Chhattisgarh has been declared the “best state” in the Pradhan Mantri Jan Arogya Yojana (PM-JAY). The state excelled at the national level with zero pendency, transparent claim processing and active cooperation of hospitals.
Raipur. Chhattisgarh has been declared the “Best Performing State” for its excellent work and excellent performance in ensuring zero pendency under the Pradhan Mantri Jan Arogya Yojana (PM-JAY).
This honor was presented by Mr. Sunil Kumar Burnwal, CEO of National Health Authority (NHA) to Chief Executive Officer of State Nodal Agency (SNA) Dr. Priyanka Shukla and Project Director (Operations) Mr. Dharmendra Gahwai during the NHA Conclave held in Bhopal.
This achievement is the result of sustained efforts by the State Nodal Agency to increase transparency, efficiency and accountability in health services.
Initiative of Chief Minister Vishnudev Sai: Planning became primary agenda
Ayushman Bharat Yojana (PM-JAY) was included as a major agenda for the first time in the recently held Collectors Conference chaired by Chief Minister Shri Vishnudev Sai.
He directed all Collectors to regularly review the scheme in their districts, thereby improving the pace of implementation and monitoring.
Major initiatives and reforms of Chhattisgarh
The State Nodal Agency took several strong steps in recent months-
- Identification of suspicious claims and comprehensive field audit
- Significant reduction in claim processing time (TAT)
- Sensitivity training of all stakeholders
- Strong formation of State Anti Fraud Unit (SAFU)
- Regular communication with empaneled hospitals (EHCPs)
The number of doubtful claims was found to be relatively high in the NHA review meeting in January 2025. After this, the state nodal agency immediately made a quick action plan and took effective action on it.
Big step towards strict action and transparency
During January-February 2025, the Health Department team conducted surprise inspection of 52 hospitals across the state. Punitive action was taken against 45 hospitals for not adhering to the scheme’s standards – the largest ever. Also, field audits were conducted in over 32,000 cases, thereby preventing fraudulent claims and making the claim settlement process more transparent.
Intensive review system at district and state level
PM-JAY was made the main agenda in the quarterly review meeting of Chief Medical Officers held under the chairmanship of Health Secretary Shri Amit Kataria. Other than this-
- Monthly review meetings of the districts started under the leadership of Dr. Priyanka Shukla, CEO of the State Nodal Agency.
- A new system was developed to send daily feedback and guidelines to the districts based on daily achievements.
Continuous communication and cooperation with hospitals
Regular meetings are being held with representatives of the Indian Medical Association (IMA) and private hospitals to resolve the problems of the empaneled hospitals. Recently, stakeholder consultation was also held in the presence of NHA experts, in which the challenges of hospitals were discussed, suggestions were collected and information about new processes was given.
Drastic decline in doubtful claims and faster claim approval
Due to the continuous efforts of the Health Department, there has been a huge decline in the number of suspicious claims. Where earlier more than 2,000 suspicious claims were filed per week, this has now dropped to less than 500. Also, the claim approval time has now reduced to just 7 to 10 days.
97% hospitals active, becoming a national example
According to National Health Authority (NHA) data, 97% of hospitals in Chhattisgarh are active under PM-JAY – a testament to the trust hospitals have in the scheme. Comparatively, this rate in Madhya Pradesh is 62% and the country’s average is only 52%.
Health Minister’s praise and further direction
Health Minister Shri Shyam Bihari Jaiswal congratulated the Health Department for this achievement. He said that PM-JAY is now the main agenda of review meetings of all districts, and the progress is being reviewed every month at the state level.
The goal of the state government is to provide quality, free and respectable health care to all eligible families of Chhattisgarh. The Minister said that Chhattisgarh has proved its efficiency and commitment at the national level by making significant improvements in the health sector in a short time.
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