The Indian government has strengthened the empanelment process for hospitals under the Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) and enhanced its grievance redressal system to ensure beneficiaries receive quality healthcare services. This press release was issued on February 4, 2025.
Stricter Hospital Empanelment
Specific guidelines have been developed for hospital empanelment under AB-PMJAY, mandating physical verification of hospitals. Public hospitals with inpatient services are automatically deemed empanelled. The National Health Authority (NHA) has launched an upgraded Hospital Engagement Module (HEM 2.0) that requires physical verification for private hospitals, including the submission of original photographs, latitude-longitude details, and information about the physical verifier to confirm the visit. HEM 2.0 also allows for periodic reviews to maintain accurate hospital information.
Robust Grievance Redressal System
Empanelled hospitals are obligated to provide services to eligible AB-PMJAY beneficiaries. A three-tier grievance redressal system (District, State, and National level) is in place to address beneficiary issues. Each level has a dedicated nodal officer and Grievance Redressal Committees.
Multiple Complaint Channels
Beneficiaries can file grievances through various channels: the web-based Centralized Grievance Redressal Management System (CGRMS), central and state call centers (14555), email, or by writing to State Health Authorities (SHAs).
Action and Penalties
Based on the nature of the grievance, appropriate action is taken, including supporting beneficiaries in accessing treatment. For fraudulent activities, SHAs can take stringent action against hospitals, such as de-empanelment, penalties, suspension, warning letters, and even lodging FIRs.
Focus on Transparency and Accountability
The stricter verification process aims to ensure that empanelled hospitals meet the required standards and are capable of providing quality care. The multi-channel grievance system empowers beneficiaries to easily raise concerns and ensures that their voices are heard. The potential for strong penalties against errant hospitals further reinforces the focus on providing quality and ethical healthcare services under the scheme.
