   | 2022-202 3   | 2023-202 4   | 2023-202 4   | 2024-202 5*   | 2024-202 5*   |
|-----------------------------|--------------|--------------|--------------|--------------|--------------|--------------|--------------|--------------|--------------|--------------|--------------|--------------|---------------|---------------|
| State/UT                    | Pub lic      | Priv ate     | Pub lic      | Priv ate     | Pub lic      | Priv ate     | Pub lic      | Priv ate     | Pub lic      | Priv ate     | Pub lic      | Priv ate     | Pub lic       | Priv ate      |
| Andaman And Nicobar Islands | 0            | 0            | 0            | 0            | 0            | 0            | 0            | 0            | 0            | 0            | 0            | 0            | 0             | 0             |
| Andhra Pradesh              | 0            | 0            | 0            | 9            | 0            | 0            | 0            | 148          | 0            | 88           | 0            | 1            | 0             | 0             |
| Arunachal Pradesh           | 0            | 0            | 0            | 0            | 0            | 0            | 0            | 0            | 0            | 0            | 0            | 0            | 0             | 0             |
| Assam                       | 0            | 0            | 0            | 1            | 0            | 0            | 0            | 2            | 0            | 5            | 0            | 0            | 0             | 0             |
| Bihar                       | 0            | 17           | 0            | 34           | 0            | 5            | 0            | 1            | 0            | 1            | 0            | 0            | 0             | 0             |
| Chandigarh                  | 0            | 0            | 0            | 0            | 0            | 0            | 0            | 0            | 0            | 1            | 1            | 0            | 0             | 0             |
| Chhattisgarh                | 0            | 0            | 0            | 2            | 0            | 0            | 0            | 1            | 0            | 0            | 0            | 0            | 0             | 9             |
| DNH&DD                      | 0            | 0            | 0            | 0            | 0            | 0            | 0            | 0            | 0            | 0            | 0            | 0            | 0             | 0             |
| Goa                         | 0            | 0            | 0            | 0            | 0            | 0            | 0            | 0            | 0            | 0            | 3            | 0            | 0             | 0             |
| Gujarat                     | 0            | 0            | 0            | 0            | 0            | 0            | 0            | 0            | 0            | 1            | 0            | 1            | 0             | 1             |
| Haryana                     | 0            | 0            | 0            | 0            | 0            | 4            | 0            | 1            | 0            | 10           | 4            | 9            | 1             | 6             |
| Himachal Pradesh            | 0            | 0            | 11           | 0            | 1            | 4            | 1            | 4            | 0            | 3            | 3            | 3            | 0             | 0             |
| Jammu And Kashmir           | 0            | 0            | 0            | 0            | 0            | 0            | 0            | 0            | 0            | 1            | 0            | 0            | 0             | 1             |
| Jharkhand                   | 0            | 20           | 0            | 3            | 0            | 16           | 0            | 0            | 0            | 40           | 0            | 81           | 0             | 24            |
| Karnataka                   | 0            | 0            | 0            | 1            | 0            | 8            | 0            | 11           | 0            | 129          | 0            | 27           | 0             | 0             |
| Kerala                      | 0            | 0            | 0            | 0            | 0            | 0            | 0            | 5            | 0            | 1            | 0            | 1            | 0             | 1             |
| Ladakh                      | 0            | 0            | 0            | 0            | 0            | 0            | 0            | 0            | 0            | 0            | 0            | 0            | 0             | 0             |

| Lakshadwee p   |   0 |   0 |   0 |   0 |   0 |   0 |   0 |   0 |   0 |   0 |   0 |   0 |   0 |   0 |
|----------------|-----|-----|-----|-----|-----|-----|-----|-----|-----|-----|-----|-----|-----|-----|
| Madhya Pradesh |   0 |   0 |   0 |   0 |   0 |   3 |   0 |  10 |   0 |  87 |   0 |  53 |   0 | 286 |
| Maharashtra    |   0 |  70 |   0 |  43 |   0 |  12 |   0 | 109 |  71 | 122 |  21 |  31 |   0 |   0 |
| Manipur        |   0 |   0 |   0 |   0 |   0 |   0 |   0 |   0 |   0 |   0 |   0 |   0 |   0 |   1 |
| Meghalaya      |   0 |   0 |   0 |   0 |   0 |   0 |   0 |   0 |   0 |   1 |   7 |   1 |   1 |   0 |
| Mizoram        |   0 |   0 |   0 |   0 |   0 |   0 |   0 |   0 |   0 |   0 |   0 |   0 |   0 |   0 |
| Nagaland       |   0 |   0 |   0 |   0 |   0 |   0 |   0 |   0 |   0 |   0 |   0 |   0 |  22 |   0 |
| Puducherry     |   0 |   0 |   0 |   0 |   0 |   0 |   0 |   0 |   0 |   0 |   0 |   0 |   0 |   2 |
| Punjab         |   0 |   0 |   0 |   0 |   0 |  15 |   0 |   4 |   0 |   3 |   0 |   0 |   0 |   0 |
| Rajasthan      |   0 |   0 |   0 |   0 |   0 |   0 |   0 |   1 |   0 |   8 |   0 |   2 |   0 |   0 |
| Sikkim         |   0 |   0 |   0 |   0 |   0 |   0 |   0 |   0 |   0 |   0 |   0 |   0 |   0 |   1 |
| Tamil Nadu     |   0 |   0 |   0 |   0 |   0 |   3 |   0 |   2 |   0 |   0 |   0 |   9 |   0 |   1 |
| Telangana      |   0 |   0 |   0 |   0 |   0 |   0 |   0 |   6 |   0 |   2 |   0 |   0 |   0 |   1 |
| Tripura        |   0 |   0 |   0 |   0 |   0 |   0 |   0 |   0 |   0 |   0 |   0 |   0 |   0 |   0 |
| Uttar Pradesh  |   0 |   3 |   0 |   3 |   1 |  74 |   0 |  45 |   0 |  40 |   2 | 204 |   0 |  47 |
| Uttarakhand    |   0 |   0 |   0 |  19 |   0 |   1 |   0 |  32 |   0 |  32 |   0 |   1 |   0 |   0 |

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* Data as on 25.11.2024