Executive Summary:
The Minister of Health and Family Welfare addressed questions regarding the impact of the Ayushman Bharat Pradhan Mantri Jan Aarogya Yojana (AB PMJAY) in rural and tribal areas, particularly in Maharashtra, Madhya Pradesh, and the UT of Dadra and Nagar Haveli and Daman and Diu (DNHDD). The response details the scheme's benefits, implementation status, and measures to improve healthcare services and infrastructure in these regions. The scheme has been extended to include ASHAs, Anganwadi workers and senior citizens. The National Health Mission (NHM) provides support to improve health infrastructure and human resources.
Key Points / Main Content:
AB PMJAY Overview:
* Provides health cover of Rs. 5 lakh per family per year for secondary and tertiary care hospitalization to 12 crore economically vulnerable families.
* Eligibility expanded in March 2024 to include 37 lakh ASHAs, Anganwadi Workers, and Anganwadi Helpers and their families.
* Extended to cover 6 crore senior citizens (70+ years) through Vay Vandana Card, regardless of socioeconomic status.
Implementation Status (Maharashtra, Madhya Pradesh, DNHDD):
* Ayushman cards created: Maharashtra (3.17 crore), Madhya Pradesh (4.35 crore), DNHDD (4.45 lakh).
* Total hospitals empanelled: Maharashtra (1,698), Madhya Pradesh (1,118), DNHDD (20).
* Number of hospital admissions: Maharashtra (33.26 lakh), Madhya Pradesh (60.27 lakh), DNHDD (1.5 lakh).
* Claims paid amount: Maharashtra (Rs. 4,215 crore), Madhya Pradesh (Rs. 7,656 crore), DNHDD (Rs. 92.69 crore).
* Chhatrapati Sambhaji Nagar: 8.87 lakh cards, 88 empanelled hospitals, 2.30 lakh admissions, Rs. 158 crore claims paid.
Addressing Healthcare Shortages (Maharashtra and DNHDD):
* NHM supports improved health infrastructure and human resources in underserved areas.
* Financial and technical support to States/UTs based on Programme Implementation Plans (PIPs).
* Incentives for medical professionals in rural areas:
* Hard Area Allowance to specialist doctors.
* Negotiable salaries and "You Quote We Pay" strategies.
* Preferential admission in postgraduate courses.
* Improved accommodation arrangements.
* Multi-skilling of doctors.
* Funds sanctioned for Human Resources in DNHDD:
* FY 2024-25 and 2025-26: Rs. 31.18 crore and Rs. 32.71 crore respectively for NHM Human Resources remuneration.
* FY 2024-25 and 2025-26: Rs. 11.36 lakh each for healthcare staff incentives.
* Funds sanctioned for Infrastructure in DNHDD:
* FY 2024-25 and 2025-26: Rs. 3.60 lakh each for infrastructure under Record of Proceeding (ROP) 2024-26.
Improving Quality of Health Services:
* National Quality Assurance Standards (NQAS) launched for all health facilities (PHCs, CHCs).
* Indian Public Health Standards (IPHS) aims to improve service quality and uniform benchmarks.
* Standards include norms for services, infrastructure, human resources, diagnostics, equipment, and medicines.
Special Facilities for Tribal and Rural Women under ABPMJAY:
* Healthcare access up to Rs. 5 lakh per family for secondary and tertiary care, including women-specific packages (high-risk pregnancies, female cancers).
* Offline mode of identification for regions with poor internet connectivity.
* Enrollment via Ayushman App, web portal (beneficiary.nha.gov.in), empanelled hospitals, or Common Service Centres.
* Self-registration available via app.
* National toll-free helpline 14555 for beneficiary assistance.
Impact Analysis:
Beneficiaries (Economically Vulnerable Families, ASHAs, Anganwadi Workers, Senior Citizens):
* Impact: Access to healthcare services up to Rs. 5 lakh per family per year, reduced financial burden for medical treatments.
* Action Required: Enroll in ABPMJAY to avail of the benefits, utilize available resources (helpline, app, offline enrollment).
State Governments (Maharashtra, Madhya Pradesh, DNHDD):
* Impact: Enhanced healthcare infrastructure and human resources, improved healthcare service quality.
* Action Required: Implement NHM proposals, ensure effective utilization of funds, monitor healthcare service standards.
Healthcare Providers (Empanelled Hospitals, Medical Professionals):
* Impact: Increased patient volume, financial reimbursements for services provided under ABPMJAY.
* Action Required: Adhere to NQAS and IPHS standards, participate in ABPMJAY scheme, ensure quality healthcare services.
Key Entities Referenced
Ayushman Bharat Pradhan Mantri Jan Arogya Yojana: A flagship health scheme providing health cover of Rs. 5 lakh per family per year for secondary and tertiary care hospitalization to economically vulnerable families.
Maharashtra: A state in India where the impact of ABPMJAY, health infrastructure, and quality of health services are being assessed and improved.
Madhya Pradesh: A state in India where the impact of ABPMJAY, health infrastructure, and quality of health services are being assessed and improved.
Dadra and Nagar Haveli and Daman and Diu: A Union Territory in India where the impact of ABPMJAY, health infrastructure, and quality of health services are being assessed and improved.
National Health Mission: A program providing support for improvement in health infrastructure and human resources in health facilities.
Chhatrapati Sambhaji Nagar district: A district in Maharashtra, specifically mentioned for the number of beneficiaries, empanelled hospitals and claims settled under ABPMJAY.
Accredited Social Health Activists: A group of health workers (ASHAs) whose families are now included in the eligibility criteria for ABPMJAY.
National Quality Assurance Standards: Standards launched for all health facilities including Primary Health Centres PHCs and Community Health Centres CHCs to ensure and enhance the quality of healthcare services.
GOVERNMENTOFINDIA
MINISTRYOFHEALTH AND FAMILYWELFARE
DEPARTMENTOFHEALTH ANDFAMILYWELFARE
LOK SABHA
UNSTARREDQUESTION NO. 967
TOBE ANSWERED ON25TH JULY,2025
IMPACTOFAB-PMJAY
†967. SHRIGYANESHWAR PATIL:
SHRIBHUMARE SANDIPANRAOASARAM:
SMT.DELKAR KALABEN MOHANBHAI:
DR. SHIVAJIBANDAPPAKALGE:
DR. KALYANVAIJINATHRAO KALE:
Will the Ministerof HEALTHANDFAMILYWELFAREbe pleased tostate:
(a) whether the impact of Ayushman Bharat-Pradhan Mantri Jan Aarogya Yojana (AB-
PMJAY) has been assessed in the rural and tribal areas across the country particularly in
Maharashtra, Madhya PradeshandUT of Dadra andNagar Haveli;
(b) if so, the number of beneficiaries, empanelled hospitals and claims settled under the said
scheme in Maharashtra particularly in Chhatrapati Sambhaji Nagar district, Madhya Pradesh and
UTof Dadra andNagar Haveli;
(c) whether the Government proposes to address the shortage of health workers and infrastructure
in Maharashtra and UT of Dadra and Nagar Haveli particularly in districts with poor health
indicators, if so, the details thereof;
(d) the various steps taken/proposed to be taken by the Government to improve the quality of
health services in Maharashtra, Madhya Pradesh and UT of Dadra and Nagar Haveli under the
National HealthMission (NHM);
(e) whether the Government proposes to provide some special facilities to tribal and rural women
of Maharashtra underAB-PMJAY; and
(f) if so, the detailsthereofand if not,the reasons therefor?
ANSWER
THE MINISTER OFSTATEIN THE MINISTRYOFHEALTHAND
FAMILYWELFARE
(SHRIPRATAPRAOJADHAV)
(a) and (b): Ayushman Bharat - Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) is a
flagship scheme of the Government which provides health cover of Rs. 5 lakh per family peryear for secondary and tertiary care hospitalization to 12 crore families constituting
economicallyvulnerable bottom 40% of India’spopulation.
Further, in March 2024, the eligibility criteria were expanded to include 37 lakh Accredited
Social Health Activists (ASHAs), Anganwadi Workers (AWWs), Anganwadi Helpers
(AWHs), and their families. Recently, the scheme has been further extended to cover 6 crore
senior citizens aged 70 years and above, representing 4.5 crore families, through Vay
VandanaCard, irrespective of theirsocio-economic status.
The scheme is implemented in the State of Maharashtra, Madhya Pradesh and UT of Dadra
and Nagar Haveli and Daman and Diu (DNH-DD) which includes rural areas of the
States/UT as well. The details of number of beneficiaries, empanelled hospitals, hospital
admissions andclaimssettled underthe scheme are asbelow:
Maharashtra Madhya Pradesh DNH-DD
Ayushman cardcreated 3.17crore 4.35crore 4.45 lakh
Total hospitals empanelled 1,698 1,118 20
Number of hospital admissions 33.26lakh 60.27lakh 1.5lakh
Claimspaidamount(inRupees) 4,215 crore 7,656crore 92.69crore
Total Number of Claimspaid
Ayushmancards
District hospitals hospital amount(in
created
empanelled admissions Rupees)
Chhatrapati
8.87lakh 88 2.30lakh 158crore
SambhajiNagar
(c): National Health Mission (NHM) provides support for improvement in health
infrastructure, availability of adequate human resources in health facilities, to improve
availability and accessibility to quality health care especially for the underserved and
marginalized groups in rural areas. The Ministry of Health and Family Welfare provides
technical and financial support to the States/UTs to strengthen the public healthcare system,
based on the proposals received in the form of Programme Implementation Plans (PIPs)
under NHM. Government of India provides approval for the proposals in the form of Record
of Proceedings(RoPs) aspernorms & available resources.
The Government of India has taken number of initiatives in the form of incentives and
honorarium to the medical professionals for encouraging better service delivery in rural and
remote areasacross the country includingMaharashtra, which include:
i. Hard Area Allowance tospecialist doctorsfor serving inrural andremote areas.
ii. Statesareallowedtooffernegotiablesalarytoattractspecialistincludingflexibilityin
strategiessuch as"YouQuote We Pay".iii. Non-monetary incentivessuch aspreferentialadmission inpostgraduate courses for
staff serving in difficult areas and improving accommodation arrangement in rural areas
have also beenintroducedunder NHM.
iv. Multi-skilling of doctors is supported under NHM to overcome the shortage of
specialists.
The following funds are sanctionedfor Human Resource inUTof Dadra andNagar Haveli:
Under National Health Mission, for remuneration of NHM Human Resources, amount
of funds approved is Rs. 31.18 crore for FY 2024-25 and Rs. 32.71 crore for FY2025-
26. Funds are also approved for the incentives for the healthcare staff, which is of Rs
11.36 lakheachfor FY2024-25 andFY2025-26.
For Infrastructure under Record of Proceeding (ROP) 2024-26, funds are approved of
Rs. 3.60lakhfor eachof FY2024-25 andFY2025-26.
(d): With the aim of ensuring and enhancing the quality of healthcare services, National
Quality Assurance Standards (NQAS) have been launched for all health facilities including
Primary Health Centres (PHCs) and Community Health Centres (CHCs). Indian Public
Health Standards (IPHS) has been laid down by the Government of India, which also aims
towards an effort to improve the standard and quality of services and provide a uniform
benchmark to assess the functionality of public health facilities. These standards include
normsfor services, infrastructure, humanresources, diagnostics, equipment,medicines,etc.
(e) and (f): AB-PMJAY provides free healthcare access up to Rs. 5 lakh per eligible
beneficiary family per year for secondary and tertiary care hospitalization in 27 different
medical specialties corresponding to 1961 procedures. This includes several packages related
to women like high-risk pregnancies, female specific cancers, etc. One of the key features
introduced under BIS 2.0 is the offline mode of identification, designed specifically to
support regionswith poor or unstable internet connectivity.
Enrollment can also be done through mobile phone application (Ayushman App), and web
portal (beneficiary.nha.gov.in) or at the nearby empanelled hospital or Common Service
Centre. The feature of self-registration is also available in the above-mentioned application.
Further, National toll-free helpline (14555) assists the beneficiaries for theirqueries.
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