**Summary:**
Lok Sabha Unstarred Question No. 966, addressed to the Minister of Health and Family Welfare and answered on July 25, 2025, concerns the settlement of payments to private hospitals under the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (ABPMJAY). As of June 30, 2025, the question seeks details regarding the total outstanding amount of the Central Government's share owed to private hospitals, as well as the average claim settlement time for private hospitals concerning the Central Government's share.
The Minister of State in the Ministry of Health and Family Welfare, Shri Prataprao Jadhav, responded that the settlement of claims under ABPMJAY is an ongoing process managed by the respective State Health Agencies (SHAs). The National Health Authority (NHA) has established guidelines mandating claim payments to hospitals within 15 days of claim submission for intrastate hospitals and within 30 days for portability claims involving hospitals located outside the state.
Key Entities Referenced
Ministry of Health and Family Welfare: The Union government ministry responsible for health policy in India.
Lok Sabha: The lower house of the Parliament of India.
Ayushman Bharat Yojana: A national health scheme in India aiming to provide financial risk protection to a large section of the population.
Shri Adhikari Deepak Dev: Member of Parliament who asked the question in Lok Sabha.
Shri Prataprao Jadhav: The Minister of State in the Ministry of Health and Family Welfare who answered the question.
Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (ABPMJAY): A health insurance scheme under the Ayushman Bharat program, providing coverage for secondary and tertiary care hospitalization.
National Health Authority: The apex body responsible for the implementation of Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY).
State Health Agencies (SHA): The state-level agencies responsible for implementing the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY) at the state level.
GOVERNMENTOFINDIA
MINISTRYOFHEALTH AND FAMILYWELFARE
DEPARTMENTOFHEALTH ANDFAMILYWELFARE
LOK SABHA
UNSTARREDQUESTION NO. 966
TOBE ANSWERED ON25TH JULY,2025
SETTLEMENTOFPAYMENTOFPRIVATE HOSPITALS
966.SHRIADHIKARIDEEPAKDEV:
Will the Ministerof HEALTHANDFAMILYWELFAREbe pleased tostate:
(a) the details of the total due amount of Central Government's share underAyushman Bharat
Yojana ason30.06.2025tobe paidtoPrivateHospitals; and
(b) the average time of Settlement of Payment claim of Private Hospitals with regard to the
Central Government's share?
ANSWER
THE MINISTER OFSTATEIN THE MINISTRYOFHEALTHAND
FAMILYWELFARE
(SHRIPRATAPRAOJADHAV)
(a) and (b): Under Ayushman Bharat - Pradhan Mantri Jan Arogya Yojana (AB-PMJAY),
settlement of claims is an ongoing process and claims are settled by respective State Health
Agencies(SHA). National HealthAuthority haslaid down guidelinesfor payment of claimto
hospitals within 15 days of claims submission for the intra-state hospitals (hospitals located
within State)andwithin 30daysincase of portabilityclaims(hospitals located outside State).
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