Indore: Private hospitals in district await Rs 80 crore dues under Ayushman – ET HealthWorld

Indore: Around 50% of the payments claimed by private hospitals against treatment of patients under PMJAY-Ayushman scheme in Indore district this fiscal, are yet to be released by the state health agency.

Authorities said that payments have been made till August and the claims yet to be cleared might be facing ‘procedural issues’.

An official on condition of anonymity said a rough estimate suggests that the treatment value under the scheme in the first six months of this fiscal year is over Rs 150 crore. “Around 50% of the demand by private hospitals – around Rs 80 crore, is yet to be cleared. The SHA made no payments in April-May, thus the delay,” he said. MP Ayushman Bharat CEO Anurag Choudhary told TOI, “There is a set procedure to clear the payments of value for treating beneficiaries under the scheme. It is uniformly done for all hospitals across the state.”

“The hospitals have got their payments till August. In case there is any amount pending before August, it must be due to some procedural issues”, he said adding payments under the scheme are a continuous process and the remaining amount will be cleared under the same process.

Ayushman Bharat- a flagship scheme of the Government of India, was launched in 2018 as recommended by the National Health Policy 2017, to achieve the vision of Universal Health Coverage (UHC). In MP so far, 20.94 lakh beneficiaries have taken treatment under the scheme in the 1000 empanelled hospitals.

Ayushman Bharat is an attempt to move from a sectoral and segmented approach of health service delivery to a comprehensive need-based health care service. Since then, the private hospitals in MP are receiving more sums as claims for authorised value of hospital admissions.