Parliament Question: Financial Disbursements under AB-PMJAY

GOVERNMENTOFINDIA MINISTRYOFHEALTH AND FAMILYWELFARE DEPARTMENTOFHEALTH AND FAMILYWELFARE LOK SABHA STARREDQUESTION NO. *287 TOBE ANSWERED ON THE 7THAUGUST,2026 FINANCIALDISBURSEMENTSUNDER AB-PMJAY *287 SHRIRAJESH VERMA: DR. D. PURANDESWARI: Will the MINISTEROFHEALTH AND FAMILYWELFARE be pleased tostate: (a) the operational progress and financial disbursements made under the Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana (AB-PMJAY)during the financial year2025-2026, State-wise; (b) the total number of Ayushman Cards generated and the total volume of cashless hospital admissions recordedacross the countryduring the last one year; (c) the total amount of Central funds released to the State Health Agencies for the settlement of the medicalclaims submitted byempanelledpublic andprivate hospitals inthe country; (d) whether the Government has identified instances of fraudulent medical claims or unauthorised billingbyprivate healthcare providersoperatingacross the country, if so, the detailsthereof; and (e) the strict regulatory and penal measures implemented by the Government to de-empanel defaulting hospitals andrecovermisappropriated funds across the country? ANSWER THE MINISTER OFHEALTH AND FAMILYWELFARE (SHRIJAGATPRAKASH NADDA) (a) to(e)AStatement islaidon the Tableof the House.STATEMENTREFERRED TO IN REPLYTOLOK SABHA STARREDQUESTION NO. 287*FOR7TH AUGUST,2026 (a) to (e) Ayushman Bharat - Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) provides cashless health coverage of Rs. 5 lakhs per family per year for secondary and tertiary care hospitalization to the bottom 40% of India’s population. The Scheme is implemented across all States/UTs, with several States converging it with theirrespective healthschemes. During the Financial Year2025–26,the following operationalprogress was achievedunderAB-PMJAY:  Atotalof 3.75crore Ayushman cardswere createdfor eligible beneficiaries.  Atotalof 2.74crore hospital admissions were authorized.  Atotalof 5,074hospitals were empanelled.  An amount of Rs. 8,438.27crore was releasedtothe States/UTs. The funding of AB-PMJAY is entirely demand driven. National Health Authority (NHA) releases funds for scheme implementation to the States/UTs on the basis of utilization certificates for previous releases anddemandreceivedfrom the States/UTs. The State/UT-wise details of the operational progress and central share fund released under the scheme during the Financial Year 2025–26,alongwith the totalfunds released since itsinception inFY2018–19 toFY2026–27(ason31.07.2026) are at Annexure. AB-PMJAY is governed by a zero-tolerance approach towards the frauds. National Anti-Fraud Unit under NHA uses Artificial Intelligence/Machine Learning-based automated triggers to flag unusual claim patterns such as unauthorised billing, duplicate entries, inflated procedures, or misuse of patient identity, etc. All fraud detection triggers are executed within 24 hours of claim submission, and claims flagged suspicious through these triggers are examined before payment. The claims confirmed as fraudulent after examination, are not paid. This mechanism has strengthened the pre-payment scrutiny of claims andresulted insavings of Rs 676.14crore ason 31.07.2026. Further, appropriate actions including suspension, de-empanelment, levying penalty, lodging of FIRs, etc.are takenagainst hospitals which are found tobe involvedinviolationsof the scheme guidelines. As on 31.05.2026, a total of 2,359 hospitals have been de-empanelled, 1,200 hospitals have been suspended by the States/UTs, 29 FIRs have been lodged and penalties amounting to Rs 328.49 crore have beenleviedfor violation of scheme guidelines.Annexure State/UT-wise detailsof Ayushman cardscreated,Hospital admissions authorized, Central share fund released during FinancialYear2025–26andfromFY2018–19toFY2026–27 No. of No. of hospital Central share fund released Ayushman admissions (incrore of Rs.) cardscreated State/UT authorizedduring during FY FY2025-26 From2018–19 up 2025-26 During 2025-26 (inlakh) to2026–27* (inlakh) Andaman 0.05 0.01 1.45 6.72 Nicobar Islands Andhra 31.08 21.50 505.45 3047.22 Pradesh Arunachal 0.18 0.07 10.60 29.76 Pradesh Assam 3.42 5.35 301.86 1573.02 Bihar 45.10 13.72 808.62 2267.31 Chandigarh 0.15 0.30 10.15 48.22 Chhattisgarh 14.52 15.23 284.08 1975.84 DNH & DD 0.09 0.23 5.35 35.35 Delhi 7.50 0.37 59.25 59.25 Goa 0.11 0.13 4.07 7.93 Gujarat 34.80 16.10 540.62 2548.03 Haryana 8.45 11.59 131.46 793.62 Himachal 0.73 1.18 58.62 361.31 Pradesh Jammu and 2.97 4.08 96.58 430.74 Kashmir Jharkhand 13.43 4.66 265.90 1095.83 Karnataka 5.69 30.10 549.83 3237.68 Kerala 3.06 9.88 173.26 1153.94 Ladakh 0.09 0.12 2.33 11.48 Lakshadweep 0.02 0.01 0.46 0.99 Madhya 20.68 19.56 772.53 3812.39 Pradesh Maharashtra 86.01 16.55 736.45 3631.00Manipur 0.56 1.05 34.40 211.78 Meghalaya 0.96 2.71 41.10 288.72 Mizoram 0.21 0.39 23.32 168.79 Nagaland 0.51 0.32 25.54 157.57 Odisha 8.07 14.68 464.92 814.48 Puducherry 0.26 0.59 8.02 34.49 Punjab 23.44 7.92 214.42 691.10 Rajasthan 5.19 19.21 450.27 2563.15 Sikkim 0.14 0.16 6.13 26.30 Tamil Nadu 6.07 12.32 452.46 3335.13 Telangana 0.15 7.44 230.34 917.91 Tripura 1.73 1.72 54.58 322.79 Uttar Pradesh 46.38 30.64 1047.53 4468.61 Uttarakhand 3.56 4.34 66.32 443.88 *As on 31.07.2026 *****