Home India Ministry of Health and Family Welfare Parliament Question: Treatment of Patients under Ayushman Bh...
Date: 2025-12-12 Category: Not Applicable State: Union Government Country: India

Parliament Question: Treatment of Patients under Ayushman Bharat Scheme

Issued by Ministry of Health and Family Welfare · Not Applicable

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Executive Summary & Key Takeaways

**Executive Summary** This document presents the Ministry of Health and Family Welfare's response to an unstarred question regarding the treatment of patients under the Ayushman Bharat Scheme in the Union Territory of Dadra and Nagar Haveli & Daman and Diu (DNH & DD) during the last five years. It details the number of patients treated, associated costs, and hospital admissions outside the UT, and payment guidelines. The response was given on December 12th, 2025. **Key Points / Main Content** * **Patient Treatment and Costs (DNH & DD):** * District-wise details of patients receiving treatment under Ayushman Bharat - Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) and associated costs for DNH & DD are provided in the Annexure. * **Hospital Admissions Outside DNH & DD:** * 9458 hospital admissions have been authorized under AB-PMJAY in hospitals outside the UT of DNH & DD in the last five years. * **Claims Settlement:** * Settlement of claims is an ongoing process handled by respective State Health Agencies. * Portability treatments (outside the state) are paid by the beneficiary's State/UT. * National Health Authority guidelines stipulate payments to hospitals within 15 days of claim submission for intra-state claims and within 30 days for portability claims. **Impact Analysis** **State Health Agencies** * **Impact:** Responsible for settling claims for patients under the Ayushman Bharat Scheme. * **Action Required:** Adhere to NHA guidelines for timely payment of claims, ensuring intra-state claims are paid within 15 days and portability claims within 30 days of submission. **Hospitals** * **Impact:** Affected by the claims settlement process and payment timelines. * **Action Required:** Submit claims promptly and adhere to all requirements to receive payments within the stipulated timeframes (15 days for intra-state, 30 days for portability). **Patients in the Union Territory of Dadra and Nagar Haveli & Daman and Diu (DNH & DD)** * **Impact:** Provides insights into treatment accessibility and usage of the Ayushman Bharat scheme within the Union Territory. * **Action Required:** No direct action specified.

Key Entities Referenced

Ayushman Bharat - Pradhan Mantri Jan Arogya Yojana (AB-PMJAY): A health scheme providing financial protection to patients for medical treatment. Ministry of Health and Family Welfare: The primary ministry responsible for health policies and programs in India. Dadra and Nagar Haveli & Daman and Diu (DNH & DD): A Union Territory in India, central to the applicability and reporting of the Ayushman Bharat scheme. National Health Authority: Agency which has laid down guidelines for payment of claims under the Ayushman Bharat scheme.
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GOVERNMENTOFINDIA MINISTRYOFHEALTH AND FAMILYWELFARE DEPARTMENTOFHEALTH ANDFAMILYWELFARE LOK SABHA UNSTARREDQUESTION NO. 2160 TOBE ANSWERED ON12TH DECEMBER, 2025 TREATMENTOFPATIENTS UNDER AYUSHMAN BHARATSCHEME †2160.SHRIPATELUMESHBHAI BABUBHAI: Will the Minister of HEALTHAND FAMILYWELFAREbe pleased tostate: (a) the total number of patients who have recevied treatment under the Ayushman Bharat scheme in the Union Territory of Dadra and Nagar Haveli & Daman and Diu (DNH & DD) during the last five years, district-wise; (b) the detailsof the totalcost of the treatment of patients underthe Ayushman Bharat Yojana borne by the Union Government and the UT of DNH & DD administration during the last five years; (c)the numberof patientsfrom the UTof DNH & DD who have recievedtreatmentunderthe Ayushman Bharat Schemeinhospitals situated outside the UTduring the last five years; (d) whether the UT of DNH & DD Administration have to pay any outstanding dues to the hospitals locatedinGujarat andotherStatesacross the country; and (e)if so, the amountof such outstanding duesalong with the reasons therefor? ANSWER THE MINISTER OFSTATEIN THE MINISTRYOFHEALTHAND FAMILYWELFARE (SHRIPRATAPRAOJADHAV) (a) and (b): The district-wise details of total number of patients who have received treatment underAyushman Bharat - Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) and the amount involved therein in the Union Territory of Dadra and Nagar Haveli & Daman and Diu (DNH & DD) during the last five yearsare at Annexure. (c): 9458 hospital admissions have been authorized under AB-PMJAY in the hospitals situated outside the UT of DNH & DDduring the last five years. (d) and (e): Under the scheme, settlement of claims is an ongoing process and claims are settled byrespective StateHealth Agencies. Portability (outside the State)treatments are paid by beneficiary’s State/UT. National Health Authority has laid down guidelines for payment of claim to hospitals within 15 days of claim submission for the intra-state hospitals (hospitals located within State) and within 30 days in case of portability claims (hospitals locatedoutside State).Annexure District-wise detailsof treatmentinthe UTof DNH & DD during the last five yearsunder AB-PMJAY Financial Daman Diu DadraandNagarHaveli Year Amount Number Amount Number Amount Number of (incrore of of (incrore of of (in crore of patients Rupees) patients Rupees) patients Rupees) 2020-21 3556 2.08 567 0.58 14,820 8.88 2021-22 3997 2.90 508 1.28 16,112 10.44 2022-23 4495 3.48 619 1.50 16,378 11.33 2023-24 3653 3.06 455 1.41 13,312 9.58 2024-25 4247 4.66 550 1.74 17,374 13.27 *****

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