Deficiencies in rollout of Ayushman & Awas schemes in Bihar: CAG
PATNA, Feb. 27 -- The Comptroller and Auditor General of India( CAG) has flagged several deficiencies in the implementation of two pivotal schemes -- Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) and Pradhan Mantri Awaas Yojana- Gramin (PMAY-G) -- in its performance audit of the two schemes for the year 2025, which was placed by finance minister Bijendra Prasad Yadav in the state assembly on Thursday.
The PMJAY is a centrally sponsored scheme, which is funded by the government, and the funding is shared between the Centre and state governments. It provides health coverage up to Rs.5 lakh per family per year.
In its performance audit of AB-PMJAY, the CAG has noted that a total of 12.1 million poor and vulnerable households including 61.8 million beneficiaries were to be covered under the scheme as per revised target ( January 2022) but in reality only 25.6 million beneficiaries (41%) were verified by the state as of March 31, 2024.
The report says that at least 595 villages in the state were deprived of the scheme's intended benefits.
Another point red-flagged by the CAG on implementation of the PMJAY is the delay in empanelment of private hospitals, ranging from one to more than 200 days. During the audit, it was found that out of 1,005 hospitals empanelled under the scheme in the state, 226 hospitals (22%) were shown as inactive, as they did not start pre-authorisations for treatment of the scheme beneficiaries during the last three months (June 9, 2024 to September 9,2025).
Also, the CAG has found that there were big delays in processing of claims and deficiencies in claims management. The CAG has said that out of 14,015 rejected pre-authorisations, 8,371 cases (60%) amounting to Rs.12.20 crore, were rejected by pre-authorisation panel doctors (PPD) due to reasons such as delay in initiation of pre-authorisation, wrong selection of package and non-compliance with queries on the part of PMAM/ medical coordinator( MEDCO), resulting in denial of treatment benefits to beneficiaries.
Processing of claims of 'same state' ( beneficiary got treatment in his.her home state) cases took one day to 1,821 days while and portability cases ( beneficiary got treatment under scheme outside his /her home state) took one day to 1,662 days against the stipulated time of 15 days and 30 days, respectively.
The CAG has observed that there should be more focus on IEC activities, adherence to the prescribed threshold limit during the verification of beneficiaries and taking additional Information Education Communication (IEC)s activities at the grass root level of the gram panchayat, ensure processing of application for empanelment of hospitals within the prescribed timeline , expedite claim payments as per stipulated turnaround time, etc, so that the implementation of the scheme is more robust.
The Pradhan Mantri Awaas Yojana-Gramin (PMAY-G) was launched on 1 April, 2016 to provide pucca houses, with basic amenities, to all poor rural households, especially those households who have been living in kutcha and dilapidated houses, by the year 2022. The Government of India further extended (September 2022) the target of housing for all to be achieved by March 2024.
In its performance audit report for the scheme, the CAG has said that against the 3.067 million houses sanctioned as of March 2024 from 2017-18, construction of 2.894 million (94%) had been completed during fiscal years 2017-24.However, the percentage of completion of houses consistently declined from 97% (in FY 2017-18) to 89% (in FY 2021-22), primarily due to delays in release of funds.
The CAG , in its audit, also detected shortcomings in providing house units under PMAY-G to landless beneficiaries, highlighting how the number of landless beneficiaries was not ascertained in the permanent waiting list (PWL). The report said that though a provision had been made under Mukhymantri Vaas Stal Kray Sahayata Yojana ( MVSKSY) for purchasing land for landless beneficiaries for which a sum of Rs.120 crore and Rs.50 crore was provided in FY 2018-19 and 2019-20, the rural development department fixed a target of 20,000 landless beneficiaries , for the FY 2018-19 under the scheme. "There after, no targets were fixed under this scheme and the department subsequently surrendered (March 2020), Rs.50 crore out of the funds received under the scheme," the report said.
Besides, the CAG report said that out of 20,000 targeted landless beneficiaries (as per information provided by the RDD ( November 2022), only 3,462 (17%) beneficiaries had received assistance for purchase of land under MVSKSY and only 2,935 (15%) beneficiaries had been sanctioned houses under the PMAY-G. In its report, the CAG has observed that there is need for ensuring proper verification of beneficiaries, including IT application to detect incorrect and irregular payments of assistance and initiate system improvement to ensure that there are no delays in release of funds to beneficiaries and eligible beneficiaries should not be deprived of the scheme benefit....
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