NEW DELHI/SHIMLA: A shocking RTI revelation has exposed a major crisis in Ayushman Bharat, India’s flagship healthcare scheme.
₹1.21 lakh crore worth of claims are still pending, with over 63 lakh cases stuck in the system.
Hospitals, especially private ones, are under financial strain. The delay in payments is affecting their operations.
But the big question remains – is this a case of bureaucratic inefficiency, or is it an attempt to prevent fraudulent claims?
Doctors' Concern – "This Delay is Hurting Healthcare!"
The United Doctors Front (UDF) has raised serious concerns over the delay.
Dr. Lakshya Mittal, UDF’s National President, said:
"Hospitals need timely payments to function properly. If claims remain stuck, how will they pay salaries to doctors, nurses, and staff?
Prolonged delays could lead to hospitals refusing Ayushman Bharat patients, defeating the scheme’s purpose."
Government's Response – "Fraud Prevention is a Priority"
On the other hand, the government argues that verification is necessary before clearing payments.
Health Ministry sources stated:
"We are not withholding payments but ensuring proper scrutiny to prevent fraudulent claims. Unchecked payments could lead to massive financial mismanagement."
The Bigger Picture – System Flaw or Scam?
This situation raises critical questions:
Are hospitals inflating claims, leading to scrutiny and delays?
Or is the government struggling with a backlog, causing unnecessary distress to hospitals?
What role do private insurance companies play in this process?
How can the system be streamlined to ensure timely and legitimate payments?
Impact on Hospitals & Patients
Currently, over 29,000 hospitals are empanelled under Ayushman Bharat, including 12,625 private hospitals.
The scheme promises cashless treatment to beneficiaries anywhere in India.
However, many hospitals are struggling due to unpaid claims, and some private hospitals are reportedly hesitant to take in Ayushman patients.
What Needs to Be Done?
Pending payments must be cleared promptly while maintaining strict verification.
A more transparent and efficient claims system is necessary.
An independent audit should determine the cause of delays – whether it's hospital overbilling or administrative inefficiency.
If there is a larger fraud involving private hospitals or insurance companies, agencies like ED and CBI must investigate.
Healthcare should not suffer due to bureaucratic delays or financial mismanagement.
It’s time for the government to address these concerns transparently.
Can Union Health Minister J.P. Nadda ensure both financial accountability and uninterrupted healthcare for millions?
