Ayushman Bharat: Govt releases funds, begins clearing hospital dues
In response to concerns raised by the Indian Medical Association (IMA), Haryana, the State Health Agency (SHA) on Tuesday clarified that budgetary funds have been received and that hospital payments under the Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) have now been initiated.
The statement follows a July 28 letter from the IMA, warning of a service withdrawal from August 7 over pending dues.
“We are pleased to inform that the budget has been received from the state government on August 4, and accordingly, payment to empanelled hospitals has been initiated on a first-in-first-out (FIFO) basis,” the SHA said.
“This development reflects the state government’s commitment to ensuring the timely disbursement of funds and the uninterrupted delivery of healthcare services under the Ayushman Bharat scheme.”
The SHA informed that claims up to the first week of May 2025 have already been processed and settled. Since the launch of the scheme, a total of Rs 2,900 crore has been disbursed to empanelled hospitals.
For the financial year 2025–26, the SHA has received Rs 240.63 crore from the state and Central governments up to July 16, which has been fully utilised to clear eligible claims.
To handle the high volume of hospital claims, the SHA has deployed a team of 50 doctors who process claims through the National Health Authority’s online portal.
“The portal ensures a transparent and impartial claim allocation process by randomly assigning cases to processors,” the agency said.
“All deductions are made strictly as per NHA guidelines and only when adequate clinical justification or documentation is lacking.”
Before any claim is rejected or partially deducted, hospitals are given an opportunity to submit supporting documents such as vital charts, OT notes, test reports and clinical images.
“If a hospital disagrees with a deduction, it may file an appeal through the portal. A designated Medical Audit Committee reviews these appeals,” said a government spokesperson.
Acknowledging the IMA’s concerns, the SHA confirmed that it had taken cognisance of grievances regarding payment delays, claim rejections and processing issues.
“To date, over 400 grievances from empanelled hospitals have been formally registered and resolved,” the spokesperson added.
The SHA’s clarification is seen as an effort to restore trust and ensure continued participation of private hospitals in the Ayushman Bharat scheme, which is a critical healthcare safety net for millions of beneficiaries in the state.
Haryana Tribune