Private hospitals across Punjab suspend treatments under Ayushman Bharat scheme
Doctors have alleged that despite multiple reminders, they have not received necessary reimbursements for services rendered under scheme
PTC Web Desk: In a major blow to beneficiaries, private hospital doctors in Ludhiana have announced a halt to treatments under the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana due to significant payment delays. At a press conference held on Wednesday, the Doctors and Nursing Home Association flayed the Punjab Government for its alleged failure to settle outstanding payments for patient treatments amounting to over Rs 600 crore accumulated over the past six months.
The doctors alleged that despite multiple reminders, they had not received the necessary reimbursements for the services rendered under the Ayushman Bharat scheme. This ongoing issue has led them to the decision to suspend all treatments covered under this scheme in private hospitals across Punjab, effective immediately.
During the press conference, the association highlighted the detrimental impact of these payment delays on healthcare services and the trust between the government and private healthcare providers.
About the scheme
The Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PM-JAY) is one of the largest cashless healthcare schemes in India, aimed at providing financial assistance for medical treatments. Sponsored by the Government of India, this initiative offers coverage to underprivileged families without restrictions on family size, gender, or age, applicable at both public and network private hospitals.
Coverage under scheme
Medical examination, treatment, and consultation fees
Pre-hospitalisation expenses
Post-hospitalisation expenses for up to 15 days
Medicine and medical consumables
Hospital admission and accommodation charges
Non-intensive and ICU facilities
Diagnostic procedures
Medical implantation services
Food services
Individuals who cannot apply for Ayushman Bharat include:
Owners of vehicles (two-wheelers, three-wheelers, or cars)
Government employees
Those with a monthly income exceeding Rs 10,000
Owners of farming machinery and equipment
Residents of well-built houses
Kisan cardholders
Owners of motorised fishing boats
Those with more than 5 acres of agricultural land
Employees in government-run non-agricultural enterprises
Those with refrigerators or landline phones in their homes
Key Features of scheme
Provides coverage of up to Rs. 5 lakh per family
Designed for individuals without internet access or online health plans
Operates on a paperless and cashless basis
Reimburses transportation costs related to pre and post-hospitalisation
Includes day-care expenses within the treatment package
Payments are made according to pre-determined package rates
Treatments are generally provided at health and wellness centres based on Socio-Economic Caste Census data
Benefits of Ayushman Bharat Yojana
Assures zero-cost treatment and healthcare for registered individuals and their families
Covers 25 specialty categories with 1,354 medical and surgical treatments
For multiple surgeries, the highest package cost is fully covered, with 50% and 25% coverage for subsequent surgeries
Includes treatment costs for oncology and chemotherapy for 50 types of cancer
Offers coverage for follow-up treatments