In a critical development impacting lakhs of patients in Haryana, private hospitals across the state have announced a complete withdrawal from the Ayushman Bharat scheme starting August 7, 2025. The Indian Medical Association (IMA) made this declaration on behalf of over 700 empaneled hospitals, citing non-payment of dues, procedural delays, and what they term a “broken system” that puts patients and providers at a disadvantage.
This mass exit is set to severely affect low-income beneficiaries under the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PM-JAY) — India’s flagship public health insurance scheme that offers cashless treatment up to ₹5 lakh per family per year. In Haryana alone, over 10 lakh families are registered under the scheme.
Why Are Private Hospitals Withdrawing from the Ayushman Scheme?
According to the IMA and Haryana Chapter of the Private Hospitals and Nursing Homes Association (PHNHA), the primary reasons behind this decision include:
- Unpaid Claims Worth ₹225 Crore: Hospitals allege that the Haryana government owes them over ₹225 crore in pending dues for treatments already delivered. Many of these bills have been stuck for more than 18 months, despite repeated follow-ups.
- Delayed Reimbursement Process: The IMA states that approvals and payments have become increasingly bureaucratic, requiring excessive documentation and digital validation through multiple portals, slowing down the process drastically.
- Unviable Treatment Rates: The scheme’s fixed package rates, especially for surgeries, diagnostics, and ICU care, are seen as economically unviable by private hospitals. In many cases, they say the costs incurred far exceed the government reimbursement.
- Penal Clauses and Audits: Hospitals have raised concerns about the heavy-handed penalty structure for procedural lapses or data mismatches. Automated claim rejections and audits are allegedly discouraging participation rather than ensuring quality.
- Lack of Transparency in Empanelment and Monitoring: Many hospitals claim the system lacks a proper grievance redressal mechanism and that even genuine service providers face harassment or blacklisting.
What This Means for Patients in Haryana
From August 7 onward, patients seeking care under the Ayushman Bharat scheme will not be able to access treatment at any private hospital in Haryana. Only public hospitals — which are often overcrowded and under-resourced — will remain available under PM-JAY for the time being.
This withdrawal is expected to impact:
- Elective surgeries and scheduled treatments that were already approved
- Emergency admissions, especially for cardiac, cancer, trauma, and maternity cases
- Follow-up care and continuity of treatment for ongoing illnesses
- Availability of specialized care in areas where private hospitals were the only providers
Patients may now have to either pay out of pocket or travel to neighbouring states like Punjab, Delhi, or Rajasthan to access empaneled private facilities.
State Government’s Response: Too Little, Too Late?
While the Haryana health department has acknowledged the outstanding payments, it has not provided a clear timeline for disbursal. Officials have maintained that technical issues in the central claim settlement portal are being addressed and that funds will be released in phases.
However, hospital administrators and medical associations remain skeptical. “This is not just a financial crisis. It’s a credibility crisis,” said a senior IMA official. “We have treated patients with dignity, but we’ve reached a point where we can’t keep bearing the loss.”
Attempts at dialogue between the IMA and the health department have failed to yield a resolution. A proposal to revise package rates and set up a fast-track grievance redressal mechanism has reportedly been ignored.
A Statewide Crisis with National Ramifications
This is not the first time that private hospitals have threatened to exit the Ayushman Bharat scheme. Similar protests have occurred in Maharashtra, Uttar Pradesh, and Tamil Nadu in recent years, often followed by temporary reconciliations.
However, the scale and firmness of Haryana’s boycott signal a deeper structural issue with the public-private health partnership model under PM-JAY. Experts warn that if the matter is not resolved swiftly, it could embolden private hospitals in other states to follow suit — potentially jeopardizing India’s goal of universal health coverage.
What’s Next for Patients and Providers?
As the August 7 deadline approaches, uncertainty looms over thousands of scheduled treatments, ongoing therapies, and insurance-backed procedures. Beneficiaries of the Ayushman Bharat scheme are being advised to contact their district Ayushman Mitras or government helplines to confirm whether their hospitals remain empaneled.
Meanwhile, the IMA has clarified that if payments are cleared and procedural reforms initiated, the hospitals are willing to return to the scheme. But until then, the standoff continues.
Healthcare Disruption at Scale: Key Numbers
- Over ₹225 crore in dues pending to Haryana private hospitals
- 700+ hospitals planning to exit the scheme across the state
- 10 lakh+ families in Haryana enrolled under Ayushman Bharat PM-JAY
- 12 major districts affected, including Gurugram, Faridabad, Hisar, Karnal, and Panipat
FAQs
Q1. Why are private hospitals in Haryana withdrawing from the Ayushman Bharat scheme?
Private hospitals are pulling out due to over ₹225 crore in unpaid claims, delayed reimbursements, unviable treatment rates, and a lack of accountability in the claim processing system.
Q2. When will the Ayushman Bharat scheme stop working in Haryana’s private hospitals?
Private hospitals across Haryana will stop accepting Ayushman Bharat PM-JAY cards from August 7, 2025, unless dues are cleared and reforms are introduced.
Q3. Can Ayushman Bharat beneficiaries still get treatment at government hospitals in Haryana?
Yes, all government hospitals will continue offering free treatment under the Ayushman Bharat scheme even after private hospitals exit.
Q4. What should patients do if their private hospital denies Ayushman scheme benefits?
Beneficiaries should contact the nearest district Ayushman Mitra, call the helpline number on their card, or seek treatment in public hospitals or private hospitals in other states where the scheme is still accepted.
Q5. Which districts in Haryana are most affected by the Ayushman Bharat suspension?
Major affected areas include Gurugram, Faridabad, Karnal, Hisar, Rohtak, Sonipat, Ambala, and Panipat, where private hospitals handle a large portion of Ayushman patients.