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Friday, February 8, 2019

Ten Salient Features of Ayushman Bharat Pradhan Mantri Jan Arogya Yojana

Ten Salient Features of Ayushman Bharat Pradhan Mantri Jan Arogya Yojana

state: Will the Minister of HEALTH AND FAMILY WELFARE be pleased to 
  • (a) whether the Government is implementing the Ayushman Bharat Yojana covering nearly half the population of the country, if so, the salient features and targets of the scheme; 
  • (b) the amount for which applications have been received under the said Yojana till date and the quantum of amount released to beneficiaries, State-wise; 
  • (c) whether the Government plans to include economically poor persons in addition to BPL Card holders under the said scheme and if so, the details thereof along with the number of persons benefited under the said scheme till date, State/UTwise; 
  • (d) whether the Government has identified adequate number of hospitals under the scheme and if so, the details thereof along with the number of hospitals covered under the scheme currently, Statewise; and 
  • (e) the steps taken by the Government to meet the shortage of doctors, tap/infuse the resources, infrastructure and paramedics into the system, create awareness among the people and effectively implement the scheme? 
Mantri+Jan+Arogya+Yojana
ANSWER 

THE MINISTER OF HEALTH AND FAMILY WELFARE
 (SHRI JAGAT PRAKASH NADDA) 

(a) to (e) : A Statement is laid on the Table of the House. 

STATEMENT REFERRED TO IN REPLY TO LOK SABHA STARRED QUESTION NO.94* FOR 8TH FEBRUARY, 2019 

(a) The Government has launched Ayushman Bharat Programme to address access to health holistically, including prevention, health promotion, primary, secondary and tertiary care. Ayushman Bharat Yojana comprises of two components namely (i) Provision of Comprehensive Primary Healthcare (CPHC) through Health and Wellness Centers (HWCs) and (ii) Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PMJAY). 

Health and Wellness Centres are envisaged to provide an expanded package of primary healthcare services encompassing reproductive and child health services, communicable diseases, non-communicable disease, palliative care and elderly care, oral health and ENT care, and basic emergency care in addition to preventive care and health promotion, provision of point of care diagnostics, regular refills of essential drugs etc. 

Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PMJAY) provides hospitalisation coverage up to Rs.5.00 lakh per family per year for secondary and tertiary care procedures including certain defined pre and post hospitalisation expenses to families eligible based on specified deprivation and occupational criteria as per Socio Economic Caste Census (SECC) database. The salient features of Ayushman Bharat- Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) are provided at Annexure-I. 

(b) to (d) AB-PMJAY is an entitlement-based scheme under which coverage is linked to deprivation. Beneficiary families for PMJAY have been identified on the basis of defined criteria using the SECC data. Beneficiaries of the scheme are entitled to cashless treatment for the approved treatment packages in the empanelled Government or Private hospitals for which claims are submitted by the hospitals. State-wise details of empanelled hospitals, beneficiaries admitted, and claims submitted by the hospitals are at annexure II. 

(e) For effective implementation of PMJAY, Government has set up a National Health Authority at national level. At the State level, State Health Agencies have been set up by the implementing States/UTs. In order to spread awareness about AB-PMJAY, a comprehensive media and outreach strategy has been developed, which, inter alia, includes use of print media, electronic media, social media platforms, traditional media, IEC materials and outdoor activities 

The steps taken by the Government to increase the numbers of doctors, paramedics, and infrastructure are at annexure III. 
Annexure I 
Salient features of Prime Minister Jan Arogya Yojana [PMJAY] 
  • 1. Government of India has launched Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PMJAY) on 23.09.2018. PMJAY is centrally sponsored scheme. It is entirely funded by Government and the funding is shared between Centre and State governments as per prevailing guidelines of Ministry of Finance. 
  • 2. PMJAY provides health coverage up to Rs. 5 lakh per family per year for secondary and tertiary hospitalization to around 10.74 crore entitled families (approx. 50 crore beneficiaries). 
  • 3. PMJAY is an entitlement based scheme. This scheme covers poor and vulnerable families based on deprivation and occupational criteria as per SECC data. 
  • 4. PMJAY provides cashless and paperless access to services for the beneficiary at the point of service in any (both public and private) empanelled hospitals across India. In other words, a beneficiary from one State can avail benefits from an empanelled Hospital anywhere in the Country. 
  • 5. Under PMAJY, the States are free to choose the modalities for implementation. They can implement the scheme through insurance company or directly through the Trust/ Society or mixed model. 
  • 6. There is no restriction on family size, ensuring all members of designated families specifically girl child and senior citizens get coverage. 
  • 7. At National level, National Health Authority (NHA) has been set up to implement the scheme. 
  • 8. MoU has been signed between National Health Agency (now National Health Authority) and 33 States/UTs to implement PMJAY. 
  • 9. About 1393 treatment packages are available for the beneficiaries under PMJAY. 
  • 10. The details of package, operational guidelines and key features are available at www. pmjay.gov.in 
Annexure II
State Beneficiary families covered (in lakhs)* Hospitals Empaneled Beneficiaries Admitted in Hospital Claims Submitted Claims Submitted Amount
Andaman And Nicobar Islands 0.78
3
8
6
23000
Arunachal Pradesh 0.89
2
164
49
884300
Assam 27.02
153
15533
8567
117679946
Bihar 108.95
631
10386
8899
72573664
Chandigarh 0.71
10
243
205
3115135
Chhattisgarh 41.46 1323 198447 180762 1278106472
Dadra And Nagar Haveli
3.4
4
2726
2422
6770020
Daman And Diu
2.4
4
899
775
2774200
Goa 0.37
4
2829
1818
65894655
Gujarat 44.85 2676 199128 145228 2108200798
Haryana 15.51
357
5228
4473
66436726
Himachal Pradesh
4.8
198
4317
2250
24414494
Jammu And Kashmir 6.13
150
1125
854
7986480
Jharkhand
57
595
50996 45277 435197902
Karnataka 115
880
85299 65172 1699590222
Kerala (implementing RSBY) 34.84
446
188193 86630 338018759
Lakshadweep 0.01
1
0
0
0
Madhya Pradesh 118
211
25321 19273 173805022
Maharashtra 83.63
488
65942 57758 1368333707
Manipur 2.77
15
931
667
11055183
Meghalaya 8.37
152
0
0
0
Mizoram 1.95
104
3758
3125
22351474
Nagaland
2.5
59
126
116
1149680
NHA Empanelled Hospitals -
21
968
593
23418837
Puducherry 1.04
1
0
0
0
Punjab
42
-
0
0
0
Rajasthan -
0
0
0
Sikkim
0.4
7
8
7
111200
Tamil Nadu 157 2180 117490 110835 1929602573
Tripura
4.9
64
2987
2505
12510700
Uttar Pradesh 118.04 1618 29532 25592 266247262
Uttarakhand 19.68
182
4723
2822
23750270
West Bengal 112 1240 17636 14777 141452393
Overall 1,136 13,779 1,034,943 791,457 10,201,455,074
Annexure III 
  • 1. Under Ayushman Bharat Programme 1.5 lakh Health Sub Centres and Primary Health Centres are to be transformed into Health and Wellness Centres (HWCs) by December, 2022 in order to expand access to Comprehensive Primary Health Care (CPHC). Sub Health Centres (SHCs) and Primary Health Centres (PHCs) are being strengthened as Health and Wellness Centres (H&WCs). The H&WCs are to provide preventive, promotive, rehabilitative and curative care for an expanded range of services encompassing reproductive and child health services, communicable diseases, non-communicable diseases, palliative care and elderly care, oral health, ENT care, and basic emergency care. 
  • 2. Approvals for over 21000 such HWCs were accorded in 2018-19 against the target of 15000 in the current year. Out of these, 8120 Health & Wellness Centres have been operationalized so far. 
  • 3. National Health Mission(NHM) is being implemented to strengthen public health systems in the States/UTs including providing support for health human resources and infrastructure. 
  • 4. For HWCs, at the level of sub-centres under Ayushman Bharat, mid-level health providers are being engaged. These are usually B.Sc (Nursing)/GNM or Ayurveda doctors that have successfully completed six months certificate course on primary healthcare and public health. B.Sc. (Community Health) pass students are also being engaged as mid-level health providers. 
  • 5. The ratio of teachers to students has been revised from 1:1 to 1:2 for all MD/MS disciplines and 1:1 to 1:3 in subjects of Anaesthesiology, Forensic Medicine, Radiotherapy, Medical Oncology, Surgical Oncology and Psychiatry. Further, teacher: student ratio in public funded Government Medical Colleges for Professor has been increased from 1:2 to 1:3 in all clinical subjects and for Asso. Prof. from 1:1 to 1:2 if the Asso. Prof. is a unit head. The same has also been extended to the private medical colleges with certain conditions. This would result in increase in number of PG seats in the country. 
  • 6. DNB qualification has been recognized for appointment as faculty to take care of shortage of faculty. 
  • 7. Enhancement of maximum intake capacity at MBBS level from 150 to 250 per Medical College. 
  • 8. Relaxation in the norms of setting up of Medical College in terms of requirement for faculty, staff, bed strength and other infrastructure. 
  • 9. Requirement of land for establishment of medical college in metropolitan cities as notified under Article 243P(c) of the Constitution of India has been dispensed with. 
  • 10. Strengthening/upgradation of State Government Medical Colleges for starting new PG courses/Increase of PG seats. 
  • 11. Establishment of New Medical Colleges by upgrading district/referral hospitals preferably in underserved districts of the country.
  • 12. Strengthening/ upgradation of existing State Government/Central Government Medical Colleges to increase MBBS seats.
  • 13. Enhancement of age limit for appointment/ extension/ re-employment against posts of teachers/dean/principal/ director in medical colleges from 65-70 years.
GOVERNMENT OF INDIA 
MINISTRY OF HEALTH AND FAMILY WELFARE 
DEPARTMENT OF HEALTH AND FAMILY WELFARE 

LOK SABHA 
STARRED QUESTION NO.94 
TO BE ANSWERED ON THE 8TH FEBRUARY, 2019 

AYUSHMAN BHARAT YOJANA 

94. SHRI MALLIKARJUN KHARGE
      SHRI OM BIRLA

*****

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