Chandigarh, August 14 — The State Health Authority (SHA), Haryana, has clarified on the recent concerns regarding the call for withdrawal of services by empanelled private hospitals under the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY) from 7th August, 2025.
In response to communications from the Indian Medical Association (IMA), Haryana, a spokesperson of the SHA said all pending payments to empanelled healthcare providers are being processed and disbursed strictly in accordance with the First-In-First-Out (FIFO) methodology. The SHA has assured that all outstanding dues will be settled without delay.
The SHA has also addressed multiple legitimate requests raised by IMA and participating hospitals. These include inclusion of hospital and IMA representatives in the State Empanelment Committee, State Grievance Redressal Committee, and District Grievance Redressal Committees and adoption of the latest package master, to ensure transparency and better operational alignment.
As of now, claims submitted up to the 2nd week of June 2025 have been paid. Since the inception of the scheme, over ₹3,050 crore has been disbursed to hospitals. For the current financial year 2025–26, up to 13th August 2025, approximately ₹480 crore has been received from the Central and State Governments and has been fully utilized for eligible claim settlements. In the last 7 days, Rs. 170 crore have been released to empanelled hospitals in the state.
The spokesperson said claims are processed through the NHA’s online platform by a team of 60 doctors, using an impartial and transparent allocation system that randomly assigns cases to processors. All deductions are strictly made per NHA guidelines, and only when there is insufficient clinical justification or documentation.
Hospitals are given an opportunity to upload supporting documents including vital charts, OT notes, clinical images, and lab reports before any claim is rejected or deducted. In case of disagreement, hospitals may appeal through the portal, and such appeals are reviewed by a Medical Audit Committee.
Regarding hospital empanelment and NABH incentives, all hospitals that received NABH incentive approvals via HEM 1.0 will continue to be eligible, provided their NABH certifications are valid. Hospitals applying a new must submit updated documentation via the HEM 2.0 portal, and these applications are being reviewed on priority.
The spokesperson said a large number of private hospitals across the state have distanced themselves from IMA’s service withdrawal call and continue to provide services. On an average, 2500 ‘pre-auths’ per day are being registered by empanelled hospitals with private hospitals raising pre-auth of Rs. 2 Crore approx. per day on average.
A recent grievance was received regarding denial of treatment to a beneficiary in Rewari. The SHA acted promptly by issuing a show-cause notice. The hospital clarified that cashless treatment is being provided under the scheme and admitted patient under the scheme. Any violation/denial of treatment report shall be dealt strictly by State Health Authority as per the rules and guidelines.
The SHA emphasized that there is no valid basis for any disruption or withdrawal of services under AB PM-JAY, as all raised issues have been effectively addressed.
