India’s flagship healthcare initiative, Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana (AB-PMJAY), is facing a deepening crisis. According to the Indian Medical Association (IMA), hospitals across India are owed a staggering ₹1.21 lakh crore in unpaid dues, raising urgent concerns about the scheme’s financial and operational sustainability.
Background of the Crisis
An RTI reveal from the National Health Authority (NHA) confirms that over 63 lakh pending claims, amounting to ₹1.21 lakh crore, remain unpaid to empanelled hospitals under Ayushman Bharat. The IMA attributes this to delayed payments, low package rates, and a cumbersome claims process, especially problematic for tertiary hospitals handling complex procedures.
Statewise Fallout: Crisis in the Making
- Haryana: Around 650 private hospitals suspended Ayushman services, citing ₹490–500 crore in pending dues. The move affected nearly 1.8 crore beneficiaries before the government intervened to resume payments.
- Punjab: The High Court ordered the attachment of salaries of senior health officials over ₹500 crore in unpaid dues to hospitals.
- Jharkhand: Some 212 hospitals have not received dues for nearly a year, while 538 others await payment for three months—together accounting for over ₹140 crore.
Additional issues have emerged in Manipur, Rajasthan, and Jammu & Kashmir, where providers have threatened to or already halted services due to sustained non-payments.
What’s At Stake?
- Financial Distress: Delays in reimbursement jeopardize hospital operations, especially for smaller facilities dependent on Ayushman funds.
- Coverage Erosion: Beneficiaries risk losing access to vital services as hospitals pull out.
- Systemic Breakdown: Hospitals cite bureaucratic delays, unexplained deductions, and insufficient reimbursements as core issues.
What the IMA Is Demanding
- Timely payments: Clear dues with applicable interest.
- Rate revisions: Packages reflective of actual treatment costs, especially for complex procedures.
- Process reforms: Streamlined claim submission and grievance handling.
- Stakeholder inclusion: IMA wants to be part of policymaking on reimbursement and operational protocols.
Government Responses
- Haryana: Released ₹240.6 crore in FY26, resumed payments via FIFO processing, and promised more support and infrastructural improvements. The Times of India
- Jharkhand: Health Minister assured clearing pending dues (~₹192 crore) soon amid technical and scrutiny-related delays.
- Punjab: Facing judicial pressure, senior officials’ salaries remain attached until dues are accounted for.
While efforts are underway, hospitals remain skeptical due to long-standing payment delays and systemic distrust.
Why It Matters
The Ayushman Bharat scheme was launched to offer cashless healthcare up to ₹5 lakh annually to the economically vulnerable. But persistent arrears now threaten its very foundation. Hospitals are at risk of closure, and poor patients could lose access to essential care. Unless systemic reforms are made, Ayushman Bharat’s promise of universal healthcare remains in peril.
