The Union Minister of State for Health and Family Welfare Prataprao Jadhav, informed the Rajya Sabha that the Government of India has developed specific guidelines for hospital empanelment under the Ayushman Bharat - Pradhan Mantri Jan Arogya Yojana (AB-PMJAY). These guidelines mandate physical verification of hospitals at the time of empanelment. As per the regulations, public hospitals with inpatient services are automatically deemed empanelled.

To streamline and enhance hospital engagement, the National Health Authority (NHA) has introduced an upgraded version of the Hospital Engagement Module (HEM 2.0). This system requires private hospitals to undergo physical verification, including the submission of original photographs, geographical coordinates, and the presence of a verifier to confirm the visit. HEM 2.0 also incorporates a periodic review feature to ensure hospital data remains accurate and up to date.

Under the AB-PMJAY scheme, empanelled hospitals are obligated to provide healthcare services to eligible beneficiaries. If a hospital fails to deliver services under the scheme, beneficiaries have the right to lodge grievances. A three-tier grievance redressal system has been established at the district, state, and national levels to address complaints. Dedicated nodal officers and grievance redressal committees are available at each level to ensure prompt resolution.

Beneficiaries can file complaints through multiple channels, including the Centralized Grievance Redressal Management System (CGRMS), state and central call centers (14,555), email, and official letters to State Health Authorities (SHAs). Based on the nature of grievances, appropriate action is taken to assist beneficiaries in availing treatment under the scheme.

Additionally, stringent measures have been put in place against fraudulent entities. State Health Authorities have provisions to impose penalties, suspend hospitals, issue warning letters, initiate de-empanelment, or even lodge FIRs against errant hospitals. This multi-faceted approach ensures that beneficiaries receive proper medical care while maintaining the integrity of the AB-PMJAY program.