The Uttar Pradesh government has introduced a major reform to make services under the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) more accessible and efficient. Beneficiaries facing problems related to their Ayushman cards will no longer have to travel to the State Health Agency (SACHIS) headquarters in Lucknow for assistance. Their issues can now be resolved at the district level itself.
The move is part of the Yogi Adityanath government’s broader effort to simplify healthcare services, improve transparency and ensure that eligible citizens receive timely benefits without unnecessary inconvenience.
Special technical IDs provided to district officials
SACHIS Chief Executive Officer Archana Verma said Chief Minister Yogi Adityanath has consistently emphasised that the true success of the Ayushman Bharat scheme lies in ensuring that eligible beneficiaries receive services smoothly and without delays.
She said the state has been focusing on digitisation and simplification of administrative procedures. As part of this effort, special technical IDs have been provided to all Chief Medical Officers (CMOs), Ayushman nodal officers and District Implementation Unit teams across Uttar Pradesh.
Through these IDs, district-level officials can now independently handle technical processes such as approving Ayushman cards, rejecting incorrect applications and disabling cards when necessary. Earlier, many such issues required intervention from the state headquarters in Lucknow.
According to Verma, the new system will save both time and money for beneficiaries while ensuring faster delivery of services.
Uttar Pradesh performing better than National average
The state government has also been working to improve the speed and transparency of claim settlements and payments under the scheme.
Officials said efforts are being made to ensure that patients receive quality treatment while hospitals that genuinely serve beneficiaries receive timely payments.
Currently, pending liabilities under the scheme have been reduced significantly, with around ₹500 crore in payments still awaiting clearance.
According to SACHIS, Uttar Pradesh’s average claim settlement and payment turnaround time stands at around 57 days, compared to the national average of 73 days. Officials say this reflects the impact of administrative reforms and technological improvements implemented by the state government.
Online training for hospitals
The agency has identified that many claim rejections occur because hospitals fail to submit complete documentation or do not follow prescribed procedures properly.
To address this issue, SACHIS has launched a series of online training programmes for hospitals. These sessions guide claim submission procedures, required documentation and compliance with standard treatment guidelines.
Officials believe that better training will help hospitals submit accurate claims on the first attempt, reducing rejections and speeding up payments.
Nearly 200 hospitals removed from the scheme
At the same time, the state government has intensified monitoring of empanelled hospitals to maintain service quality.
Archana Verma said around 200 hospitals have been de-empanelled from the Ayushman Bharat scheme during the current financial year due to quality-related concerns and various irregularities.
The action was taken to ensure that only hospitals providing quality healthcare and acting in the interest of beneficiaries remain part of the programme.
Audit underway in 300 hospitals
The agency has also identified nearly 300 hospitals where there are concerns regarding upcoding and suspicious claims that may have been used to obtain improper payments.
Notices are being issued to these hospitals, and detailed field audits are currently underway. Officials have warned that strict action will be taken wherever irregularities are confirmed.
SACHIS said its objective is to ensure that only hospitals meeting prescribed standards continue to participate in the scheme. Hospitals providing quality treatment will be encouraged, while claim processing and payment mechanisms will be made even more efficient and transparent.
