PMJAY (Ayushman Bharat) Procurement

PMJAY (Pradhan Mantri Jan Arogya Yojana) procurement refers to the empanelment process and associated health benefit packages under Ayushman Bharat, India's national health protection scheme covering 55 crore economically vulnerable citizens with Rs 5 lakh per family per year for hospitalisation, creating a large structured healthcare market for empanelled hospitals.

What is PMJAY Procurement?

PMJAY, implemented by the National Health Authority (NHA) under MoHFW, operates by empanelling public and private hospitals (called Health Care Providers or HCPs) and fixing package rates for 1,929 defined health benefit packages covering medical, surgical, and day-care procedures.

From a healthcare market perspective, PMJAY empanelment involves:

• Empanelment criteria: NABH accreditation (or state equivalent quality standard), minimum bed strength, specialist availability, functional OT and ICU for relevant specialities
• Rate structure: NHA fixes all-inclusive package rates per procedure; empanelled hospitals must accept these rates for PMJAY beneficiaries
• Pre-authorisation: hospitals request digital pre-authorisation from state health agencies before planned procedures
• Claim settlement: digital claim submission, settlement within 15-30 days

Unlike CGHS (which covers central government employees), PMJAY covers Below Poverty Line (BPL) and vulnerable populations identified through Socio-Economic Caste Census. The scheme runs through State Health Agencies (SHAs) in most states.

From an equipment and consumables procurement angle, hospitals seeking PMJAY empanelment must demonstrate functional infrastructure, creating secondary demand for medical equipment tenders as hospitals invest in upgrade to meet empanelment criteria.

NHA also issues tenders directly for IT systems (beneficiary identification, pre-authorisation portals, fraud detection platforms) serving the scheme's digital backbone.

Why PMJAY matters for Indian government suppliers

PMJAY has created a large structured market for quality-certified hospitals and healthcare providers in Tier 2 and Tier 3 cities previously underserved by private healthcare. For medical equipment companies, PMJAY's quality requirements drive equipment upgrade procurement at district hospitals and smaller private hospitals entering the scheme.

Example

A multi-speciality hospital in a Tier 3 city seeks PMJAY empanelment to access the beneficiary volume. To meet empanelment criteria, it needs to upgrade its ICU with ventilators and patient monitors. The hospital issues a tender for five ICU ventilators and 15 bedside patient monitors. After procurement and installation, it applies for PMJAY empanelment, which is granted within 45 days.

Frequently Asked Questions

How many procedures does PMJAY cover?

PMJAY covers 1,929 Health Benefit Packages (HBPs) across 27 speciality groups including cardiology, oncology, orthopaedics, neurosurgery, and paediatrics. Each package has a fixed all-inclusive rate covering hospitalisation, drugs, consumables, and surgeon fees.

Are private hospitals eligible for PMJAY empanelment?

Yes. Both public and private hospitals can be empanelled. As of 2024, over 27,000 hospitals are PMJAY-empanelled nationwide, approximately 40% private. Private hospitals in Tier 2 and 3 cities gain significant patient volume through PMJAY.

What digital technology contracts does NHA issue?

NHA issues tenders for beneficiary database management, claim processing software, fraud detection systems, hospital management system integrations, and mobile applications. These are procured through CPPP under NHAs IT budget, using QCBS for complex technology contracts.

Can healthcare equipment suppliers benefit from PMJAY indirectly?

Yes. PMJAY empanelment criteria require minimum equipment standards in hospitals. As smaller hospitals upgrade to meet empanelment requirements, they drive equipment procurement. Medical equipment companies targeting this segment market their products specifically to PMJAY-aspirant hospitals.