Parliament Question: Withdrawal of Private Empanelled Hospitals from Ayushman Bharat

GOVERNMENTOFINDIA MINISTRYOFHEALTH AND FAMILYWELFARE DEPARTMENTOFHEALTH ANDFAMILYWELFARE LOK SABHA UNSTARREDQUESTION NO. 3613 TOBE ANSWERED ON13TH MARCH, 2026 WITHDRAWALOFPRIVATEEMPANELLED HOSPITALSFROM AYUSHMAN BHARAT 3613. SHRIRAHULGANDHI: Will the Minister of HEALTHAND FAMILYWELFAREbe pleased tostate: (a) whether it is a fact that several private empanelled hospitals have withdrawn from the Ayushman Bharat scheme and if so, the number of hospitals that have withdrawn from the scheme since itsinception, year-wiseandState-wise; (b) the reasons for private hospitals withdrawing from the scheme; (c) the number of Ayushman Bharat beneficiaries inthe country affected by such withdrawal, State-wise; (d) whether the Government is aware of the recent reports that ongoing admissions and treatmentsof beneficiarieswere halted asa result of such withdrawals from the scheme andif so, the steps takenbythe Government to ensure adequatecare toaffected beneficiaries;and (e) the number of pending claims and the total amount of unpaid reimbursements under Ayushman Bharat since its inception, year-wise (by year of claim) along with the reasons for the delayinreleasing such reimbursements? ANSWER THE MINISTER OFSTATEIN THE MINISTRYOFHEALTHAND FAMILYWELFARE (SHRIPRATAPRAOJADHAV) (a) to (d): Under Ayushman Bharat - Pradhan Mantri Jan Arogya Yojana (AB-PMJAY), hospitalempanelmentisacontinuousprocessandisundertakenbytheimplementingState/UT based on the requirements and availability of healthcare providers meeting the criteria as per empanelment guidelines of National Health Authority. The empanelment of private hospitals undertheschemeisentirelyvoluntary. As on 28.02.2026,the empanelment of hospitals under AB-PMJAYhas increased from 6,917 hospitals in FY 2018–19, comprising 3,013 public and 3,904 private hospitals, to 36,229 hospitals, comprising 19,483 public and 16,746 private hospitals. All eligible beneficiariesunderthe scheme canavailtreatment through a network of these 36,229empanelledhospitals across the country. As per the empanelment guidelines under the scheme, empanelled hospitals cannot deny treatment to eligible beneficiaries. In cases of denial of treatment by an empanelled hospital, beneficiaries can register their grievances through the Centralized Grievance Redressal Management System (CGRMS) or the 24×7 toll-free helpline number 14555. Such grievances are monitored through a three-tier grievance redressal mechanism at the District, State and National level. At each level, designated nodal officers and Grievance Redressal Committeesare inplace toexamineandresolve the grievances. (e): Under the scheme, settlement of claims is a regular and uninterrupted process and claims are settled by respective State HealthAgencies asperclaim adjudication guidelinesissued by National Health Authority. As per the guideline, the permissible turnaround time for settlement of claimto hospitals iswithin 15 daysof claim submission for intra-state hospitals (hospitals located within the State) and within 30 days in case of portability claims (hospitals located outside the State). Further, the claims submitted by empanelled hospitals are scrutinized based on the clinical documents, investigation reports and other supporting records, inaccordancewith the prescribed standard treatmentguidelines. *****