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Hindustan Times
4 days ago
- Health
- Hindustan Times
Denial of treatment to Ayushman beneficiaries will invite strict action: Haryana State Health Authority
The Haryana State Health Authority (SHA) Friday said that pre-authorisation claims amounting to ₹2.5 crore were received from empanelled private hospitals across all districts of the state on August 7. The SHA stated that it has not received any grievances related to refusal of treatment to any Ayushman Bharat beneficiary across any grievance portals. In a statement the SHA said that 'several empanelled hospitals' have conveyed that they are not participating in the Indian Medical Association's (IMA) call to withdraw services from August 7 under the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY). The SHA further said that payments up to the first week of May 2025 have been cleared. 'Empanelled hospitals across the state have been reassured that all pending payments will be cleared at the earliest,' the SHA said, adding that all pending dues will be cleared in a timely and systematic manner. The SHA stated that it has not received any grievances related to refusal of treatment to any Ayushman Bharat beneficiary across any grievance portals. 'There is no valid reason for the withdrawal or disruption of services as all demands and issues have been addressed effectively. Any complaint or grievance regarding denial of treatment or imposition of charges on Ayushman beneficiaries will be dealt with strictly as per the guidelines issued by the National Health Authority (NHA) and the SHA,' the statement said.
The Print
4 days ago
- Health
- The Print
Empanelled hospitals not participating in IMA's call for Ayushman services suspension: Haryana govt
In Haryana, the IMA represents nearly 650 private hospitals empanelled under the Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana (AB-PMJAY), a flagship scheme of the Modi government that provides a health cover of Rs 5 lakh per family per year for secondary and tertiary care. The Haryana chapter of the Indian Medical Association (IMA) on Thursday announced the suspension of Ayushman Bharat scheme services in the state over the issue of pending dues of empanelled hospitals despite an assurance from the state government to release the payments at the earliest. Chandigarh, Aug 8 (PTI) A day after Haryana chapter of the Indian Medical Association announced the suspension of Ayushman Bharat scheme services, a government statement on Friday claimed that several empanelled hospitals have conveyed that they are not participating in the IMA's call. A state government statement here on Friday said that the State Health Authority (SHA) Haryana has informed that pre-authorization claims amounting to Rs 2.5 crore were received from empanelled private hospitals across all districts of the state on August 7. 'In addition, several empanelled hospitals have conveyed that they are not participating in the Indian Medical Association's call to withdraw services under the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY),' the statement said. It said payments of the private empanelled hospitals up to the first week of May 2025 have been cleared. The State Health Authority (SHA), Haryana remains in regular contact with all empanelled hospitals through District Implementation Units and other channels, it said. Empanelled hospitals across Haryana have been reassured that all pending payments will be cleared at the earliest. The SHA affirms that all payments to empanelled hospitals are being processed and released in accordance with the FIFO (First-In-First-Out) methodology. All pending dues will be cleared in a timely and systematic manner, it asid. 'SHA Haryana has not received any grievances related to refusal of treatment to any Ayushman Bharat beneficiaries across any grievance portals, including the 'CM Window' and 'Jan Samvad portals', social media platforms/SMGT portal, CPGRAMs and CGRMS portals managed by the Government of India or through emails or other channels,' the government statement further said. It said the SHA maintains that there is no valid reason for the withdrawal or disruption of services as all demands/issues have been addressed effectively. 'Any complaints or grievances regarding denial of treatment or imposition of charges on Ayushman beneficiaries will be dealt with strictly as per the guidelines issued by the National Health Authority (NHA) and the SHA,' it said. The authorities have also considered and addressed several genuine demands from the IMA and empanelled hospitals, including the inclusion of IMA and hospital representatives in the State Empanelment Committee, State Grievance Redressal Committee and District Grievance Redressal Committees, it said. The SHA remains committed to ensuring the smooth functioning of the scheme and safeguarding the welfare of all beneficiaries. Notably, the Haryana chapter of IMA had earlier warned that the private hospitals would stop treatment under the scheme from August 7 if pending dues were not cleared. After talks with IMA representatives on Wednesday, Additional Chief Secretary (Health), Haryana, Sudhir Rajpal had appealed to them to reconsider their decision. IMA's Haryana secretary Dhirender K Soni said on Thursday that the state government has failed to clear the reimbursement of private hospitals. 'The government itself admits that Rs 490 crore in dues are pending. By the time they will disperse this amount, the pendency will keep on increasing,' Soni had said. Soni had said that talks were held on Wednesday with senior state government officials, but it did not yield the desired outcome. After the meeting, the Haryana chapter of IMA held a virtual meeting with the private empanelled hospitals under the Ayushman scheme and later it was decided to suspend the services from midnight (beginning August 7), he said. Earlier on Tuesday, the Haryana government had said that the claims of empanelled hospitals under the Ayushman Bharat scheme are being settled. During the financial year 2025-26, up to July 16, Rs 240.63 crore has been received from the state and central governments and fully utilised for the settlement of eligible claims, the state government had maintained. PTI SUN NB NB This report is auto-generated from PTI news service. ThePrint holds no responsibility for its content.
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Business Standard
6 days ago
- Health
- Business Standard
Haryana hospitals to continue AB-PMJAY strike despite partial payments
Officials from the Indian Medical Association's (IMA) Haryana unit on Wednesday said the body will proceed with suspending services under the Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) from today over pending reimbursements to hospitals empanelled under the scheme. This decision comes despite the state health agency (SHA) stating that partial repayment of outstanding dues to empanelled hospitals was initiated on a 'first in, first out' basis from August 4. In its July 28 notice, the hospital body alleged inaction by the state government over dues pending for six to seven months, despite repeated representations and assurances. 'Around Rs 500 crore in dues are pending to be paid to private hospitals empanelled under the scheme in Haryana,' Dhirendra Soni, honorary secretary of IMA Haryana, told Business Standard. IMA Haryana had issued a similar warning in January this year, which was withdrawn after the government released partial reimbursements. A statement from the SHA said it had processed and paid claims submitted by empanelled hospitals up to the first week of May 2025. 'A total of Rs 2,900 crore has been disbursed to hospitals since the inception of the scheme. During the financial year 2025–26, up to July 16, 2025, an amount of Rs 240.63 crore has been received from the state and central governments and fully utilised for settlement of eligible claims,' the statement added. Soni, however, said hospitals have a trust deficit with the SHA, which has not offered a concrete solution to the year-long problem. Calling delays in reimbursement a recurring issue, an administrator of a Gurugram-based hospital empanelled under PMJAY said the Haryana government had failed to find a permanent solution, leading to cash shortages in hospitals. The IMA has also urged the government to pay 1 per cent interest per week for any delay exceeding 15 days. 'This is part of the contract signed by hospitals while empanelling under the PM-JAY scheme, but no hospital has received such payment from the government despite the heavy pendency of claims,' Soni said. The AB-PMJAY scheme provides health insurance cover of Rs 5 lakh per family and currently enlists 1,341 hospitals in Haryana, of which around 650 are in the private sector. Hospitals empanelled under the scheme provide free treatment to registered patients and later raise reimbursement requests on an online portal. These are reviewed and cleared by a state agency before payments are disbursed. Another issue raised by hospitals is the introduction of the Chirayu scheme, a state health insurance programme running parallel to the Centre's Ayushman Bharat scheme. 'While hospitals have been enthusiastically participating in Ayushman Bharat since its launch in 2022, the launch of Chirayu cards in November 2022 has made payments very erratic due to the sheer number of beneficiaries,' the IMA Haryana said in an open letter to the state government.
Time of India
7 days ago
- Health
- Time of India
Ayushman Bharat: Haryana initiates hospital payments
Chandigarh: The state health agency, Haryana, on Tuesday urged all the stakeholders to mellow down their call of withdrawal of services under the Ayushman scheme as a protest. In an official communication to stakeholders, the health agency stated that the budget was received from the state govt on August 4, and accordingly, payment to empanelled hospitals was initiated on a first-in-first-out basis. The development reflects the state govt's commitment to ensuring timely disbursement of funds and uninterrupted delivery of healthcare services under the Ayushman Bharat scheme , read the communication. The state health agency (SHA), Haryana, has already processed and paid claims submitted by the empanelled hospitals up to the first week of May 2025. A total of Rs 2,900 crore was disbursed to hospitals since the inception of the scheme. During the financial year 2025-26, up to July 16, an amount of Rs 240.63 crore was received from the state and central govts and fully utilised for the settlement of eligible claims, stated the SHA. Claims submitted by empanelled hospitals are processed by a team of 50 doctors through the NHA's online platform. The portal ensures a transparent and impartial claim allocation process by randomly assigning cases to processors. All deductions are made strictly as per the NHA guidelines and only when adequate clinical justification or documentation is lacking. Before any rejection or deduction, hospitals are given an opportunity to upload the required supporting documents such as vital charts, clinical images, OT notes, and test reports. If a hospital disagrees with a deduction, it may file an appeal through the portal. These appeals are reviewed by a designated medical audit committee, the SHA mentioned. The state health agency has also taken cognisance of the grievances raised by hospitals regarding payment delays, claim rejections, and non-processing of claims. To date, over 400 grievances from empanelled hospitals have been formally registered and resolved through the Central Grievance Redressal Management System (CGRMS) 2.0 portal, it mentioned.
Hindustan Times
7 days ago
- Health
- Hindustan Times
Haryana: Ayushman Bharat payments released after IMA threat to halt services
After Haryana chapter of the Indian Medical Association (IMA) threatened to halt services under the Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) from August 7 due to outstanding payments, Haryana's state health agency (SHA) on Tuesday said that the claims till first week of May have been released to the empanelled hospitals. The SHA said that the claims submitted by empanelled hospitals are processed by a team of 50 doctors through the NHA's online platform. In a statement the SHA said that it had received the budget from the state government on August 4 and that payment to empanelled hospitals has been initiated on a first-in-first-out (FIFO) basis. 'The SHA, Haryana has already processed and paid claims submitted by empanelled hospitals up to the first week of May 2025,' the statement says, adding that a total of ₹2,900 crore has been disbursed to hospitals since the inception of the scheme. 'During the financial year 2025-26, up to July 16, 2025, an amount of ₹240.63 crore has been received from the state and Central governments and fully utilised for settlement of eligible claims.' The SHA said that the claims submitted by empanelled hospitals are processed by a team of 50 doctors through the NHA's online platform. The portal ensures a transparent and impartial claim allocation process by randomly assigning cases to processors. The SHA has also taken cognizance of the grievances raised by hospitals regarding payment delays, claim rejections and non-processing of claims.
