Chhattisgarh Tops Nation In PM-JAY Efficiency, Achieves Zero Pendency In Claims
National Health Authority data says 97% of the hospitals registered under PM-JAY in Chhattisgarh are active, a testament to the hospitals' confidence in the scheme.
Published : October 16, 2025 at 8:04 PM IST
Raipur: Chhattisgarh has topped among states in terms of performance in the Pradhan Mantri Jan Arogya Yojana (PM-JAY), ensuring zero pendency in claims. The nodal agency's chief executive officer, Dr Priyanka Shukla, and project director (operations), Dharmendra Gahwai received the award by National Health Authority (NHA) CEO Sunil Kumar Barnwal during the NHA Conclave held in Bhopal on Wednesday.
The role of the state was specifically mentioned for achieving near-zero claim pendency, indicating a highly efficient system for processing claims. The officials attribute the success to the state government's stress on the timely execution of project work and effective monitoring by Chief Minister Vishnu Deo Sai. The Chief Minister at the recent Collectors' Conference had also directed all collectors to conduct regular reviews of the scheme in their districts.
Key initiatives by Chhattisgarh government
The state nodal agency has taken several robust measures in recent months, including conducting comprehensive field audits to identify suspicious claims, significantly reducing the turnaround time (TAT) for processing, providing orientation and sensitivity training to all stakeholders, establishing a State Anti-Fraud Unit team, and mantaing regular communication and coordination mechanisms with empanelled healthcare providers (EHCPs).
A review meeting by the NHA in January found a relatively high number of suspicious claims in Chhattisgarh. To address this situation, the nodal agency chalked out and implemented an immediate action plan.
Strict action and transparency
The health department team conducted surprise inspections of 52 hospitals across the state between January and February. Penal action was taken against 45 hospitals for non-compliance with the scheme's standards.
Additionally, field audits were conducted in over 32,000 cases, preventing fraudulent claims and making the claim settlement process more transparent.
Intensive district and state-level reviews
Hospitals were re-inspected in all districts in the state as directed by the health secretary Amit Kataria. PM-JAY was a key agenda item at the quarterly review meeting of Chief Medical Officers, chaired by Kataria. Monthly district review meetings were initiated under the leadership of the nodal agency CEO, and a system was developed to provide daily feedback and guidelines to districts based on daily achievements.
Continuous communication with hospitals
The state authorities ensured regular meetings with representatives of the Indian Medical Association and private hospitals to address issues faced by empanelled hospitals. Recently, a stakeholder consultation was held in the presence of NHA experts, where hospital issues were addressed, suggestions were solicited, and they were briefed on the scheme's procedures.
As a result of these efforts by the Health Department, the number of suspicious claims declined significantly. Previously, over 2,000 suspicious claims were filed per week. Now, it has dropped to less than 500. Claim approval time has now decreased to only 7–10 days.
'97% hospitals active'
According to data from the National Health Authority, 97% of the hospitals registered under PM-JAY in Chhattisgarh are active, a testament to the hospitals' confidence in the scheme. In contrast, this rate is only 62% in neighbouring Madhya Pradesh, and the national average is only 52%.
Health minister Shyam Bihari Jaiswal, while congratulating health department officials for this achievement, said PM-JAY has been included as a key agenda item in all district review meetings.
Monthly reviews are also held at the state level with districts to assess the progress of the scheme. The state government's goal is to ensure that all eligible families in the state have access to quality, free, and respectful healthcare, officials said.
Jaiswal said Chhattisgarh has achieved significant improvements in the health sector in a short period of time, earning recognition for its efficiency and commitment at the national level.
Read more
