Question : Accumulation of Dues under PMJAY

Will the Minister of HEALTH AND FAMILY WELFARE be pleased to state:

(a) whether it is a fact that dues of crores of rupees are pending for reimbursement to the hospitals under Pradhan Mantri Jan Arogya Yojana (PMJAY);

(b) if so, the details thereof;

(c) whether his Ministry has raised the concern with the Finance Ministry for the same;

(d) if so, the details thereof along with the response of the Finance Ministry;

(e) if not, the reasons therefor; and

(f) the time likely to be taken by the Government to release the pending amount to the said hospitals?

ANSWER
THE MINISTER OF STATE IN THE MINISTRY OF HEALTH AND
FAMILY WELFARE
(SHRI ASHWINI KUMAR CHOUBEY)
(a) & (b): Under Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) the reimbursement process towards the hospital claim starts from the day hospital submits all the requisite documents. After adequate evaluation of the claim, appropriate amount gets reimbursed to the hospital within 15 to 45 days depending upon the agreement signed.

(c) to (e): No. Sufficient funds are available for implementation of AB-PMJAY.

Further, hospitals are reimbursed either by the Insurance Companies or by the States/UTs/ State Health Agencies themselves depending upon the mode of implementation. The timely settlement of claim is monitored by the National Health Authority.

(f): The approved claim amount gets reimbursed after processing of the claim within 15 to 45 days depending upon the agreement signed between State/UTs with insurance companies/hospitals.