Haryana Hospitals Suspend Ayushman Bharat Scheme Over Rs 490 Crore Dues

Private hospitals empaneled under the Ayushman Bharat scheme in Haryana have suspended their services as of midnight on August 6 due to unresolved grievances with the state government, primarily over unpaid bills amounting to Rs 490 crore and inadequate budget allocations.

The move, affecting 650 empaneled hospitals across the state, is expected to disrupt healthcare access for over 1.8 crore enrolled beneficiaries, including low-income families and senior citizens.

The Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana (PMJAY), aimed at providing universal health coverage, offers up to Rs 5 lakh annually in cashless hospitalisation to nearly 55 crore economically disadvantaged individuals, covering the bottom 40 per cent of India's population.

On August 2, 650-700 private hospitals in Haryana announced their exit from the scheme, effective August 7, over unpaid dues.

Ankita Adhikari, the Joint Chief Executive Officer of Ayushman Bharat Haryana, admitted there has been a delay in disbursing claims amounting to Rs 470 crore, but that was the case in every state due to a very tight 15-day turnaround time.

"We are already processing claims from all districts in Haryana. Claims for May are being handled... It's true there has been a delay in disbursing claims amounting to Rs 470 crore. But payments have been delayed across every state because the 15-day turnaround time is very strict and practically impossible, requiring us to raise queries when hospitals fail to provide necessary documents, which creates a backlog," Ms Adhikari told NDTV.

"Many hospitals also fail to comply with guidelines. As per our knowledge not all hospitals have suspended their Ayushman Bharat scheme services till now. We are urging them not to," she said.

A recent meeting between Additional Chief Secretary (ACS) Sudhir Rajpal and officials of the Ayushman Bharat Haryana High Authority revealed that Rs 245 crore has been allocated for this quarter - Rs 175 crore from the Haryana government and Rs 70 crore from the central government.

However, the IMA highlighted that Rs 490 crore in arrears to private hospitals remains unpaid.

"They have started distributing it on a FIFO (first-in, first-out) basis from August 5," the IMA said, quoting Mr Rajpal.

"He informed us that at present, about Rs 490 crore is due to private hospitals. When we told him this amount was insufficient, he said he would place a demand for a supplementary budget in the monsoon session of the Haryana Vidhan Sabha on August 22, but could not specify the amount," the IMA said.

Despite assurances from Chief Minister Nayab Singh Saini and Chief Principal Secretary Rajesh Khullar for an annual budget of approximately Rs 2,500 crore for fiscal 2026 to support the scheme, the state government has not met this commitment.

This shortfall has led to recurring issues, with private hospitals suspending services for the fourth time due to unpaid dues. IMA Haryana demanded a budget allocation of Rs 2,500 to Rs 3,000 crore to ensure uninterrupted healthcare services under the scheme.

The IMA Haryana has also demanded an interest penalty on delayed payments, referencing a signed MoU, but was informed that interest cannot be paid.

Manipur, Jammu and Kashmir, and Rajasthan are also struggling to sustain the Ayushman Bharat scheme.

Manipur's Association of Healthcare Providers announced a temporary service suspension starting August 16, citing delayed PMJAY claim reimbursements causing severe financial and operational strain on hospitals, clinics, and diagnostic centres.

The Indian Medical Association (IMA) Haryana chapter formalised the suspension in a letter to the authorities, which stated: "As already communicated vide our letter No. IMAHSB2025/133 dated 28.7.25, we regret to inform you that the Ayushman Empanelled Hospitals are unable to continue with their services and have suspended Ayushman Services from 00:00 Hrs of 7.8.25 as there has been no satisfactory resolution of our grievances."

The IMA has scheduled a review on August 14 to decide whether to resume services or escalate the protest.

Madhu Madhukar, director of Tula Hospital in Haryana's Palwal, told NDTV all private hospitals have suspended services under the Ayushman Bharat scheme.

"We are prepared to face scrutiny for this decision. The government is urging us not to take this step but has failed to provide concrete solutions. Our primary demand is a sufficient budget proportional to the number of beneficiaries," Mr Madhukar told NDTV.

"Currently, private hospitals are not receiving adequate funds to provide the required services. We are not taking this step willingly; we are forced to do so because the government is not addressing our concerns," he added.

"If any patient seeks medical or emergency care at our hospital, we will not accept the Ayushman card. We want the Ayushman Bharat scheme to be strengthened, but the government must act sincerely. The key issues are the lack of budget and slow processing of bills. All hospitals, big and small, are willing to provide services, but the government must offer rational reimbursement rates," he said.

Nationally, the IMA has flagged unpaid bills under the Ayushman Bharat scheme totaling over Rs 1.21 lakh crore, noting that package rates are too low to cover treatment costs, particularly for complex procedures in private tertiary hospitals.

The suspension raises concerns about immediate impacts on patients relying on the scheme for critical and emergency care. Hospitals have clarified they will remain open to non-Ayushman patients but will not accept Ayushman cards until their demands are met.