AB PM-JAY and ABDM implementation reviewed by Centre and States at national meeting

The National Health Authority (NHA), under the Ministry of Health and Family Welfare, Government of India, convened a two-day National Review Meeting in Kolkata on November 5–6, 2026, to review the progress of Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY) and the Ayushman Bharat Digital Mission (ABDM), and discuss priorities and strategies for strengthening their implementation in the coming phase.

The meeting brought together senior officials from States and Union Territories to review the implementation and progress of the two initiatives and discuss strategies for strengthening them in the coming years. The discussions provided a platform for the Centre and States to assess programme performance, share implementation experiences and identify measures to improve the reach, efficiency and impact of the initiatives.

The deliberations focused on expanding beneficiary coverage, strengthening healthcare delivery, ensuring financial protection and accelerating digital health adoption. The discussions also covered the use of technology, data analytics, automation and Artificial Intelligence (AI) to enhance operational efficiency, transparency, accountability and health outcomes.

Addressing the gathering, Dr. Sunil Kumar Barnwal, Chief Executive Officer, National Health Authority, highlighted the progress made by West Bengal following its integration with the national AB PM-JAY platform, with over four crore Ayushman Cards generated within a short span. He said the next phase of implementation must focus on translating coverage achievements into improved access to healthcare and health outcomes for beneficiaries.

“Every rupee spent on healthcare must lead to better care for our people. Technology, data and artificial intelligence can strengthen implementation, improve efficiency and support more informed decision-making. As we move forward, our focus must increasingly shift from financing treatment towards achieving better health outcomes for beneficiaries,” he said.

Speaking at the occasion, Shri Manoj Kumar Aggarwal, Chief Secretary, Government of West Bengal, highlighted the importance of strengthening primary healthcare alongside financial protection under AB PM-JAY. He said that while the scheme provides financial security to eligible families at the hospitalisation stage, a primary healthcare system is required for preventive care, early detection of diseases and reducing the burden on hospitals.

“Healthcare should never push a family into poverty. AB PM-JAY is a game changer in ensuring healthcare security for every eligible family. At the same time, strengthening primary healthcare is essential to reducing the burden on hospitals and improving health outcomes. West Bengal is committed to making the implementation of the scheme robust, comprehensive and people-centric,” he said.

Shri Narayan Swaroop Nigam, Principal Secretary, Department of Health and Family Welfare, Government of West Bengal, stated that West Bengal joined AB PM-JAY as the 36th State. Since the launch of the scheme in the State on August 16, 2026, 4.2 crore beneficiaries have been enrolled and 2.2 lakh people have received treatment under the scheme. He highlighted that AB PM-JAY and ABDM represent two pillars of healthcare transformation, bringing together financial protection and digital empowerment.

The inaugural session was attended by Shri Ashish Madhao Rao, Additional CEO, NHA; Shri Kiran Gopal Vaska, Joint Secretary and Mission Director, ABDM; Ms. Varnali Deka, Joint Secretary and Mission Director, ABDM, NHA; and Shri Sharad Dwivedi, CEO, State Health Agency, West Bengal, along with officials from NHA and representatives of participating States and Union Territories.

A key focus of the deliberations was ensuring that all eligible beneficiaries are covered under AB PM-JAY and informed about the benefits available under the scheme. The review also examined the progress of ABDM and ways to strengthen its adoption across healthcare facilities. The discussions emphasised coordinated implementation of the two initiatives to facilitate access to healthcare services, improve beneficiary experience and establish an integrated and patient-centric healthcare ecosystem.

The meeting also discussed claims processing and fraud prevention mechanisms under AB PM-JAY. A session on the National Anti-Fraud Unit (NAFU) and auto-adjudication examined the use of automation in claims settlement, including its impact on processing timelines, operational costs and the quality of adjudication. The discussions highlighted the importance of regular fraud reviews, monitoring mechanisms and strengthening the institutional capacity of State Anti-Fraud Units to ensure transparency and accountability in the implementation of the scheme.

The meeting reviewed the Model Digital Health Facility Framework and Tripura’s implementation experience. The discussions highlighted that digitisation of healthcare facilities requires the deployment of digital solutions, changes in institutional processes, workflow redesign and capacity building of healthcare personnel. Such integration is expected to strengthen ABDM-enabled workflows and ensure the availability of data for the implementation of AB PM-JAY.

The role of Artificial Intelligence in healthcare systems was also discussed. Prof. Phaneendra Yalavarthy, TANUH, IISc Bengaluru, presented the Benchmarking Open Data Platform for Health AI (BODH), which enables the evaluation and benchmarking of health AI models using Indian datasets. States were encouraged to use the platform to assess the performance and suitability of AI solutions before adoption and incorporate BODH-based benchmarking into their healthcare AI procurement processes.

The meeting also reviewed the operationalisation of the National Health Claims Exchange (NHCX), highlighting the importance of ABDM-enabled Hospital Information Systems for its integration across AB PM-JAY empanelled hospitals. Greater integration by hospitals and digital solution providers was identified as a requirement for expediting claims processing and improving the accuracy and quality of claims adjudication.

Further, the Health Analytics and Artificial Intelligence Unit (HAAU) presented its findings on data quality. The discussions highlighted the need to strengthen institutional capacity for data analytics and evidence-based decision-making, with States committing to establish dedicated analytics and AI teams to support planning and targeted interventions.

On the second day, the deliberations focused on health financing models, convergence of health schemes, ease of digital integration and cybersecurity. Dr. Darez Ahamed, Secretary, Health and Family Welfare, Government of Tamil Nadu, shared the State’s experience in implementing insurance and assurance models of health coverage. The discussion highlighted the importance of aligning the choice of health coverage model with the nature of risks being addressed, supported by ring-fenced funds and timely payments to hospitals.

The session on convergence explored the scope for States to use NHA’s IT platform to implement their respective health schemes. The platform’s existing health benefit packages, empanelled hospital network and fraud-detection mechanisms were discussed as enablers for standardisation, implementation and monitoring of State health schemes.

A demonstration of Sandbox 2.0, enhanced with agentic AI capabilities, showcased the use of AI-assisted tools in simplifying and expediting ABDM integration. During the demonstration, an ABDM Milestone 1 integration for ABHA creation was completed in real time, illustrating how AI can reduce the time and technical effort required for integration. The initiative is expected to facilitate the onboarding of technology partners and Hospital Information System providers, while reducing dependence on manual technical support.

Cybersecurity was also discussed in view of the information handled by national digital health platforms. The discussions examined potential threats, including phishing attacks, fraudulent URLs and applications, credential leaks and third-party vulnerabilities. States were advised to designate cybersecurity leads, strengthen authentication and access controls, and undertake security audits of applications and APIs to safeguard digital health infrastructure and health data.

The meeting also witnessed a demonstration of NHA’s Ambient AI-enabled Voice Scribe, a technology that converts doctor-patient conversations into structured clinical records in multiple Indian languages. The records are reviewed and approved by doctors before being linked to ABHA. The demonstration highlighted the potential of the technology to reduce the documentation burden on doctors, streamline clinical workflows and accelerate the digitisation of healthcare facilities.

The National Review Meeting concluded with a roadmap for the next phase of implementation of AB PM-JAY and ABDM. The deliberations reaffirmed the importance of Centre-State coordination, implementation mechanisms and the use of technology to translate the progress achieved under the two initiatives into benefits for citizens.

The discussions underscored that the next phase must focus on expanding coverage and digital adoption, ensuring access to healthcare, strengthening financial protection and improving health outcomes. Data, secure and interoperable digital systems, monitoring mechanisms and the adoption of emerging technologies will remain central to these objectives.

The two-day meeting comprised 15 sessions covering programme implementation, operational efficiency, digital health infrastructure and technological interventions.

The Ministry of Health and Family Welfare reiterated its commitment to working with States and Union Territories to strengthen the implementation of AB PM-JAY and ABDM and advance the vision of an accessible, affordable, efficient and people-centric healthcare system in the country.