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| Private hospitals warn of Ayushman exit, Govt rushes to defuse crisis | | |  Early Times Report
Jammu, June 15: The Jammu and Kashmir Government on Monday stepped in to address the long-pending payment dispute between private healthcare institutions and the authorities implementing the Ayushman Bharat–SEHAT Scheme, amid growing concerns that private hospitals may stop accepting Ayushman Bharat "Golden Cards" from July 1.
Health and Medical Education Minister Sakina Itoo said the government was actively examining the issues raised by private hospitals and dialysis centres and would make every effort to resolve the matter at the earliest to ensure that beneficiaries do not suffer.
Speaking to reporters after inaugurating a medical camp organised by Sher-i-Kashmir Institute of Medical Sciences, the minister acknowledged that private hospitals had expressed concerns regarding delayed payments under the flagship health insurance scheme. "The issues raised by private hospitals are under active consideration. The government is examining the matter and is committed to finding a solution so that healthcare services under the scheme continue without disruption," Itoo said, expressing confidence that the concerns would be addressed soon.
The minister's assurance comes against the backdrop of a warning issued by private hospitals and dialysis centres across the Union Territory that they would stop accepting Ayushman Bharat Golden Cards from July 1 if their long-pending reimbursement claims are not cleared.
The proposed move is likely to impact thousands of economically weaker patients, particularly those suffering from chronic illnesses who depend on the Ayushman Bharat–SEHAT Scheme for cashless treatment at empanelled private healthcare facilities.
The Jammu and Kashmir Private Hospitals and Dialysis Centres Association (JKPHDA), representing around 135 empanelled hospitals and dialysis centres across the Union Territory, has announced its decision to seek de-empanelment from the scheme with effect from July 1, citing persistent delays in claim settlements, non-adherence to guidelines of the National Health Authority (NHA), and mounting financial pressures.
According to the Association, despite repeated representations to the authorities, payments for approved claims under the scheme have remained pending for prolonged periods, severely affecting the functioning of private healthcare institutions.
The Association claimed that the financial crisis facing empanelled hospitals has continued despite partial payments released by the authorities in recent days. It alleged that nearly Rs 275 crore in pending dues remain unpaid, placing hospitals under significant financial stress.
Earlier, the Association had threatened to suspend services under the Ayushman Bharat–SEHAT Scheme from April 15 over pending payments amounting to nearly Rs 295 crore. Although a portion of the outstanding amount has reportedly been released by the State Health Agency (SHA), hospital representatives maintain that the majority of dues are still pending.
Private hospital operators have stated that they have continued to provide critical healthcare services—including surgeries, cardiac procedures, dialysis, emergency treatment, and intensive care services—for more than a year without receiving timely reimbursements. They argue that the prolonged delay has adversely affected their financial viability and raised serious concerns about sustaining healthcare services under the scheme.
The Association has further maintained that the delay in claim settlements violates the timelines prescribed under NHA guidelines and the contractual provisions governing the scheme. It has also pointed out that, under the provisions of the Memorandum of Understanding (MoU) signed with the authorities, empanelled institutions are entitled to interest on delayed payments, a provision that has allegedly not been implemented.
With private hospitals reiterating their July 1 deadline, the government's efforts to resolve the payment dispute assume significance, as any disruption in services under the Ayushman Bharat–SEHAT Scheme could affect healthcare access for thousands of beneficiaries across Jammu and Kashmir. |
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