Eight Committees Set Up to Strengthen Implementation of Ayushman Bharat in Delhi
Introduction
In a significant administrative move aimed at expanding access to affordable healthcare, the Government of Delhi has formed eight specialized committees to facilitate the implementation of the Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana (AB-PMJAY). Delhi, which was among the last states/UTs to join the scheme, has now started forming institutional mechanisms to carry out empanelment, monitoring, and grievance redressal processes efficiently.
This update is not only important for CLAT 2026 aspirants studying general knowledge and current policy but also presents a strong real-life example of how public policy and governance function at the grassroots level—topics often explored in legal reasoning and current affairs questions. As part of the curriculum at CLAT Gurukul—the Best CLAT Coaching in Patna and provider of best online coaching for CLAT—such topics are regularly integrated into reading comprehension sets, critical reasoning exercises, and essay writing.
Why in News?
As Delhi begins implementing the AB-PMJAY, the Department of Health & Family Welfare has set up a state empanelment committee and seven other district and functional committees to manage empanelment, monitor fraud, handle grievances, and supervise service utilization under the scheme. The formation of these bodies marks a crucial step in operationalizing India’s largest health assurance program in the national capital.
Point-wise Summary of the Article
- About Ayushman Bharat (AB-PMJAY):
- A flagship healthcare insurance scheme by the Government of India.
- Provides free and cashless treatment for up to ₹5 lakh per family per year.
- Covers 1,961 medical procedures across 27 specialties, including surgeries, hospitalization, ICU care, medicines, and diagnostics.
- Delhi’s Status:
- Delhi is the 35th state/UT to start implementing the scheme.
- The government has now initiated the empanelment of healthcare service providers under AB-PMJAY.
- State Empanelment Committee:
- Headed by the AB-PMJAY CEO.
- Responsible for:
- Overseeing the hospital empanelment process.
- Ensuring verification of hospitals and providers.
- Managing disciplinary proceedings related to service quality.
- District Empanelment Committees:
- To be formed in all 11 districts of Delhi.
- Will ensure:
- Timely registration of hospitals.
- Addressing rejection or delay of hospital applications.
- Supporting the State Health Agency in decision-making.
- District Implementation Committee:
- Headed by the local MLA and district magistrate.
- Tasks:
- Oversee awareness campaigns.
- Support empanelment and monitoring of hospitals.
- Promote beneficiary participation.
- Handle grievance management and beneficiary enrollment.
- State Grievance Redressal Committee (SGRC):
- Deals with grievances escalated beyond the district level.
- Final authority for beneficiary-related complaints.
- State Anti-Fraud Cell:
- Investigates frauds and anomalies under the scheme.
- Assists in blocking/de-empaneling hospitals engaged in malpractices.
- State Claim Review Committee (CRC):
- Reviews claims denied or partially settled by insurance agencies.
- Performs audit checks on 2% of pre-authorizations and 5% of claims each quarter.
- State Medical Committee:
- Evaluates Unspecified Surgical Packages (USP).
- Grants approval to medical procedures not clearly defined in PMJAY’s list.
- State Appellate Authority:
- Reviews escalated complaints from the SGRC.
- Final appeal body for unresolved grievances under the scheme in Delhi.
Explanatory Notes (Key Terms):
Term | Meaning / Explanation |
Empanelment | Registration and approval of hospitals or service providers to offer services under a scheme. |
Unspecified Surgical Package (USP) | Medical procedures not listed under the official scheme; need special approval. |
District Magistrate | Administrative head of a district in charge of governance and public welfare. |
AB-PMJAY | Health assurance scheme providing insurance coverage for secondary and tertiary healthcare. |
Grievance Redressal | Formal process of addressing complaints from patients or hospitals. |
Importance for CLAT 2026 Aspirants
This topic is highly relevant for CLAT preparation due to the intersection of law, public policy, and governance:
- Constitutional Relevance:
- Article 21 – Right to Life includes the right to health, as interpreted in multiple Supreme Court judgments.
- Directive Principles (Article 47) – Obliges the state to improve public health.
- Legal Reasoning:
- Questions can be asked about procedural fairness in empanelment, authority hierarchy in grievance redressal, and fraud detection in public schemes.
- Reading Comprehension:
- Government schemes like AB-PMJAY often appear as passage sources.
- This case has layered administrative structure, perfect for tone, assumption, inference, and role of different actors type questions.
- Current Affairs Utility:
- Students should track updates about national schemes.
- Could be part of CLAT GK/Legal GK, particularly under social justice or healthcare policy.
Conclusion
The operationalization of Ayushman Bharat in Delhi through the formation of eight specialized committees reflects a structured, multi-tiered governance model aimed at ensuring transparency, quality, and accountability. For Delhi’s residents, this move could be transformative in terms of access to affordable, reliable, and accessible healthcare services.
For CLAT aspirants, understanding such schemes helps in:
- Strengthening legal comprehension.
- Enhancing policy awareness.
- Practicing real-world application of legal doctrines.
At CLAT Gurukul, which offers the Best CLAT Coaching in Patna and best online coaching for CLAT, such topics are taught not only for exam success but also to inspire future lawyers to understand the role of law in society.
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