Lok Sabha Question No. 102 (STARRED), answered on 2026-02-06
Subject: PM-JAY Scheme
Ministry: HEALTH AND FAMILY WELFARE
Asked by: Smt. Priyanka Gandhi Vadra

## GOVERNMENTOFINDIA MINISTRY OF HEALTH AND FAMILY WELFARE DEPARTMENTOFHEALTH AND FAMILYWELFARE

## LOK SABHA STARRED QUESTION NO. 102 TO BE ANSWERED ON THE 6 TH FEBRUARY, 2026

## PM-JAY SCHEME

## *102. SMT. PRIYANKA GANDHI VADRA:

Will the MINISTER OF HEALTH AND FAMILY WELFARE be pleased to state:

- (a) whether a significant number of private hospitals in the country have reportedly opted out of the Pradhan Mantri Jan Arogya Yojana (PM-JAY) and suspended services thereunder, if so, the reasons therefor, State/UT-wise including Kerala;
- (b) the details of private hospitals empanelled under PM-JAY which have opted out of the PM- JAY during the last three years, payments pending to empanelled hospitals and the average time being taken for settlement of claims;
- (c) the details of PM-JAY empanelled hospitals in Kerala and the number of hospitals which have opted out during the last three years along with the details of pending payments, including Wayanad Lok Sabha Parliamentary Constituency;
- (d) whether the Government has taken any action to assist beneficiaries affected due to the suspension of services by private empanelled hospitals opting out of the PM-JAY, if so, the details thereof; and
- (e) whether the Government proposes to initiate measures to empanel more hospitals under PM-JAY, if so, the details thereof?

## ANSWER THE MINISTER OF HEALTH AND FAMILY WELFARE

## (SHRI JAGAT PRAKASH NADDA)

- (a) to (e) A Statement is laid on the Table of the House.

## STATEMENT REFERRED TO IN REPLY TO LOK SABHA STARRED QUESTION NO. 102 * FOR 6 TH FEBRUARY, 2026

(a) to (e) Under Ayushman Bharat - Pradhan Mantri Jan Arogya Yojana (AB-PMJAY), hospital empanelment is a continuous process and is undertaken by implementing State/UT based on the requirements and availability of healthcare providers meeting the criteria as per empanelment guidelines of National Health Authority. The empanelment of private hospitals under the scheme is entirely voluntary.

The empanelment of hospitals under the scheme has increased from 6,917 hospitals in FY 2018-19, comprising 3,013 public and 3,904 private hospitals, to 33,270 hospitals as on 31.12.2025, out of which 17,537 are public and 15,733 are private hospitals.

Out of 15,733 empanelled private hospitals, 6952 private hospitals have been empanelled in the last three years (April 2022 to March 2025), whereas 458 hospitals have voluntarily opted out of the scheme during the same period due to reasons including administrative reasons, empanelment only for the COVID period, closure or non-functionality of hospitals, relocation of hospitals, among others.

In the State of Kerala, as on 31.12.2025, 581 hospitals, including 377 private hospitals and 204 public hospitals, are empanelled under the scheme. During the last three years (April 2022 to March 2025), 246 hospitals have voluntarily opted out of the scheme in the State of Kerala. Out of these, 229 hospitals were temporarily empanelled during the COVID-19 period which discontinued their services after the pandemic and 17 hospitals have voluntarily opted out from the scheme due to administrative or other reasons.

All eligible beneficiaries under AB-PMJAY can avail treatment through a network of over 33,270 public and private empanelled hospitals. In cases of denial of treatment by an empanelled hospital, beneficiaries can register their grievances through the Centralized Grievance Redressal Management System (CGRMS) or the 24×7 toll-free helpline number 14555.

Under the scheme, settlement of claims is a regular and uninterrupted process and claims are settled by respective State Health Agencies as per claim adjudication guidelines issued by National Health Authority. As per the guideline, the permissible turnaround time for settlement of claim to hospitals is within 15 days of claim submission for intra-state hospitals (hospitals located within the State) and within 30 days in case of portability claims (hospitals located outside the State).

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