Chhattisgarh Private Hospitals halt Ayushman Bharat services over payment delays

Chhattisgarh: The Centre’s flagship health insurance scheme, Ayushman Bharat (Pradhan Mantri Jan Arogya Yojana or PM-JAY), is facing a serious setback in Chhattisgarh, with unpaid dues nearing Rs 200 crore, which has led private hospitals to suspend cashless treatment services for poor and vulnerable patients.

The Association of Healthcare Providers of India (AHPI), representing private hospitals across the state, has announced a five-day suspension of services under Ayushman Bharat. The move comes in protest against delayed reimbursements that have made it impossible for hospitals to run the scheme sustainably.

Medical Dialogues had previously reported that 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.

Also Read: Rs 1500 crore pending for hospitals under Ayushman Bharat, IMA Raipur raises concern

According to India Today, "Running hospitals without funds is unsustainable. Even the mandatory DGRC meetings, which should happen monthly, are not being held. There is no platform for grievance redressal," said Dr Rakesh Gupta, president of Chhattisgarh AHPI.

Ayushman Bharat offers coverage of up to Rs 5 lakh per family annually for poor households, covering costly surgeries and treatments. However, as per the news reports, unsettled bills worth lakhs are pending across private healthcare facilities in the state. Pediatric hospitals are particularly hard hit, as children requiring long-term therapies and expensive surgeries face interruptions due to funding shortfalls.

Some of the largest hospitals in the state, including Ramkrishna Care, VY, Dani, and NKH Super Speciality, have drawn criticism from patients who claim they were asked to pay cash despite holding valid Ayushman cards. While some patients continue to receive cashless treatment, many others are being turned away or forced to cover treatment expenses out of pocket.

"The scheme is supposed to be free, but we had to mortgage our land for treatment," said a patient from Bilaspur. Another, from Sukma, said, "We came here with hope. But the hospital says the Ayushman card is not working", reports India TV.

Hospital administrators confirm that the mounting dues are making it impossible to provide cashless treatment. Dr Sandeep Dave, Director of Ramkrishna Hospital, said that dues are piling up and hospitals cannot run the scheme without funds.

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Contrary to the hospitals’ claims, the Chhattisgarh Health Minister Shyam Bihari Jaiswal has denied any shortage of funds for the scheme. He stated that Rs 505 crore, including the Centre’s share, has already been released to the state. Speaking to India Today, he said, "Such hospitals that aren't treating people under the scheme must give that in writing to us.”