Parliament Question: Violations by Hospitals Empanelled under AB-PMJAY

GOVERNMENTOFINDIA MINISTRYOFHEALTH AND FAMILYWELFARE DEPARTMENTOFHEALTH ANDFAMILYWELFARE LOK SABHA UNSTARREDQUESTION NO. 3563 TOBE ANSWERED ON13TH MARCH, 2026 VIOLATIONS BYHOSPITALSEMPANELLEDUNDER AB-PMJAY 3563. SMT.RACHNABANERJEE: Will the Minister of HEALTHAND FAMILYWELFAREbe pleased tostate: (a) whether the Government has received any cases or complaints regarding irregularities or violations by hospitals empanelled under the Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana (AB-PMJAY)inthe country; (b) if so, the details thereof since the inception of the scheme, including the nature and categoriesof such violations, State-wise andyear-wise;and (c) the number of hospitals de-empanelled, suspended or penalised along with the amount of penaltiesimposed inthe countryduring the last five years, State-wise? ANSWER THE MINISTER OFSTATEIN THE MINISTRYOFHEALTHAND FAMILYWELFARE (SHRIPRATAPRAOJADHAV) (a)to (c):AyushmanBharat-PradhanMantriJanArogyaYojana(AB-PMJAY)isgovernedon azero-toleranceapproachtowardsfraud.NationalAnti-FraudUnit(NAFU)usesAI/ML-based automatedtriggerstoflagunusual claimpatternssuchasduplicateentries, inflatedprocedures ormisuseofpatientidentityetc. NAFU works in close coordination with the State Anti-Fraud Units to investigate and take actionagainstcasesoffraud.Appropriateactionsincludingsuspension,issuanceofshowcause notices,warningletter,de-empanelmentofhospitals,levyingpenaltylodgingofFIRsaretaken againstfraudulententities. As on 10.03.2026, 2021 hospitals have been de-empanelled, 590 hospitals suspended and penaltiesamountingtoRs263.72crorehavebeenleviedforfraudulentactivities. *****