Seven years after his launch, Ayushman Bharat, government health insurance for the poor, got into trouble. More than 600 private hospitals in Haryana have suspended services for patients within this program this month, referring to waiting fees.
Private and public hospitals across the country tried to get back from the government for patients with Ayushman Bharat, which they treat. What goes wrong? Mint explains.
What is Ayushman Bharat?
This health insurance system, which was also called Ayushman Bharat Pradhan Mantri Jan Aogya Yojna (PMJay). Every family covered under the scheme gets up £5 LAKH cashless health insurance every year.
This applies to secondary and tertiary care in public and private hospitals emphasized within the system. Since his launch, Ayushman Bharat has released over 41 crore cards for recipients and authorized admission to the hospital worth almost £1.2 trillion in more than 32,000 empaneous hospitals, according to the latest data from the National Health Office.
How does the scheme work?
Families identified in the lower part of the series based on the criteria of deprivation of professional criteria of socio -economic caste census 2011 qualify for this system, with various qualifications for rural and urban families.
Families covered by previous health insurance schemes operated by the Center, and various state governments were also included in Ayushman Bharat when they were launched in 2018. Patients with Ayushman Bharat card can be treated in an empaneous hospital for free. These hospitals require treatment costs from state or central health authorities for the list of rates set by the government within the system.
What is the problem now?
At the beginning of this month, more than 600 private hospitals in Haryana ceased to receive patients covered by Ayushman Bharat scheme after more than six months when it is in danger. These hospitals, represented by the chapter of the Indian Medical Association Haryan, said they were not paid for free treatment provided to patients by the insured government.
In the post on X (formerly Twitter) Ima Haryan said that the Haryana government has only cleaned up £245 crore of the total waiting fees for almost £500 crore from August 7th.
Is it only a problem with Haryana?
No. Private and public hospitals across the country tried to get back from the government from the government for patients Ayushman Bharat, which heals. Three years ago, Chandigarha’s prestigious government hospital PGI stopped by dealing with Ayushman Bharat after the Pandjab government did not clean up fees £16 crore.
Last year, Nursing cell within IMA suspended cashless treatment of patients with Ayushman Bharat in private hospitals and nursing homes, which it represents, referring to waiting fees.
Private hospitals in several other countries, including Andhra Pradesh and Telangana, were reluctant to join Ayushman Bharat; Last November, the Karnataka deputy even proposed to “take action” against private hospitals who refuse to be entered in the system.
How many hospitals in India are owed within the Ayushman Bharat scheme?
The National Health Office did not officially publish this number on its dashboard for this system. However, in response to the right to an information question AJAY BASUDEV BOSE, the Empaneled Hospital has been owed £1.21 trillion in unpaid fees since February this year.
The Ministry of Health did not respond to a question to the mint on waiting fees. In 2023, the Minister of the Ministry of Health in Lok Sabha replied that 77% of all claims were settled within the Ayushman Bharat system and 86% of all private hospitals since February of the same year.
What will happen now?
The center and various state governments must settle the waiting fees or issue a formal rejection of claims for cases waiting for empaneous hospitals. The Bose’s RTI quoted quoted above mentioned that almost 64 cases of Lakh had to be settled within the Ayushman Bharat system.
In addition, IMA and other representative authorities claim that the prices of different procedures and medical packages within this system are too low to be viable; They want these prices to be raised.
(Tagstotranslate) Ayushman Bharat (T) Health Insurance Scheme (T) Private Hospital (T) Awaiting Dees (T) Empaneous Hospital (T) Ayushman Bharat (T) Ayushman Bharat Bharat Bharat Bharat Bharat Bharat. Bharat Haryana
