Rs 1500 crore pending for hospitals under Ayushman Bharat, IMA Raipur raises concern
Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana (AB-PMJAY)
Raipur: The Indian Medical Association (IMA) Raipur branch has requested Chhattisgarh’s health minister, Shyam Bihari Jaiswal to release the pending payment of Rs 1,500 crore for treatments provided at state-run hospitals under the Ayushman Bharat scheme over the past five months.
Hospitals are still awaiting payment for claims under the Ayushman Bharat health insurance scheme, one of the flagship initiatives of Prime Minister Narendra Modi's government. Despite efforts by the Union government to address the issue, hospitals have not received crores worth of screening payments for up to 10 months.
Officially known as the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY), it is dubbed the largest publicly funded health insurance scheme and it currently covers secondary and tertiary care healthcare facilities for beneficiaries up to Rs 5 lakh per family a year at both public and private empanelled hospitals. The IMA's correspondence with the government points to issues over the sustainability of continuing the scheme for patients if the claims reimbursement process is delayed, reports News18.
“Data shows that there are 29,000 hospitals which have up to 50 beds empanelled under the scheme followed by 3,750 hospitals with a capacity of 50-100 beds and 1,600 hospitals with a capacity of 100-200 beds," Girdhar J Gyani, director-general, AHPI, told News18. Evidence suggests that the system disproportionately affects smaller healthcare facilities. “These small hospitals won’t be able to sustain without timely reimbursement as they do not have deep pockets. Eventually, they will stop providing the services under the scheme which will be very unfortunate for Ayushman Bharat, a scheme of world-class stature," Gyani said.
When it comes to the issue of overspending that causes payment delays, AHPI often points the finger at state governments as well. The benefit of the initiative has been extended by numerous state governments to beneficiaries beyond the database of the Union government. The federal government foots 60% of the bill, while the individual states chip in the remaining 30%. Therefore, states should be careful with their spending as they bring more people into the program.
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