Chandigarh, Aug 5 – The State Health Agency (SHA), Haryana acknowledges the letter issued by the Indian Medical Association (IMA), Haryana dated 28th July 2025, wherein the IMA has expressed its decision to halt services under the Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) starting from 7th August 2025, citing outstanding payments as the reason. In this context, SHA, Haryana wishes to clarify the current status of payments, claim processing, grievance redressal mechanisms, and empanelment procedures to provide transparency and reassurance to all stakeholders.
We are pleased to inform that the budget has been received from the State Government on 4th August 2025, and accordingly, payment to empanelled hospitals has been initiated on a First-In-First-Out (FIFO) basis. This development reflects the State Government’s commitment to ensuring timely disbursement of funds and uninterrupted delivery of healthcare services under the Ayushman Bharat scheme.
The SHA, Haryana has already processed and paid claims submitted by empanelled hospitals up to the first week of May 2025. A total of Rs. 2,900 crore has been disbursed to hospitals since the inception of the scheme. During the financial year 2025-26, up to 16th July 2025, an amount of Rs. 240.63 crore has been received from the State and Central Governments and fully utilized for settlement of eligible claims.
Claims submitted by empanelled hospitals are processed by a team of 50 doctors through the NHA’s online platform. The portal ensures a transparent and impartial claim allocation process by randomly assigning cases to processors. All deductions are made strictly as per NHA guidelines and only when adequate clinical justification or documentation is lacking. Before any rejection or deduction, hospitals are given an opportunity to upload the required supporting documents such as vital charts, clinical images, OT notes, and test reports. If a hospital disagrees with a deduction, it may file an appeal through the portal. These appeals are reviewed by a designated Medical Audit Committee.
The SHA has also taken cognizance of the grievances raised by hospitals regarding payment delays, claim rejections, and non-processing of claims. To date, over 400 grievances from empanelled hospitals have been formally registered and resolved through the CGRMS 2.0 portal. In an effort to support hospitals in using this platform effectively, the SHA has conducted training sessions for hospital representatives. Additional training sessions are scheduled in the coming days to enhance understanding and address any functional issues.
Regarding hospital empanelment and NABH incentives, all hospitals that submitted NABH incentive applications and received approval through the earlier HEM 1.0 portal shall continue to be eligible for the incentive, provided their NABH certificates remain valid. Hospitals applying afresh for NABH incentives are required to submit updated documents via the HEM 2.0 portal. Such applications are reviewed on priority by the Office of AB-HHPA, SHA, Haryana.
The SHA wishes to highlight that regular communication is maintained with IMA Haryana to address their concerns. Notably, Haryana is the first state to ensure IMA representation in the District Medical Audit Committees and District Grievance Redressal Committees. Additionally, representation of private hospitals through IMA is ensured in the State Grievance Redressal Committee and State Empanelment Committee.
SHA, Haryana remains committed to ensuring transparency, timely disbursement of payments, and strengthening public-private partnerships in healthcare delivery. Regular updates on the payment status and other operational matters are being shared with stakeholders through official channels. The SHA urges all stakeholders to continue their collaborative efforts in serving the healthcare needs of the people of Haryana under the Ayushman Bharat scheme.
