**Executive Summary:**
This document summarizes the Indian government's response to questions regarding the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (ABPMJAY) in the Jamui Lok Sabha Constituency. It details the number of Ayushman cards issued, the number of empanelled hospitals, the value of claims settled, and the steps taken to increase awareness and empanel more hospitals. Data is provided up to the date of the response, August 1, 2025, with claims data covering the previous three years.
**Key Points / Main Content:**
* **Ayushman Bharat PMJAY Data for Jamui District:**
* 2.94 lakh families and 6.63 lakh individuals have Ayushman cards.
* 16 hospitals are empanelled: 10 public and 6 private.
* All public hospitals providing inpatient or daycare services are deemed empanelled.
* **Claims and Treatments:**
* Claims worth Rs 34.38 crore have been settled in the last three years.
* Major ailments treated include Cataract, Dysentery, Kidney Failure (Acute and Chronic), Acute Febrile Illness, and Neonatal Care.
* **Awareness and Hospital Empanelment Initiatives:**
* Comprehensive media outreach strategy includes traditional media, frontline workers (ASHAs, AWWs, VLEs), and a 24x7 call center (14555).
* Actions to improve hospital participation:
* Revised Health Benefit Package (HBP) with 1961 procedures.
* Monitoring of claim settlement turnaround time.
* Improved Hospital Engagement Module (HEM2.0).
* Hospital-specific call center (14413).
* District Implementation Units (DIUs) for hospital visits.
* **Responsibilities:**
* Hospital empanelment is the responsibility of the respective State/UT.
* The Government of India encourages States/UTs to empanel more hospitals.
**Impact Analysis:**
**Beneficiaries (Families and Individuals with Ayushman Bharat Cards):**
* *Impact:* Increased access to cashless healthcare for eligible families and individuals in Jamui District. Awareness campaigns aim to inform them of their rights and entitlements.
* *Action Required:* Utilize available resources such as the 24x7 call center (14555) for assistance and information.
**Public and Private Hospitals:**
* *Impact:* Opportunity to empanel under ABPMJAY, increasing patient volume and revenue. Required to meet ABPMJAY criteria for empanelment.
* *Action Required:* Engage with the State Health Agencies for empanelment. Utilize the hospital-specific call center (14413) for concerns. Engage with DIUs during their visits.
**State/UT Governments:**
* *Impact:* Responsible for empanelling hospitals under ABPMJAY within their jurisdiction. Encouraged to increase hospital empanelment to ensure healthcare access.
* *Action Required:* Proactively empanel hospitals, ensuring they meet ABPMJAY criteria.
**National Health Authority (NHA):**
* *Impact:* Responsible for the overall implementation and monitoring of ABPMJAY. Continuously working to improve the scheme and increase hospital participation.
* *Action Required:* Continue to monitor claim settlements, improve the HEM, and provide support to hospitals through the call center and DIUs.
Key Entities Referenced
Ayushman Bharat Pradhan Mantri Jan Arogya Yojana ABPMJAY: A health scheme providing financial protection to families and individuals, also referred to as ABPMJAY.
Jamui Lok Sabha Constituency: A Lok Sabha constituency, the geographical area of focus for data regarding the Ayushman Bharat scheme beneficiaries.
Jamui District: A district for which data regarding Ayushman Bharat scheme is available.
Ministry of Health and Family Welfare: The government ministry responsible for health policies and family welfare programs.
National Health Authority NHA: The implementing agency for Ayushman Bharat PMJAY, responsible for revisions to the Health Benefit Package and claim settlements.
ASHA: Accredited Social Health Activist, frontline workers engaged in creating mass awareness at the grassroot level
AWW: Anganwadi Workers, frontline workers engaged in creating mass awareness at the grassroot level
VLEs Village level Entrepreneurs: Village level Entrepreneurs who are pivotal in creating mass awareness at the grassroot level.
GOVERNMENTOFINDIA
MINISTRYOFHEALTH AND FAMILYWELFARE
DEPARTMENTOFHEALTH ANDFAMILYWELFARE
LOK SABHA
UNSTARREDQUESTION NO. 2224
TOBE ANSWERED ON01STAUGUST,2025
PUBLICANDPRIVATEHOSPITALSEMPANELLEDUNDERAYUSHMAN
BHARAT
2224. SHRIARUNBHARTI:
Will the Minister of HEALTHAND FAMILYWELFAREbe pleased tostate:
(a) the total number of families and individuals in the Jamui Lok Sabha Constituency who
have been issued Ayushman Bharat (PM-JAY) cards and are eligible for benefits under the
scheme;
(b) the number of public andprivate hospitals empanelledunder Ayushman Bharat within the
constituency andwhether thisnumber meetsthe prescribed population-to-hospital ratio, if so,
the detailsthereof;
(c)the totalvalue of claimssettled for treatmentsprovidedtobeneficiaries from Jamui during
the last three yearsalong with the majorailmentsfor which treatmentswere sought; and
(d) the steps being taken by the Government to increase awareness about the scheme and
empanel more specialty hospitals in the region to ensure comprehensive and accessible
cashless healthcare?
ANSWER
THE MINISTER OFSTATEIN THE MINISTRYOFHEALTHAND
FAMILYWELFARE
(SHRIPRATAPRAOJADHAV)
(a): Under Ayushman Bharat - Pradhan Mantri Jan Arogya Yojana (AB-PMJAY),
constituency-wise data is not captured in the scheme, instead, district-wise data is available.
As on date, the totalnumberof familiesandindividualsfor which Ayushman cardshave been
createdinJamui District are 2.94lakhsand6.63lakhsrespectively.
(b): As on date, a total of 16 hospitals have been empanelled under AB-PMJAY in Jamui
District,including10public hospitals and6private hospitals.All public hospitals providingin-patientservices or daycare facilitiesare deemedempanelled
under the scheme. As public health is a State subject, the responsibility of empaneling
hospitals under the scheme, lies with the respective State/UT. Further, hospital empanelment
is a continuous process and is undertaken based on the requirements and availability of
healthcare providers (meeting AB-PMJAY criteria) within a given State / UT. The
Government of India encourages States/UTs to empanel more hospitals under the scheme to
ensure accesstoqualityhealthcare toalleligiblebeneficiaries.
(c): Under AB-PMJAY, claims worth Rs 34.38 crore have been settled for treatments
providedtobeneficiaries from Jamui District during the last three years.
Cataract,Dysentery, Kidney Failure (Acute andChronic), Acute FebrileIllness, andNeonatal
Care are the major ailments for which treatment was sought in the district in the last three
years.
(d): AB-PMJAY has a comprehensive media and outreach strategy to spread awareness and
empower beneficiaries for their rights and entitlements. This includes advertisement over
traditional media platforms including newspapers, community radio, street plays, digital
displays, radio campaigns, mass messaging, telecast of beneficiary testimonials via
Doordarshan, etc. In addition to this, State Health Agencies have also engaged the wide
network of frontline workers i.e., ASHAs, AWWs and VLEs (Village level Entrepreneurs)
who are pivotal in creating mass awareness at the grassroot level. In addition to this,
beneficiariescancall to24x7callcentre (14555) for anyassistance/queries.
In order toimprove the participation of hospitals, following actionshave beentaken:
i. NHA (National Health Authority) has released a revised Health Benefit
Package(HBP)with increased numberof procedures(1961).
ii. Claimsettlementismonitoredatthehighestlevelanditisensuredthatclaimis
settled within definedturnaround time.
iii. NHAhaslaunched animprovedversion of the Hospital Engagement Module
(HEM2.0) for enhancingthe empanelment process of the hospitals.
iv. Ahospital-specificcallcenter(14413)hasbeenset-uptoaddresstheirconcern
on a real-time basis.
v. District Implementation Units (DIUs) have been set-up to regularly visit
empaneled hospitals to understand the issues faced by beneficiaries and
hospitals.
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