Haryana ensures timely payments to hospitals under Ayushman Bharat Scheme

The Haryana Government, through the Ayushman Bharat–Haryana Health Protection Authority, is implementing Ayushman Bharat–Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) and CHIRAYU Yojana to provide cashless indoor treatment of up to ₹5 lakh to more than 45 lakh eligible families in the state.

A spokesperson of the State Health Authority (SHA) said that in response to communications from the Indian Medical Association (IMA), Haryana regarding its call for withdrawal of services, that all pending payments to empanelled healthcare providers are being processed and released in a timely manner.

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All outstanding dues will be settled without delay, with priority given to smaller hospitals and healthcare facilities. Adequate funds have been sanctioned and received to clear the pending payments of empanelled hospitals in the state.

As of now, claims submitted up to the second week of June 2025 have been paid. Since the launch of the scheme, over ₹3,050 crore has been disbursed to hospitals.

For the current financial year 2025–26, up to August 18, approximately ₹480 crore has been received from the Central and State Governments and fully utilized for eligible claim settlements. Since August 5, ₹200 crore has been released to empanelled hospitals, while an additional ₹291 crore sanctioned by the state government under the CHIRAYU Yojana will be disbursed shortly.

The spokesperson clarified that all claims are processed through the National Health Authority’s (NHA) online platform by a team of 60 doctors using an impartial and transparent system that randomly allocates cases.

Queries are raised with hospitals whenever claims are incomplete or lack mandatory documents such as vital charts, OT notes, clinical images, or lab reports. Deductions are made strictly in accordance with NHA guidelines and only when there is inadequate clinical justification or documentation. Hospitals can appeal such deductions through the online portal, where appeals are reviewed by a Medical Audit Committee.

Significantly, a large number of private hospitals across the state have distanced themselves from the IMA’s service withdrawal call and continue to provide healthcare services. On average, 2,500 pre-authorizations are registered daily by empanelled hospitals, with private hospitals alone raising pre-auths worth nearly ₹2 crore per day. The spokesperson reiterated that any denial of treatment to beneficiaries would invite strict action as per the rules and guidelines.

Taking a strict view of irregularities in claim submissions, the Health Department conducted surprise inspections at several empanelled hospitals across the state today. Action will be taken against any violations detected during these visits, strictly in line with established rules and guidelines.

The Health Department is also continuously upgrading district hospitals across Haryana. A majority of newly recruited doctors, nurses, and paramedical personnel have been posted at district hospitals. The postgraduate policy has further increased the number of specialists available at these facilities.

Steps are being taken to strengthen infrastructure, with continuous upgradation of biomedical equipment. Advanced services such as dialysis, CT/MRI scans, modern blood banks, and cancer care are already available in most district hospitals, while the remaining hospitals will soon be equipped with these facilities.

In case empanelled hospitals under Ayushman Bharat–PMJAY refuse treatment, district hospitals are well prepared to handle additional patient load. This is evident from the rising admissions in public hospitals under the scheme. For tertiary care, newly established government, government-aided, and private medical colleges across the state are supplementing the services of the Health Department wherever required.