IMA Haryana to suspend treatment under Ayushman Bharat services over pending dues of Rs 400 cr from private hospitals: All you need to know

On Sunday, 26th January, the Indian Medical Association (IMA) in Haryana stated that around 600 private hospitals in the state have decided to stop treating patients under the Ayushman Bharat scheme from February 3rd. The IMA’s Haryana unit said that the patients at the private hospital relying on the slated government health scheme would hardly benefit from the scheme as the doctors would not treat them under the said scheme. The IMA’s Haryana unit said that this is because the government has not yet cleared the reimbursement of the hospitals worth Rs 400 crores.

As per the reports, there are around 1300 hospitals eligible for the Ayushman Bharat scheme of which 600 are private facilities. The Ayushman Bharat scheme launched by the BJP government in 2018 aims to provide free access to health insurance coverage for low-income earners in the country. In the state of Haryana, there are around 1.2 crore people who are registered under the scheme.

The association opined that the private hospitals were not able to manage their expenses while treating the patients under the Ayushman Bharat scheme, given no reimbursement from the government. Dr Mahavir Jain, president of IMA (Haryana) commented on the matter and said that the speed of reimbursement from the government is very sluggish. He demanded that the payment of the hospitals should be released immediately.

“Our payments should be released immediately as it is exceedingly difficult for doctors to operate hospitals without funds. Around Rs 400 crore is pending. These medical bills are already discounted by the hospitals. How will they survive if they do not receive the bare minimum,” he said.

The association said that the government to date has issued only 15-20% reimbursement of the total bills raised by the hospitals. As per the reports, the hospitals treat the patients at their cost under the slated scheme and then raise the payment to the government through online portals. As per the doctors, the government has only issued 15% of the total bills raised.

“it is extremely unfortunate that even after 15 days, the members have not received any significant amount and the funds received have ‘substantial unwarranted deductions’,” Dhirendar K Soni, secretary of IMA-Haryana was quoted as saying. Several hospitals in Gurugram, including Park Hospital, Centre for Sight, Pushpanjali Hospital, and Kamla Hospital, are among those affected by the decision. 

The Ayushman Bharat scheme was launched by the Narendra Modi-led government in the year 2018 to provide free healthcare up to Rs 5 lakh per family per year. About 1.2 crore individuals in the state have enlisted under the initiative, which covers everything from regular testing to surgery.

The scheme can be availed by families with annual incomes of less than Rs 2.5 lakh, the elderly, and other eligible criteria. However, with the government’s delay in releasing payments, hospitals are finding it challenging to manage their expenses.