Sources revealed that this issue extends beyond Haryana, with similar concerns about delayed payments being raised by hospitals and healthcare centers in other states, including Uttar Pradesh, Chhattisgarh, Madhya Pradesh, Maharashtra, and Uttarakhand. Reports of patients being denied admission under the PM-JAY health cover are said to be growing.

According to sources who requested anonymity, numerous patients have been denied treatment, raising concerns about the ability of hospitals and beneficiaries to fully avail the benefits guaranteed under the scheme.

Dues amount to ₹400 crore for the last three months

Meanwhile, Dr. Mahaveer P. Jain, President of the IMA Haryana Branch, told CNBC-TV18, “Dues amounting to ₹400 crore for the last three months are pending. This is in addition to several earlier dues that remain unpaid.”

An email query sent to the Union Health Ministry and the National Health Authority (NHA) on the matter remained unanswered.

Dr Jain, voicing the demands of hospitals, said, “Empanelled hospitals in Haryana have approached us to act on their behalf and inform you that if the following demands are not met soon, they will be forced to suspend Ayushman Bharat services from February 3.”

He also highlighted additional demands from the hospitals, including: “All pending dues to be cleared immediately. Proper allocation of nearly ₹2,000 crore should be made for this scheme separately” from state allocation. Interest on delayed payments should be calculated as per MoU and to be paid to all concerned hospitals.”

In Haryana, approximately 1,300 hospitals are empanelled under Ayushman Bharat, of which 600 are private facilities.

Ayushman Bharat scheme

Ayushman Bharat, a flagship scheme of the Government of India, was launched following the recommendations of the National Health Policy 2017 to achieve the vision of Universal Health Coverage (UHC).

The government claims that Ayushman Bharat PM-JAY is the largest health assurance scheme in the world, providing health cover of ₹5 lakh per family per year for secondary and tertiary care hospitalisations. The scheme aims to benefit over 12 crore poor and vulnerable families, accounting for approximately 55 crore beneficiaries, which form the bottom 40% of India’s population.

The eligible households are determined based on deprivation and occupational criteria outlined in the Socio-Economic Caste Census (SECC) 2011 for rural and urban areas, respectively.

Previously known as the National Health Protection Scheme (NHPS), PM-JAY was renamed and subsumed the Rashtriya Swasthya Bima Yojana (RSBY), which was launched in 2008. The coverage under PM-JAY includes families that were part of RSBY but are not present in the SECC 2011 database. The scheme is fully funded by the government, with implementation costs shared between the central and state governments.