Ayushman Bharat Yojana

2021-06-26T03:57:42Z

2401:4900:40A5:FFD9:1B5B:2171:6F74:B500: Removed unnecessary content.

{{short description|Healthcare programme in India}}
{{Use dmy dates|date=October 2020}}
{{Use Indian English|date=May 2016}}
{{Infobox project
| image = Ayushman Bharat logo.png
| country = [[India]]
| type = [[Health insurance]]
| budget = {{INRConvert|8088|c}} (2021 - 2022) <ref>https://health.economictimes.indiatimes.com/news/policy/budget-2020-healthcare-gets-rs-69000-crore-rs-6400-crore-for-ayushman-bharat/73833215</ref>
| primeminister = [[Narendra Modi]]
| ministry = [[Ministry of Health and Family Welfare]]
| launched = {{Start date and age|2018|09|23|df=y}}
| current_status = {{tick}} Active
| website =https://www.pmjay.gov.in/
}}

'''Ayushman Bharat Pradhan Mantri Jan Arogya Yojana''' (''abb.'' AB PM-JAY, translation: ''Longeval India Prime Minister's People's Health;'' also referred to as '''Ayushman Bharat''' '''National Health Protection Scheme''' ''abb.'' NHPS) of the [[Government of India]] is a national health insurance scheme of the state that aims to provide free access to healthcare for low income earners in the country. Roughly, the bottom 50% of the country qualifies for this scheme. <ref>{{Cite news|url=http://infnd.com/ayushman-bharat-yojana-in-hindi/|title=आयुष्मान भारत राष्ट्रीय स्वास्थ्य संरक्षण (नेशनल हेल्थ प्रोटेक्शन) योजना - Ayushman bharat|date=2015-06-17|work=Infnd|access-date=2018-11-28|language=en-US}}</ref> People using the program access their own [[primary care]] services from a family doctor. When anyone needs additional care, then PM-JAY provides free [[secondary health care]] for those needing specialist treatment and [[tertiary health care]] for those requiring hospitalization.<ref>{{Cite web|url=https://pmjay.gov.in/about-pmjay|title=About Pradhan Mantri Jan Arogya Yojana (PM-JAY)|website=pmjay.gov.in|access-date=2020-03-02}}</ref>

[[File:Urban Primary Health Centre Ayushman Bharat Bidipeth Nagpur.jpg|thumb|Urban Primary Health Centre Ayushman Bharat Bidipeth Nagpur]]

The programme is part of the Indian government's [[National Health Policy]] and is [[means-tested]]. It was launched in September 2018 by the [[Ministry of Health and Family Welfare]]. That ministry later established the [[National Health Authority]] as an organization to administer the program. It is a centrally sponsored scheme and is jointly funded by both the federal government and the states. By offering services to 50 crore (500 million) people it is the world's largest government sponsored healthcare program.<ref>{{cite web|last=|first=|date=6 March 2019|others=PTI|title=Ayushman Bharat on way to become world's largest free healthcare: Arun Jaitley|url=https://economictimes.indiatimes.com/industry/healthcare/biotech/healthcare/ayushman-bharat-on-way-to-become-worlds-largest-free-healthcare-scheme-arun-jaitley/articleshow/68288261.cms|url-status=live|archive-url=|archive-date=|access-date=15 February 2021|website=The Economic Times}}</ref> The program is a [[means-tested]] as its users are people with low [[income in India]].

==History==
In 2017 an Indian version of the [[Global Burden of Disease Study]] reported major diseases and risk factors from 1990 to 2016 for every state in India.<ref>{{cite journal|last1=Dandona|first1=Lalit|last2=Dandona|first2=Rakhi|last3=Kumar|first3=G Anil|last4=Shukla|first4=D K|last5=Paul|first5=Vinod K|last6=Balakrishnan|first6=Kalpana|last7=Prabhakaran|first7=Dorairaj|last8=Tandon|first8=Nikhil|last9=Salvi|first9=Sundeep|last10=Dash|first10=A P|last11=Nandakumar|first11=A|display-authors=4|date=December 2017|title=Nations within a nation: variations in epidemiological transition across the states of India, 1990–2016 in the Global Burden of Disease Study|url=|journal=The Lancet|volume=390|issue=10111|pages=2437–2460|doi=10.1016/S0140-6736(17)32804-0|pmc=5720596|pmid=29150201|via=NCBI|last119=Pati|last118=Parameswaran|first118=Sreejith|first12=Vikram|first119=Sanghamitra|last120=Prasad|last117=Pandya|first117=Sapan|last114=Nongmaithem|first116=Jeyaraj D|last116=Pandian|first115=Anu M|last115=Oommen|first114=Romi S|last121=Prasad|first113=Lipika|first120=Kameshwar|first124=Sreebhushan|first121=Narayan|first126=Thara|first129=Yogesh|last129=Sabde|first128=Ambuj|last128=Roy|first127=Goura K|last127=Rath|last126=Rangaswamy|last122=Purwar|first125=Siddarth|last125=Ramji|first112=Sreenivas A|last124=Raju|first123=Asma|last123=Rahim|first122=Manorama|last113=Nanda|last109=Murhekar|last112=Nair|first98=Raman K|first101=Laishram|last101=Ladusingh|first100=Anura|last100=Kurpad|first99=Rashmi|last99=Kumar|last98=Kumar|first102=Rakesh|first97=Avdhesh|last97=Kumar|first96=Anand|last96=Krishnan|first95=Parvaiz A|last95=Koul|first94=Sanjay|last102=Lodha|last103=Mahesh|first111=Sanjeev|last108=Mukhopadhyay|last111=Nair|first110=G V S|last110=Murthy|first109=Manoj|first130=K S|first108=Satinath|first107=Murali|first103=P A|last107=Mohan BV|first106=Dileep|last106=Mavalankar|first105=Matthews|last105=Mathai|first104=Rajesh|last104=Malhotra|last130=Sachdeva|last134=Sharma|last131=Sadhu|last155=Varughese|last158=Vijayakumar|first157=K|last157=Venugopal|first156=S|last156=Venkatesh|first155=Santosh|first154=Mathew|last159=Xavier|last154=Varghese|first153=Srikanth|last153=Tripathy|first152=Nihal|last152=Thomas|first151=Kavumpurathu R|last151=Thankappan|first158=Lakshmi|first159=Denis|last150=Thakur|first164=Theo|first167=Soumya|last167=Swaminathan|first166=Christopher J L|last166=Murray|first165=K Srinath|last165=Reddy|last164=Vos|last160=Yajnik|first163=J V R Prasada|last163=Rao|first162=Sanjay|last162=Zodpey|first161=Geevar|last161=Zachariah|first160=Chittaranjan S|first150=J S|first149=Babasaheb|first131=Harsiddha|last136=Shirude|last139=Singh|first138=Sharvari R|last138=Shukla|first137=Rajan|last137=Shukla|first136=Shreya|first135=Anita|last140=Singh|last135=Shet|first134=Rajendra|first93=Ajay|first133=Mari J|last133=Sankar|first132=Rajesh|last132=Sagar|first139=Gagandeep|first140=Narinder P|last149=Tandale|first145=A|first148=P N|last148=Sylaja|first147=Rajaraman|last147=Swaminathan|first146=Vanita|last146=Suri|last145=Srividya|last141=Singh|first144=R K|last144=Srivastava|first143=Dhirendra N|last143=Sinha|first142=Anju|last142=Sinha|first141=Virendra|last94=Kinra|last93=Khera|last13=Agarwal|last38=Furtado|first41=Ravi|last41=Mehrotra|first40=Chris M|last40=Varghese|first39=Eliza|last39=Dutta|first38=Melissa|first37=Puneet|first42=P|last37=Dewan|first36=Kirankumar|last36=Rade|first35=Raghuram|last35=Rao|first34=Sunil D|last34=Khaparde|last42=Jambulingam|last43=Kaur|last33=Chadha|last48=Anjana|first51=Arvind|last51=Chopra|first50=Anurag|last50=Agrawal|first49=Viswanathan|last49=Mohan|first48=Ranjit M|first47=Reeta|first43=Tanvir|last47=Rasaily|first46=Rashmi|last46=Arora|first45=Shalini|last45=Singh|first44=Meenakshi|last44=Sharma|first33=Vineet K|first32=Harvey|first52=Ashish J|first17=Avula|last21=Afshin|first20=Manu R|last20=Mathur|first19=Subhojit|last19=Dey|first18=Preet K|last18=Dhillon|last17=Laxmaiah|last22=Fitzmaurice|first16=Prashant|last16=Mathur|first15=R S|last15=Dhaliwal|first14=Prakash C|last14=Gupta|first13=Sanjay K|first21=Ashkan|first22=Christina|last32=Whiteford|last28=Lim|first31=Jeffrey D|last31=Stanaway|first30=Gregory A|last30=Roth|first29=Mohsen|last29=Naghavi|first28=Stephen S|first27=Hmwe|last23=Gakidou|last27=Kyu|first26=Nicholas J|last26=Kassebaum|first25=Simon I|last25=Hay|first24=Peter|last24=Gething|first23=Emmanuela|last52=Mathew|last53=Bhardwaj|first92=Tripti|first78=Rajeev|last82=Gururaj|first81=M D|last81=Gupte|first80=Tarun|last80=Gupta|first79=Subodh S|last79=Gupta|last78=Gupta|last83=Harikrishnan|first77=Randeep|last77=Guleria|first76=N|last76=Gopalakrishnan|first75=Aloke G|last75=Ghoshal|first74=Sagnik|first82=G|first83=Sivadasanpillai|first73=Paresh V|first88=Rajni|last92=Khanna|first91=Kiran|last91=Katoch|first90=Amal C|last90=Kataki|first89=Anita|last89=Kar|last88=Kant|last84=Iyer|last12=Patel|last87=Joshua|first86=Panniyamamkal|last86=Jeemon|first85=Sudhir K|last85=Jain|first84=Veena|last74=Dey|last73=Dave|first53=Deeksha|last58=Abdulkader|first61=Sandra|last61=Albert|first60=Rakesh|last60=Aggarwal|first59=Ashutosh N|last59=Aggarwal|first58=Rizwan S|first57=Scott|first62=Atul|last57=Glenn|first56=Kelly|last56=Bienhoff|first55=Parul|last55=Mutreja|first54=Pallavi|last54=Muraleedharan|last62=Ambekar|last63=Arora|first72=Siddharth K|first68=Anurag|last72=Das|first71=D J|last71=Christopher|first70=Bilali|last70=Camara|first69=Eesh|last69=Bhatia|last68=Bhargava|first63=Monika|first67=Anil|last67=Bhansali|first66=Gufran|last66=Beig|first65=Ashish|last65=Bavdekar|first64=Damodar|last64=Bachani|first87=Vasna}}</ref> This study brought a lot of interest in government health policy because it identified major health challenges which the government could address.<ref>{{cite journal |last1=Bhargava |first1=Balram |last2=Paul |first2=Vinod K |title=Informing NCD control efforts in India on the eve of Ayushman Bharat |journal=The Lancet |date=September 2018 |pages=S014067361832172X |doi=10.1016/S0140-6736(18)32172-X|pmid=30219331 |s2cid=52189318 |doi-access=free }}</ref> In 2018 the Indian government described that every year, more than six crores Indians were pushed into poverty because of out of pocket medical expenses.<ref>{{cite web|author1=|first=|author-link1=|date=17 November 2018|others=Press Trust of India|title=Medical Expenses Push 6 Crore Indians To Poverty Annually: Top Official|url=https://www.ndtv.com/india-news/medical-expenses-push-6-crore-indians-to-poverty-annually-top-official-indu-bhushan-1949129|url-status=live|archive-url=|archive-date=|access-date=15 February 2021|website=NDTV}}</ref> Despite various available regional and national programs for [[healthcare in India]], there was much more to be done. The Indian government first announced the Ayushman Bharat Yojana as a [[universal health care]] plan in February 2018 in the [[2018 Union budget of India]].<ref name="Pareek 2018">{{cite journal |last1=Pareek |first1=Manoj |title=Ayushman Bharat-National Health Protection Mission a way towards Universal Health Cover by reaching the bottom of the pyramid to be a game changer or non-starter |journal=International Journal of Advanced and Innovative Research |date=31 July 2018 |volume=7 |issue=7 |doi=10.5281/zenodo.1341912}}</ref> The [[Union Council of Ministers]] approved it in March. In his 2018 [[Independence Day (India)|Independence Day]] speech Prime Minister [[Narendra Modi]] announced that India would have a major national health program later that year on 25 September, also commemorating the birthday of Pandit [[Deendayal Upadhyaya]].<ref>{{cite journal |last1=Mukherjee |first1=Reema |last2=Arora |first2=Manisha |title=India's national health protection scheme: A preview |journal=Medical Journal of Dr. D.Y. Patil Vidyapeeth |date=2018 |volume=11 |issue=5 |pages=385 |doi=10.4103/mjdrdypu.mjdrdypu_109_18|s2cid=169815602 |doi-access=free }}</ref>

In June 2018 the applications opened for hospitals through an "empanelment process".<ref name="Pareek 2018" /> In July 2018, the Ayushman Bharat Yojana recommended that people access benefits through [[Aadhaar]], but also said that there was a process for people to access without that identity card.<ref name="Pareek 2018" /> AB PM-JAY was first launched on 23 September 2018 at [[Ranchi]], [[Jharkhand]].<ref>{{cite web |title=PM Modi launches PMJAY- Ayushman Bharat in Ranchi |url=https://www.aninews.in/videos/national/pm-modi-launches-pmjay-ayushman-bharat-ranchi/ |website=ANInews |language=en |date=23 September 2018}}</ref> By 26 December 2020 the scheme was extended to the Union Territories of Jammu Kashmir and Ladakh.<ref>{{Cite web|date=2020-12-24|title=PM Modi to launch Ayushman Bharat health insurance scheme for residents of Jammu and Kashmir on Dec 26|url=https://www.hindustantimes.com/india-news/pm-modi-to-launch-ayushman-bharat-health-insurance-scheme-for-residents-of-j-k-on-dec-26/story-W5tvJBES6MqyldUP3o2pOO.html|access-date=2020-12-26|website=Hindustan Times|language=en}}</ref> The program has been called "ambitious".<ref>{{cite web|last1=Singh|first1=Poonam Khetrapal|date=1 October 2018|title=Ayushman Bharat: An ambitious set of reforms that should benefit millions of India's poor and vulnerable|url=https://www.who.int/southeastasia/news/opinion-editorials/detail/ayushman-bharat-an-ambitious-set-of-reforms-that-should-benefit-millions-of-india-s-poor-and-vulnerable|url-status=live|archive-url=|archive-date=|access-date=15 February 2021|website=|publisher=World Health Organization|language=en}}</ref><ref>{{cite journal |last1=Zodpey |first1=S |last2=Farooqui |first2=HH |title=Universal health coverage in India: Progress achieved & the way forward. |journal=The Indian Journal of Medical Research |date=April 2018 |volume=147 |issue=4 |pages=327–329 |doi=10.4103/ijmr.IJMR_616_18 |pmid=29998865|pmc=6057252 }}</ref>

== Features ==
[[File:Healthcare centre near Mahua.jpg|thumb|A health and wellness centre established as a part of Ayushman Bharat Yojna at Mahua community development bloc, [[Bihar]].]]
Features of PM-JAY include the following— providing health coverage for 10 crores households or 50 crores Indians;<ref>{{cite web |author1=Our Bureau |title=PM unveils Ayushman Bharat; 50 cr to get health cover of ₹5 lakh |url=https://www.thehindubusinessline.com/news/national/pm-unveils-ayushman-bharat-50-cr-to-get-health-cover-of-5-lakh/article25022030.ece |website=[[Business Line]] |language=en |date=23 September 2018}}</ref> providing a cover of {{INRConvert|5|l|lk=on|year=2021}} per family per year for medical treatment in empaneled hospitals, both public and private; offering [[cashless payment]] and [[paperless]] recordkeeping through the hospital or doctor's office;<ref>{{cite web |last1=Sharma |first1=Yogima Seth |title=Labour ministry to provide cashless secondary and tertiary medical care services under AB-PMJAY |url=https://economictimes.indiatimes.com/industry/healthcare/biotech/healthcare/labour-ministry-to-provide-cashless-secondary-and-tertiary-medical-care-services-under-pmjay/articleshow/71114979.cms |website=[[The Economic Times]] |date=13 September 2019}}</ref> using criteria from the [[Socio Economic and Caste Census 2011]] to determine eligibility for benefits;<ref>{{cite web |title=NHA issues circular advising states to identify eligible PMJAY beneficiaries |url=https://economictimes.indiatimes.com/news/politics-and-nation/nha-issues-circular-advising-states-to-identify-eligible-pmjay-beneficiaries/articleshow/66096010.cms |website=[[The Economic Times]] |date=6 October 2018}}</ref><ref>{{cite web |last1=Sharma |first1=Neetu Chandra |title=Govt looks beyond SECC 2011 to include more beneficiaries under Modicare |url=https://www.livemint.com/politics/policy/govt-looks-beyond-secc-2011-to-include-more-beneficiaries-under-modicare-1560187873216.html |website=[[Mint (newspaper)|Livemint]] |publisher=[[HT Media]] |language=en |date=10 June 2019}}</ref> no restriction on family size, age or gender; all previous medical conditions are covered under the scheme; it covers 3 days of pre-hospitalisation and 15 days of post-hospitalisation, including diagnostic care and expenses on medicines; the scheme is portable and a beneficiary can avail medical treatment at any PM-JAY empanelled hospital outside their state and anywhere in the country;<ref>{{cite web |last1=Sharma |first1=Neetu Chandra |title=Over 40,000 people availed portable treatment under Ayushman Bharat |url=https://www.livemint.com/politics/policy/over-42-000-people-availed-portable-treatment-under-ab-pmjay-1569476280775.html |website=[[Mint (newspaper)|Livemint]] |publisher=[[HT Media]] |language=en |date=26 September 2019}}</ref> providing access to free [[COVID-19 testing]].<ref>{{cite web |last1=Kumar |first1=Rajeev |title=Free COVID-19 testing under PMJAY: NHA to empanel ICMR approved labs |url=https://www.financialexpress.com/lifestyle/health/free-covid-19-testing-under-pmjay-nha-to-empanel-icmr-approved-labs/1972430/ |website=[[The Financial Express (India)|The Financial Express]] |date=27 May 2020}}</ref><ref>{{cite web |last1=Kaul |first1=Rhythma |title=2,000 under treatment, 3,000 tested free for Covid-19 under Ayushman Bharat scheme |url=https://www.hindustantimes.com/india-news/2-000-under-treatment-3-000-tested-free-for-covid-19-under-ayushman-bharat-scheme/story-ROgYn2caqy6gnMMaYDdxQL.html |website=Hindustan Times |language=en |date=20 May 2020}}</ref>

==Implementation==

=== Reach ===
'''Participation by states and union territories'''

India's [[States and union territories of India|28 states and 8 union territories]] each make their own choice about whether to participate in Ayushman Bharat Yojana.<ref name="Pareek 2018" /> In February 2018 when the program was announced 20 states committed to join.<ref name="Pareek 2018" /> In September 2018 shortly after launch some states and territories declined to participate in the program.<ref>{{cite web|author1=|first=|date=24 September 2018|title=5 states opted out of Ayushman Bharat: Here's why|url=https://www.moneycontrol.com/news/india/5-states-opted-out-of-ayushman-bharat-heres-why-2979691.html|url-status=live|archive-url=|archive-date=|access-date=15 February 2021|website=Moneycontrol}}</ref> Maharashtra and Tamil Nadu initially declined to join because they each had their own state healthcare programmes.<ref>{{Cite news|last=|first=|date=9 October 2020|title=Ayushman Bharat Yojana and its impact on medical devices industry|work=Express healthcare|url=https://www.expresshealthcare.in/blogs/guest-blogs-healthcare/ayushman-bharat-yojana-and-its-impact-on-medical-devices-industry/425234/|url-status=live|access-date=15 February 2021}}</ref><ref name="Porecha 2019">{{cite web|last1=Porecha|first1=Maitri|date=24 September 2019|title=A year on, Ayushman Bharat faces multiple challenges ahead|url=https://www.thehindubusinessline.com/economy/a-year-on-ayushman-bharat-faces-multiple-challenges-ahead/article29497106.ece#|url-status=live|archive-url=|archive-date=|access-date=|website=The Hindu Business Line|language=en}}</ref> Those programs, [[Mahatma Jyotiba Phule Jan Arogya Yojana]] and the programme for Tamil Nadu, were already functioning well. These states later both joined Ayushman Bharat Yojana with special exceptions to make it part of their existing infrastructure.<ref name="Porecha 2019" /> In a similar way, Kerala, despite having its own health program agreed to begin using Ayushman Bharat Yogana from November 2019.<ref>{{cite web|author1=|first=|author-link1=|date=9 June 2019|others=PTI|title=Kerala govt joins issue with PM on Ayushman Bharat, says state member of scheme|url=https://www.business-standard.com/article/pti-stories/kerala-govt-joins-issue-with-pm-on-ayushman-bharat-says-state-member-of-scheme-119060900444_1.html|url-status=live|archive-url=|archive-date=|access-date=|website=Business Standard|language=en}}</ref><ref>{{cite web|last1=Krishnakumar|first1=R.|date=12 April 2019|title=A better option in Kerala|url=https://frontline.thehindu.com/cover-story/article26641511.ece|url-status=live|archive-url=|archive-date=|access-date=15 February 2021|website=Frontline|language=en}}</ref> West Bengal initially joined the program but then opted out in favor of establishing their own regional health programme.<ref>{{cite web|last1=Khanna|first1=Rohit|date=8 June 2019|title=Ayushman Bharat targets 3 crore beneficiaries if West Bengal rejoins the scheme|url=https://timesofindia.indiatimes.com/city/kolkata/ayushman-bharat-targets-3-crore-beneficiaries-if-west-bengal-rejoins-the-scheme/articleshow/69706045.cms|url-status=live|archive-url=|archive-date=|access-date=|website=The Times of India|language=en}}</ref> Telangana did the same.<ref>{{cite web|last1=Menon|first1=Amarnath K.|date=9 September 2019|title=Telangana CM rejects Centre's Ayushman Bharat for state medical health scheme|url=https://www.indiatoday.in/india/story/telangana-cm-rejects-centre-s-ayushman-bharat-for-state-medical-health-scheme-1597334-2019-09-09|url-status=live|archive-url=|archive-date=|access-date=|website=India Today|language=en}}</ref> By January 2020 Odisha had not joined the scheme.<ref name="PTI December 2019">{{cite web|author1=|first=|author-link1=|date=10 December 2019|others=PTI|title=People in Delhi, WB, Odisha, Telangana not getting Ayushman Bharat scheme benefits: Harsh Vardhan|url=https://economictimes.indiatimes.com/news/politics-and-nation/people-in-delhi-wb-odisha-telangana-not-getting-ayushman-bharat-scheme-benefits-harsh-vardhan/articleshow/72458435.cms|url-status=live|archive-url=|archive-date=|access-date=|website=The Economic Times}}</ref> In March 2020 Delhi announced that it would join the program.<ref>{{cite web|author1=|first=|author-link1=|date=23 March 2020|others=PTI|title=AAP govt will implement Ayushman Bharat scheme in Delhi: Sisodia|url=https://economictimes.indiatimes.com/news/politics-and-nation/aap-govt-will-implement-ayushman-bharat-scheme-in-delhi-sisodia/articleshow/74774988.cms|url-status=live|archive-url=|archive-date=|access-date=|website=The Economic Times}}</ref>

'''Participation by local people'''

In May 2020 Prime Minister [[Narendra Modi]] said in his radio show ''[[Mann Ki Baat]]'' that the Ayushman Bharat scheme had recently benefited more than one crore people.<ref>{{cite web|last1=Tandi|first1=Dev Narayan|date=31 May 2020|title=Prime Minister narendra modi addresses 12th Episode of 'Mann Ki Baat 2.0'|url=https://www.narendramodi.in/prime-minister-narendra-modi-addresses-12th-episode-of-mann-ki-baat-2-0-550037|url-status=live|archive-url=|archive-date=|access-date=|website=narendramodi.in}}</ref> By May 2020, the scheme had provided more than 1 crore treatments with a value of {{INR|13412}} crore.<ref>{{cite web|last1=Kumar|first1=Rajeev|date=20 May 2020|title=Ayushman Bharat-PMJAY crosses new milestone! WhatsApp chatbot, special e-cards planned for celebration|url=https://www.financialexpress.com/lifestyle/health/ayushman-bharat-pmjay-1-crore-treatment-milestone-whatsapp-chatbot-special-e-cards-for-celebrations/1964719/|url-status=live|archive-url=|archive-date=|access-date=|website=The Financial Express}}</ref> The number of public and private hospitals empanelled nationwide stands at 24,432.<ref>{{cite news |title=Ayushman Bharat: Fresh push by National Health Agency to get hospitals on board |url=https://indianexpress.com/article/delhi/ayushman-bharat-fresh-push-by-national-health-agency-to-get-hospitals-on-board-5464090/ |access-date=6 December 2018 |work=The Indian Express|date=26 November 2018}}</ref> The Ayushman Bharat Yojana programme announced a special collaboration with the [[Employees' State Insurance]] programme in November 2019.<ref>{{cite web|last1=Sharma|first1=Yogima Seth|date=13 November 2019|title=ESIC partners with PMJAY to provide medical facilities to beneficiaries|url=https://economictimes.indiatimes.com/industry/healthcare/biotech/healthcare/esic-partners-with-pmjay-to-provide-medical-facilities-to-beneficiaries/articleshow/72041738.cms|url-status=live|archive-url=|archive-date=|access-date=|website=The Economic Times}}</ref> From June 2020, the program had entered a pilot to cover 120,000 workers with that insurance at 15 hospitals.<ref>{{cite web|last1=Sharma|first1=Yogima|date=23 June 2020|title=ESIC beneficiaries to soon get facilities of hospital empanelled under Ayushman Bharat|url=https://economictimes.indiatimes.com/industry/healthcare/biotech/healthcare/linking-of-ayushman-esic-schemes-in-102-districts-soon/articleshow/77115922.cms|url-status=live|archive-url=|archive-date=|access-date=|website=The Economic Times}}</ref>

==Challenges==
When Ayushman Bharat Yojana began there were questions of how to reconcile its plans with other existing health development recommendations, such as from [[NITI Aayog]].<ref name="Hooda 2018">{{cite web|last1=Hooda|first1=Shailender Kumar|date=26 November 2018|title=With Inadequate Health Infrastructure, Can Ayushman Bharat Really Work?|url=https://thewire.in/health/with-inadequate-health-infrastructure-can-ayushman-bharat-really-work|url-status=live|archive-url=|archive-date=|access-date=|website=The Wire}}</ref> A major challenge of implementing a national health care scheme would be starting with infrastructure in need of development to be part of a modern national system.<ref name="Hooda 2018"/> While Ayushman Bharat Yojana seeks to provide excellent healthcare, India still has some basic healthcare challenges including relatively few doctors, more cases of infectious disease, and a national budget with a comparatively low central government investment in health care. Some of the problems lay outside the Health Ministry such as urban development or transport.<ref>{{cite journal |last1=Nirula |first1=SR |last2=Naik |first2=M |last3=Gupta |first3=SR |title=NHS vs Modicare: The Indian Healthcare v2.0. Are we ready to build the healthier India that we envisage? |journal=Journal of Family Medicine and Primary Care |date=June 2019 |volume=8 |issue=6 |pages=1835–1837 |doi=10.4103/jfmpc.jfmpc_309_19 |pmid=31334141|pmc=6618227 }}</ref> While many government hospitals have joined the program, many private corporate hospitals have not. The private hospitals report that they would be unable to offer their special services at the government low price, even with a government subsidy.<ref name="Porecha 2019" />

The scheme has faced challenges in form of fraudulent bills. In response, [[National Health Authority]] has revoked empanelment of 171 hospitals and imposed a penalty of {{INRConvert|4.6|c|lk=on|year=2021}}. Another 390 hospitals have been issued show cause notice.<ref>{{Cite web|last=The World|first=Republic|title=171 hospitals de-empanelled, Rs 4.6 Cr penalty levied for committing fraud in PMJAY|url=https://www.republicworld.com/india-news/general-news/171-hospitals-de-empanlled-rs-4-dot-6-cr-penalty-levied-for-pmjay-fraud|access-date=2020-06-11|website=Republic World}}</ref>

There have been media reports of misuse of the Ayushman Bharat scheme by unscrupulous private hospitals through submission of fake medical bills. Under the Scheme, surgeries have been claimed to be performed on persons who had been discharged long ago and dialysis has been shown as performed at hospitals not having kidney transplant facility.<ref>{{cite news |title=Ayushman Bharat: Hospitals use Bizarre Ways to Siphon Off Public Funds |url= https://timesofindia.indiatimes.com/india/under-ayushman-bharat-how-hospitals-use-bizarre-ways-to-siphon-off-public-funds/articleshow/70654696.cms |access-date=18 August 2019 |work=The Times of India|date=15 August 2019}}</ref> There are at least 697 fake cases in [[Uttarakhand]] State alone, where fine of {{INRConvert|1|c|lk=on|year=2021}} has been imposed on hospitals for frauds under the Scheme.<ref>{{cite news |title=Hospitals Penalised for Irregularities in Ayushman Bharat Scheme |url= https://www.thehindubusinessline.com/news/national/uttarakhand-hospitals-to-be-penalised-over-rs-1-cr-for-irregularities-in-ayushman-bharat-scheme/article28133763.ece |access-date=18 August 2019 |publisher=Hindu Business Line |date=25 June 2019}}</ref> However, unlike the earlier RSBY (Rashtriya Swasthya Bima Yojana) era, plagued by lax monitoring of insurance fraud, AB-PMJAY involves a robust information technology infrastructure overseeing transactions and locating suspicious surges across the country. Health Minister [[Harsh Vardhan (Delhi politician)|Harsh Vardhan]] has blacklisted hospitals and named them publicly for misconduct.<ref>{{cite web |last1=Vachhatani |first1=Jitesh |title=Harsh Vardhan's 'name & shame' list to curb frauds under AB-PMJAY |url=https://www.republicworld.com/india-news/general-news/harsh-vardhans-name-and-shame-list-to-curb-frauds-under-ab-pmjay.html |website=[[Republic TV]] |date=30 September 2019}}</ref> Initial analysis of high-value claims under PMJAY has revealed that a relatively small number of districts and hospitals account for a high number of these, and some hint of an anti-women bias, with male patients getting more coverage. Despite all efforts to curb foul-play, the risk of unscrupulous private entities profiteering from gaming the system is clearly present in AB-PMJAY.<ref>{{cite news |title=Ayushman Bharat – PMJAY at one: A step closer to universal health coverage |url= https://www.orfonline.org/research/ayushman-bharat-pmjay-at-one-a-step-closer-to-universal-health-coverage-55807/ |publisher=ORF |date=24 September 2019}}</ref>

==References==
{{reflist}}

==Further consideration==
*{{cite web |author1=Nexdigm |title=India's National Health Protection Scheme Ayushman Bharat |url=https://www.skpgroup.com/data/resource/indias_national_healthcare_protection_scheme_.pdf |website=skpgroup.com |publisher=SKP Group |date=2019}}

==External links==
{{Scholia|Q55604588}}
*{{official website|https://pmjay.gov.in/}}

{{Government Schemes in India}}

{{DEFAULTSORT:Yojana, Ayushman Bharat}}
[[Category:Health programmes in India]]
[[Category:Publicly funded health care]]
[[Category:2018 introductions]]
[[Category:Social security in India]]
[[Category:2018 establishments in India]]

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Ayushman Bharat Yojana