“The main reasons cited for denying services to Ab-PMJAY beneficiaries at private hospitals in Jammu & Kashmir are insufficient fund allocation towards the health insurance scheme.”
Complaints about Private sector hospitals denying services to beneficiaries of the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) scheme due to payment delays are galore in Jammu & Kashmir and such complaints head to no dead for almost more than a year now. The main reasons cited for denying services to Ab-PMJAY beneficiaries at private hospitals in Jammu & Kashmir is insufficient fund allocation towards the health insurance scheme. Since the scheme is jointly funded by the J&K and Central Governments in the ratio of 60:40 as is the procedure for implementing this scheme in case of other union territories and states of the country as well, it is for the Jammu & Kashmir’s Health & Medical Education Department to settle the payment disputes with the Central Government’s Ministry of Health & Family Welfare to ensure hassle free services to AB-PMJAY benificiaries in both private and Government hospitals across Jammu & Kashmir. Interestingly the officials of NITI Aayog, Central Government’s Health & Family Welfare Ministry, and private hospitals at a review meeting of the scheme in May this year raised concerns over the inadequate release of funds by states for the AB-PMJAY scheme. While it is a fact that NITI Aayog’s role is at the centre of the dispute and as such the onus of resolving the matter of releasing the payments to states and union territories with NITI Aayog lies on the Union Health & Family, the deadlocks in the payments under AB-PMJAY scheme to private hospitals for the beneficiaries of the scheme necessitate the intervention of the J&K Government’s Health & Medical Education Department.
“Since experiences have shown that reduced cash flow forces private hospitals to deny services to beneficiaries of AB- PMJAY, the hassle free cash flow would ensure hassle free services to patients at private hospitals under AB-PMJAY scheme. Till the dispute of reduced cash flow to states and union territories for AB-PMJAY scheme is resolved by the Central Government’s Health & Family Welfare Ministry with the NITI Ayog it is time for the J&K Health & Medical Education to settle the disputes of pending bills with the private hospitals across Jammu & Kashmir.”
Since the delay in payments for the beneficiaries of AB-PMJAY scheme is a serious operational issue, it demands a serious attention and intervention of both the J&K Government’s Health & Medical Education Department and as well as Central Government’s Health & Family Welfare Ministry. While most of the AB-PMJAY beneficiaries in Jammu & Kashmir prefer private hospitals over Government hospitals due to improving patient care facilities at private hospitals, the increasing participation of private hospitals in the Ayushman Bharat scheme necessitates free flow of cash to these hospitals for the convenience of the beneficiaries of this scheme. Since experiences have shown that reduced cash flow forces private hospitals to deny services to beneficiaries of AB- PMJAY, the hassle free cash flow would ensure hassle free services to patients at private hospitals under AB-PMJAY scheme. Till the dispute of reduced cash flow to states and union territories for AB-PMJAY scheme is resolved by the Central Government’s Health & Family Welfare Ministry with the NITI Ayog it is time for the J&K Health & Medical Education to settle the disputes of pending bills with the private hospitals across Jammu & Kashmir.
