Issuing a stern warning to the state government, Indian Medical Association (IMA) Haryana, declared that private hospitals across the state would stop fresh admission under the Ayushman Bharat scheme from June 5 over prolonged payment delays and unresolved grievances.
In a detailed letter to the Chief Executive Officer (CEO) of Ayushman Bharat Haryana Health Protection Authority (HHPA), Panchkula, IMA Haryana accused the authorities of failing to honour assurances given during an online meeting held on April 16 this year, regarding clearance of pending claims and other grievances faced by empanelled hospitals.
As per the association, hospitals had submitted detailed records of unresolved cases, including unpaid claims despite updated queries, pending cases due to change of portal from TMS-1 to TMS- 2, deductions in recently cleared payments, and missed TMS-2 cases. IMA claimed officials had assured that most payments would be processed before the next review meeting scheduled for May 5.
“It is extremely unfortunate that none of the assurances given earlier have been fulfilled and there has been no further communication from the authorities regarding the pending cases,” said Dr Sunila Soni, president of IMA Haryana unit.
She further said that due to the continued delay and lack of response, private hospitals would stop taking fresh Ayushman Bharat beneficiaries from June 5. She also indicated that several hospitals are considering surrendering the scheme due to financial and operational stress.
The state president said that private hospitals in Haryana had been supporting the Ayushman Bharat scheme since its launch in 2018 and had continued their cooperation even after the expansion of coverage under the Chirayu scheme in October 2022. The government has failed to allocate a sufficient budget after nearly 80 to 90 per cent of the state population came under the scheme, she added.
“Payments that were supposed to be made within 15 days as per the MoU are now delayed by three to five months. In some procedures, especially Percutaneous Transluminal Coronary Angioplasty (PTCA) packages mainly handled by private hospitals, payments are delayed by six to nine months,” said Dr Ajay Mahajan, former president of IMA Haryana and chairman of Hospital Board of India Haryana Chapter.
He also raised concerns over the implementation of the TMS-2 portal, alleging that the transition created technical problems and left several cases unpaid. He questioned the functioning of State Anti-Fraud Unit (SAFU), alleging that minor or unintentional errors were treated as fraud without proper justification.
“There should be a graded punishment system where hospitals are informed about errors and allowed to rectify them. Instead, multiple issues are clubbed together and hospitals are de-empanelled through a single notice,” he added.
Dr Yogesh Jindal, secretary of IMA Haryana, also highlighted issues due to which private hospitals are not able to continue this service. “Grievance and empanelment committee meetings had not been conducted for the last seven to eight months, affecting hospitals seeking empanelment and approval for additional specialties,” he added.
He along with other office bearers alleged that doctors raising concerns over delayed payments and procedural issues are being targeted by conducting raids on their premises.
“We request the government to solve these problems at the earliest so that inconvenience to the patients can be avoided,” said the state president.
