Lok Sabha Question No. 178 (STARRED), answered on 2015-07-31
Subject: Beneficiaries under RSBY
Ministry: HEALTH AND FAMILY WELFARE
Asked by: NISHIKANT  DUBEY

**GOVERNMENT OF INDIA**

**MINISTRY OF HEALTH AND FAMILY WELFARE**

**DEPARTMENT OF HEALTH AND FAMILY WELFARE**

**LOK SABHA**

**STARRED QUESTION NO. 178**

**TO BE ANSWERED ON THE 31** **ST** **JULY, 2015**

**Beneficiaries under RSBY**

***178. SHRI NISHIKANT DUBEY:**

Will the Minister of **HEALTH AND FAMILY WELFARE** be pleased to state:

(a) the total number of beneficiaries under the Rashtriya Swasthya Bima Yojana (RSBY) in the unorganised sector along with the number out of these covered under the Aam Aadmi Bima Yojana;

(b) the total funds allocated under the yojana to the beneficiaries in the country particularly in Jharkhand;

(c) whether the Government proposes to increase the insurance cover provided under RSBY, if so, the details thereof and if not, the reasons therefor;

(d) whether the Government has received complaints of malpractices/ irregularities in certain cases under RSBY during each of the last three years; and

(e) if so, the details thereof, State-wise and the action taken against the erring hospitals?

**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.178 FOR 31** **ST** **JULY, 2015**

(a) The total number of beneficiaries who are presently active under the Rashtriya Swasthya Bima Yojana (RSBY) scheme is 3,65,74,800 (Category wise details of beneficiaries is annexed). RSBY and AABY are two separate Schemes with different sets of eligibility conditions and the data regarding RSBY beneficiaries covered under AABY is not maintained.

(b) Under RSBY, funds are not allocated to the beneficiaries. It is a Scheme to provide smart card based cashless health insurance cover of Rs. 30,000/- per annum to the insured families (a unit of five) in the unorganized sector   The premium is shared between Government of India and State Government in the ratio of 75:25.  In case of  North Eastern states and Jammu & Kashmir, the premium is shared in the ratio of 90:10.  The amount of Central Government share of premium released to Jharkhand  during the last three years is as under:

|   **Sl.No.** | **Financial Year**   |   **Amount of funds released (Rs.. In crore)** |
|--------------|----------------------|------------------------------------------------|
|           1. | 2012-13              |                                          56.68 |
|           2. | 2013-14              |                                          51.25 |
|           3. | 2014-15              |                                           5.51 |

(c) For the time being, RSBY would be implemented with the insurance cover of Rs.30, 000 per family per annum.

(d) & (e) Taking note of reports of malpractices/irregularities regarding hysterectomy operations performed by some private hospitals in certain states under Rashtriya Swasthya Bima Yojana (RSBY) a High Level Team had investigated the matter in August 2012. As a precaution, an advisory has been issued to the State/UTs stating that for all hysterectomy operations proposed to be performed by the hospitals on women less than 40 years of age, prior approval (Authorization letter) of the Insurance Company has to be taken.

Based on investigation of the complaints received regarding malpractices/ irregularities, 407 hospitals have been de-empanelled in 11 states as stated below:-

**State-wise details are as under:**

| **S.No.**   | **Name of State**   |   **No. Hospitals** |
|-------------|---------------------|---------------------|
| 1           | Bihar               |                  27 |
| 2           | Chhattisgarh        |                  14 |
| 3           | Gujarat             |                   9 |
| 4           | Haryana             |                  74 |
| 5           | Jharkhand           |                  11 |
| 6           | Kerala              |                  43 |
| 7           | Orissa              |                   1 |
| 8           | Punjab              |                  29 |
| 9           | Uttar Pradesh       |                 156 |
| 10          | West Bengal         |                  12 |
| 11          | Maharashtra         |                  31 |
| Total       |                     |                 407 |

**Annexure**

| Categories of Beneficiaries enrolled             |                     |
|--------------------------------------------------|---------------------|
| Categories                                       | **Total Enrolment** |
| BPL                                              | 33621670            |
| MGNREGA                                          | 2818621             |
| Building and Other Construction Worker (BOC)     | 57813               |
| Domestic Workers                                 | 33083               |
| Street Vendors                                   | 22698               |
| Beedi Worker                                     | 15958               |
| Auto Rickshaw Pullerskshaw Drivers & Taxi Driver | 2951                |
| Sanitation Workers                               | 710                 |
| Rag Pickers                                      | 454                 |
| Rickshaw Pullers                                 | 334                 |
| Mine Workers                                     | 284                 |
| Railway Porters                                  | 224                 |
| Grand Total                                      | 36574800            |