Pune hospitals move HC against mandatory enrolment in Govt health schemes

Pune: Challenging the state government order that mandates compulsory enrolment of all charitable hospitals in government health schemes, the Association of Hospitals (AOH), Pune, representing several leading charitable hospitals, has filed a writ petition in the Bombay High Court seeking revocation of the government order and reinstatement of voluntary empanelment.

Citing financial and operational difficulties with the move, the association stated that charitable hospitals should not be forced into joining government schemes that threaten their viability. These schemes include the Mahatma Phule Jan Arogya Yojana (MPJAY), the Pradhan Mantri Jan Arogya Yojana (PMJAY), Rashtriya Bal Swasthya Karyakram, the National Child Health Programme, among others.

The hospital members from the association, including Ruby Hall Clinic, Jehangir Hospital, Vishwaraj Hospital, KEM Hospital, Sancheti Hospital, Inlaks and Budhrani Hospital, Poona Hospital, and NM Wadia Hospital in their petition argued that the rates under the schemes are too low to meet the cost of the advanced cutting edge equipement and technology that provides world class treatment to the patients.

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They alleged that while they support providing care to the underprivileged, the package rates under these schemes are too low to cover the operational costs of running tertiary care hospitals.

Medical Dialogues in April this year reported that the Maharashtra government made it mandatory for all charitable hospitals in the state to enrol in government health schemes. Previously, joining these schemes was optional for private and charitable hospitals. The decision was made after a government-appointed committee found that Pune’s Deenanath Mangeshkar Hospital, a charitable hospital, had refused to admit a woman during childbirth due to non-payment of an advance of Rs 10 lakh and tragically, the woman died after giving birth on March 31.

Subsequently, on June 4, 2025, the Joint Charity Commissioner’s office in Pune issued directives requiring charitable hospitals to begin implementation and submit compliance reports by June 12.

However, a section of charitable hospitals that are members of the AOH, an association that represents several leading hospitals in the region, opposed the move. These hospitals are not happy with the mandatory enrollment in the schemes.

According to data shared by officials, there are 58 charitable hospitals in Pune, 74 in Mumbai, and 468 in other parts of Maharashtra. All charitable hospitals are already obligated under the Indigent Patients Fund (IPF) scheme, mandated by a 2006 Bombay High Court order, to allocate 2% of their gross billing for free or subsidised treatment. This includes reserving 10% of beds for indigent patients (treated entirely free) and another 10% for economically weaker sections at a 50% discount.

The AOH claims the charitable hospitals are already fulfilling their duty by providing free and subsidised treatment to the needy under the IPF scheme. However, the government has issued the GR to ensure that no needy patient is deprived of medical aid due to the unavailability of IPF. Many times, the charitable hospitals have reportedly denied or refused treatment to the needy patients, stating unavailability of IPF and in such cases, the patients can be given the option or benefit of other government health schemes.

Dr HK Sale, executive director of Noble Hospital and chairman of the Association of Hospitals, Pune, told HT, “If the hospitals start all the schemes, they will be flooded with patients who want to get treated under the scheme, and there will be no space for other patients. For investigations, the hospitals have high-end, latest machinery and devices, which are cost-exorbitant. There are senior and expert doctors and trained staff which needs to be paid at par with the market rates. How will it be possible for the hospitals to survive?”

Adv Manjusha Kulkarni, from Ruby Hall Clinic, who is secretary and legal advisor of AOH, said, “The petition was filed by the association, which includes all trust hospitals, against the government decision. This will affect the hospitals badly, and they won’t be able to sustain and compete with the global healthcare facilities that offer advanced technology in healthcare. We will not be able to develop or sustain it, and every hospital needs to maintain its standards.”

As per AOH, around 78% healthcare services are provided by private hospitals, and they are not considered by the government prior to making any decisions. Currently, everyone is using Robots for surgery, and it is expensive, and patients can’t be provided surgical management under the rates offered by the schemes.

Furthermore, diagnostic facilities like CT Scan machines cost around Rs 8 to 10 crore, and scan machines are worth up to Rs 50 crore. Comprehensive Maintenance Contract (CMC) for medical equipment costs around Rs 50 lakh to Rs 2 crore, due to which the scan tests cost around Rs 15 to 18k. This test cannot be provided for nominal charges, unlike small nursing homes that have CT machines worth Rs 40 to 50 lakh.

Ashish Purnale, district coordinator for RBSK, said, "Only nine hospitals are currently empanelled under the scheme, of which six are private. There are over 104 procedures covered under RBSK, but uptake remains low."

Dr. Vinod Sawantwadkar, CEO of Jehangir Hospital, emphasised that government facilities should first upgrade their infrastructure. “We are already contributing through IPF and health camps. The issue is limited bed capacity and staff. Government hospitals need better facilities; private hospitals cannot bear the entire burden. Maintaining high standards of care is non-negotiable. We offer world-class treatment through specialised doctors and cutting-edge technology. Quality cannot be compromised for affordability alone.”

Dr Priti Lokhande, coordinator for MJPJAY and PM-JAY scheme, who is coordinating with the Charitable hospitals for the empanelment, said, “There has been a Lukewarm response even after the GR and directions from Charity Commissionerate hospitals. We have received requests from only two charitable hospitals in the Pune district who have shown interest in getting empanelled. However, the charitable hospitals remain firm on their stand and are not ready to get empanelled."

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