Speaking to the Indian Express, the petitioner, Ram Kumar, said the Ayushman Bharat Health Scheme was launched by the union government in 2018 to provide cashless medical treatment up to Rs 5 lakh per family per year. Under the scheme, healthcare costs are shared by the Centre and states in a 60:40 ratio, and empanelled hospitals are required to be reimbursed within 15 days, extendable to a maximum of 30 days, from the date of submission of claims. However, Kumar said that the situation on the ground is starkly different. Hospitals across several states have complained of reimbursement delays stretching into months, causing severe financial stress. He said these prolonged delays have forced many hospitals to suspend, or threaten to suspend, treatment under the scheme, leaving eligible patients without access to promised free healthcare.
Medical Dialogues had previously reported that the Indian Medical Association (IMA), Haryana chapter, has expressed serious concerns over the implementation and operational aspects of the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY), even as the central government recently revealed that over Rs 1.40 lakh crore has been spent under the scheme so far.
Kumar said he had raised the issue with the Union government as well as the Punjab and Haryana governments, urging them to ensure timely payments in line with the policy guidelines. In their replies, the Punjab government stated that payments were being made on a “first-in, first-out” basis, while the Haryana government claimed it had decided to clear payments within 30 days.
Despite these assurances, Kumar said that delays continued unabated, compelling him to file a public interest litigation (PIL) through his counsel, Satish Bhardwaj.
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He also mentioned that the high court’s involvement would compel the authorities to streamline the reimbursement process, ensure financial stability for empanelled hospitals, and prevent disruptions in treatment for beneficiaries of the flagship health scheme.
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