Ayushman Bharat scheme: Haryana govt releases funds, restarts payments to private hospitals

Time of India

3 days ago

Gurgaon: Days before 650 private hospitals in Haryana were set to withdraw from Ayushman Bharat services over dues, State Health Agency (SHA) on Tuesday announced that fresh budgetary funds were released by the Haryana govt and claim payments have been restarted.
SHA, which said payments to empanelled hospitals had been initiated on Aug 4 on a first-in-first-out (FIFO) basis, also urged stakeholders "not to disrupt services". On July 28, Haryana chapter of Indian Medical Association (IMA) issued a letter, which warned of halting services under the Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) from Aug 7, citing long-pending dues and claim rejections.
In a statement, the SHA said, "We remain committed to ensuring transparency, timely disbursement of payments and strengthening public-private partnerships under Ayushman Bharat.
We urge all stakeholders to sustain their collaborative efforts to serve the people of Haryana."
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Since the launch of the scheme, Rs 2,900 crore was disbursed to hospitals, including Rs 240.6 crore released this financial year up to mid-July, SHA said. Claims up to the first week of May 2025 were already processed and paid, SHA officials said.
However, the private hospitals still plan to withdraw from the scheme starting Aug 7 if their dues aren't cleared to satisfaction, even as hospitals say "months of claims remain unpaid".
Former president of IMA (Haryana) Dr Ajay Mahajan said, "We are still going to withdraw the services from Aug 7. All Ayushman empanelled hospitals of Haryana are unable to function as all payments are not cleared. The responsibility of any inconvenience caused to the poor people of Haryana will lie completely on the shoulders of the govt of Haryana, which is neither providing adequate budget nor smoothening the process of this scheme.
" Meanwhile, SHA said the claims are processed by a 50-member team of doctors via the NHA's online platform, with case allocation done randomly to ensure "impartiality".
"All deductions follow NHA guidelines and are made only when supporting documents like vital charts, OT notes, or diagnostic reports are missing. Hospitals are given the opportunity to appeal against such deductions, which are reviewed by a medical audit committee," SHA said.
SHA also acknowledged concerns raised over delayed payments and non-processing of claims.
Over 400 grievances from hospitals were formally resolved through the CGRMS 2.0 portal, it said, adding that more training sessions will be held to help hospitals use the system effectively.
As regards another long-standing issue, the SHA said hospitals that earlier received approval for NABH (National Accreditation Board for Hospitals & Healthcare Providers) incentives through the HEM 1.0 portal will remain eligible as long as their certificates are valid. Fresh applications must now be submitted through the HEM 2.0 portal. The agency said Haryana is the first state to include IMA representatives in both district-level and state-level medical audit and grievance redressal committees.