New Delhi, Mar 12 (PTI) A parliamentary committee has recommended that the age criterion of 70 years and above for Ayushman Vay Vandana Cards should be rationalised to 60 years and above irrespective of the people's socio-economic status in order to widen the coverage of the Ayushman Bharat health insurance scheme.

Keeping in view the huge expenditure on critical healthcare, the Department-related Parliamentary Standing Committee on Health and Family Welfare in its 163rd report presented in Rajya Sabha on Wednesday also recommended revising healthcare coverage from the existing Rs 5 lakh per family per year to Rs 10 lakh per family per year.

It also pointed out that several high-end interventions/procedures and even high-end diagnostics are not included in Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana (AB-PMJAY).

The panel thus recommended that the number of packages/procedures covered under the Yojana should be reviewed and the fresh packages/procedures related to treatment of critical illness with high cost of treatment and expensive high-end investigations/diagnostics like radiological diagnostics (CT, MRI and imaging including nuclear imaging) be incorporated in AB-PMJAY instead of leaving the same to be booked as add-on packages.

The committee appreciated that the government has recently expanded the AB-PMJAY to cover six crore senior citizens of age 70 years and above belonging to 4.5 crore families under the Vay Vandana scheme, irrespective of their socio-economic status.

An amount to the tune of Rs 1,443 crore has been earmarked for the treatment of senior citizens of the age of 70 years and above holding Ayushman Vay Vandana Cards.

"The Committee is of the view that the age criteria of 70 years and above for Ayushman Vay Vandana Cards should be rationalised to 60 years and above irrespective of their socio-economic status for widening the coverage of the scheme in the better interest of common masses," the panel said in its report.

The committee, however, pointed out a persistent trend of underutilisation of allocated funds, particularly in the previous year as well as in the current financial year.

It stated that the AB-PMJAY is a pivotal and visionary health initiative aiming to provide financial protection and healthcare access to a large number of India's vulnerable population.

While the scheme has seen substantial growth in terms of state participation, card creation and hospital admissions, several key areas require attention like budget utilisation and state participation.

The committee observed that in the FY 2023-24, Rs 7,200 crore was allocated as budget estimates (BE) 2023-24 which was reduced to Rs 6,800 crore at revised estimates (RE) stage, however, the actual expenditure was Rs 6,670.47 crore.

In 2024-25, Rs 7,300 crore was made in BE 2024-25 which was revised to Rs 7,605.54 crore at RE 2024-25, however, the actual expenditure was to the tune of Rs 5,034.03 crore till January 9.

In 2025-26, the enhanced amount of Rs 9,406 crore has been allocated as BE 2025-26.

This indicates potential inefficiencies in fund disbursement or implementation bottlenecks. The committee, therefore, recommended a thorough review of the fund release mechanisms to states and Union Territories (UTs). This review should focus on identifying and eliminating bottlenecks that contribute to underutilisation.

The department should implement a system of proactive monitoring of fund utilization by states, coupled with targeted support to address any implementation challenges.

Furthermore, the committee suggested that the release of funds be linked to the performance of states in terms of card creation, hospital admissions and beneficiary feedback, ensuring that funds are directed to areas of greatest need and impact.

Underlining that besides the large number of empanelled hospitals and issuance of cards, the crucial factor for its successful implementation is public awareness and recommended a focused campaign, high-level engagement with the respective state governments, addressing their specific concerns and highlighting the benefits of the scheme for their populations.

The department should intensify its efforts to enhance beneficiary awareness, particularly in rural and underserved areas. This can be achieved through targeted information, education and communication (IEC) campaigns, utilising local languages and community-based approaches.

Leveraging ASHA and Anganwadi workers, as well as digital platforms, to disseminate information and facilitate card creation is crucial.

A dedicated helpline and easily accessible grievance redressal mechanism should also be established to address beneficiary concerns promptly.

The committee also highlighted instances of delay in the settlement of claims of empanelled hospitals under AB-PMJAY and that the package rates have not been reasonably revised in many states resulting into inconvenience caused to the patients due to denial of treatment by many empanelled hospitals.

The committee thus stated that states and UTs which have not revised the package rates may be persuaded by the department to revise the package rates on the similar lines of rates revised by some of the states in 2022.

In addition, the committee recommended that the ministry review and streamline the process related to the settlement of claims submitted by the empanelled hospitals within the specified time. PTI PLB KSS KSS