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New Indian Express
01-07-2025
- Health
- New Indian Express
Private hospitals seek 1 per cent interest on delayed Ayushman scheme reimbursements
NEW DELHI: Over two months after its formal launch, the Ayushman Bharat scheme is struggling to gain traction among the city's private hospitals. Major healthcare institutions such as Fortis, Gangaram, Max, Apollo, and BLK continue to stay away from the scheme, citing unresolved legacy issues, including low reimbursement rates and persistent delays in payments. Since its rollout on April 10, only 26 new healthcare facilities have joined the scheme. Officials have confirmed that, of the total 93 empanelled hospitals, 67 were already conducting procedures prior to the formal launch. With more than 1,200 private hospitals operating in the capital, the numbers reflect a lack of enthusiasm that healthcare experts attribute to both structural and financial shortcomings. In a letter to the Delhi government, the Association of Healthcare Providers of India (AHPI) has demanded amendments to the scheme's terms. The body, representing a large section of private hospitals, has urged the government to include a clause for 1 percent interest on bills that remain unpaid beyond 30 days. According to them, the demand is aimed at ensuring accountability among officials responsible for processing reimbursements. 'If the government assures payments within a month, mid-size hospitals can consider joining. But for larger hospitals, the current rates are simply not viable. If payments are delayed, a 1 percent interest must be added to compel timely disbursement and maintain pressure on officials,' said Dr Girdhar J Gyani, Director General of AHPI. Doctors also pointed out that the scheme's reimbursement rates are just 30 to 40 per cent of prevailing market costs and are even lower than the Central Government Health Scheme (CGHS) rates, which have not been revised since 2014. Many hospitals have also flagged pending dues under the Delhi Arogya Kosh (DAK) scheme introduced by the previous AAP government. 'My payment of `60 lakh is still stuck under DAK,' said Dr Narin Sehgal, owner of Sehgal Neo Hospital. He said the compensation offered under the Ayushman Bharat scheme barely covers operating costs. 'The government must act promptly to release outstanding dues if it expects the participation of private hospitals. Past experiences in other states show how delayed payments have hampered implementation, and Delhi seems no different,' added Sehgal, who also serves as Secretary of the AHPI's Delhi Chapter.
Time of India
19-05-2025
- Health
- Time of India
Why pvt hosps are hesitant in joining cashless health scheme
New Delhi: More than 50 private and 15 Delhi govt hospitals have enrolled under the State Health Authority (SHA) to provide cashless treatment to patients under Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY). However, many private facilities are reluctant to join the scheme over concerns of low rates being offered by govt. Most private healthcare facilities previously registered with AB-PMJAY through the National Health Authority (NHA) during the previous AAP regime were automatically transferred to city authority oversight. However, several prominent private hospitals raised issues regarding AB-PMJAY reimbursement rates, stating these do not adequately cover treatment expenses and could lead to financial deficits. While smaller healthcare facilities might find the scheme workable, larger hospitals consider it financially unviable due to substantial operational expenses, including infrastructure and advanced medical equipment. Clarifying why corporate and larger hospitals are reluctant to participate, Dr Sunil K Khetarpal, director, Association of Healthcare Providers India (AHPI), cited inadequate package rates for advanced medical procedures. He also highlighted concerns about delayed payments reported in some states implementing this scheme. AHPI, representing about 15,000 private hospitals, including Fortis, Max Healthcare, Manipal, Medanta, Narayana and Apollo, has sought discussions with Delhi govt to address these concerns. Girdhar J Gyani, AHPI's director general, has written to chief minister Rekha Gupta, stressing the necessity of establishing a dedicated grievance redressal system and accelerating reimbursements process under Delhi's recent inclusion in AB-PMJAY. Dr Narin Sehgal, medical director, Sehgal Neo Hospital, and AHPI secretary, Delhi, acknowledged the scheme's significance as the largest health insurance programme. He noted widespread hesitation in enrolment and suggested reconsideration of rates by govt and timely payments, citing issues with similar schemes, like CGHS. Despite AHPI's intervention and NHA's promises to revise the rates, the adjustments remained selective and insufficient, said Dr Sehgal. On April 5, Delhi govt entered an agreement with the Centre to implement AB-PMJAY, with card distribution beginning April 10. Very few private hospitals joined afterwards. CM Gupta said Delhi govt will cover 2,35,000 families in the first phase. Currently, 67 out of over 1,000 Delhi hospitals are participating in the scheme. Govt facilities include Lok Nayak, Deep Chand Bandhu Hospital, Rajiv Gandhi Super Specialty Hospital and Delhi State Cancer Institute while private participants include Dharamshila Narayana Superspeciality Hospital, Metro Hospital & Cancer Institute and Sri Balaji Action Medical Institute. Most of the empanelled private hospitals are in New Delhi district and are dedicated to eye care, general surgery, oncology, obstetrics and gynaecology. The scheme offers free treatment covering 1,961 medical procedures across 27 specialities, including medicines, diagnostics, hospitalisation, ICU care and surgeries.
