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

By  Jasleen Kaur September 18th 2024 03:00 PM -- Updated: September 18th 2024 04:04 PM

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

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