New Delhi: Union Minister of Health and Family Welfare, Prataprao Jadhav, informed the Lok Sabha that a total of 18,184 grievances have been recorded in the Central Grievance Redressal and Monitoring System (CGRMS). These grievances pertain to issues such as denial of treatment, improper charges for admission, discharge, or medicines, and the unavailability of Pradhan Mantri Arogya Mitras (PMAMs), among others.
The Minister emphasized that the Ayushman Bharat—Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) is governed by a zero-tolerance policy towards fraud and abuse. Several measures are implemented to prevent, detect, and address fraudulent activities throughout the scheme’s operational stages.
The announcement follows an inquiry by parliamentarian Shri Sudama Prasad, who raised concerns about unnecessary surgeries conducted by empanelled hospitals, a controversy that has prompted skepticism among citizens about receiving free medical care at health camps organized under the scheme.
Key Points Highlighted by the Minister
- Fraud Prevention Measures:
- An FIR was lodged on November 12, 2024, against a hospital implicated in fraudulent activities. Both the hospital and the involved doctors have been suspended from the scheme.
- The National Anti-Fraud Unit (NAFU) and State Anti-Fraud Units (SAFU) investigate fraud cases and take actions such as suspension, de-empanelment of hospitals, penalty imposition, and lodging FIRs.
- Grievance Redressal System:
- A three-tier grievance redressal mechanism has been established at district, state, and national levels.
- Beneficiaries can file complaints through the web-based Central Grievance Redressal and Monitoring System (CGRMS), call centers, email, and letters.
- Coverage and Beneficiary Data:
- As of October 31, 2024, 35.8 crore Ayushman cards and 2.04 million Ayushman Vay Vandana cards have been issued.
- The scheme provides Rs. 5 lakh health cover per family annually for approximately 55 crore individuals from 12.37 crore economically vulnerable families.
- Funding Allocation:
- Central funding is distributed to states based on actual scheme usage by beneficiaries, with no fixed allocation for individual states.
Funds Released to States (in crore Rs.):
| Year | Funds Allocated |
|---|---|
| 2018-19 | 2079 |
| 2019-20 | 5795 |
| 2020-21 | 5995 |
| 2021-22 | 5995 |
| 2022-23 | 6000 |
| 2023-24 | 6220 |
| 2024-25 | 6878 |
The government reaffirmed its commitment to ensuring quality healthcare services under AB-PMJAY, reinforcing its stance against any misuse of the scheme.
