Shimla, January 6:
Thousands of patients in Himachal Pradesh are still waiting for reimbursement of treatment costs under the Himcare Scheme, with payments pending since 2022–23, including in government institutions such as PGI.
The long delay has put the flagship health insurance scheme under a cloud, forcing the state government to take a hard look at its functioning.
Against this backdrop, Chief Minister Sukhvinder Singh Sukhu on Tuesday reviewed the Himcare and Chief Minister Sahara schemes, acknowledging the need to fix systemic gaps.
He directed the authorities to clear pending payments of private hospitals, admitting that unpaid claims have weakened both patient confidence and hospital participation.
To plug leakages and rein in misuse, Sukhu ordered a local audit of the Sahara Scheme.
A three-member committee at the district level will now verify beneficiaries to ensure that only eligible families receive assistance, signalling concerns over the integrity of beneficiary lists.
The Chief Minister also announced tighter scrutiny under Himcare, with face-recognition-based verification at the time of registration.
Directions have been issued to the Health and Digital Technologies & Governance departments to implement the system, aimed at preventing duplication and fraudulent claims.
Linking beneficiaries to the Him Parivar Portal was another key decision, intended to create a unified database of welfare recipients. Sukhu also issued fresh guidelines on budgetary provisions and operational parameters under Himcare, indicating a reset of the scheme’s financial discipline.
Even as arrears remain unpaid, the government has allowed treatment in private wards of government hospitals under Himcare, a move officials say will ease patient access but has also raised questions about affordability unless old dues are cleared first.
Sukhu said Himcare data will be analysed to assess disease patterns in the state, claiming it would help in evidence-based health policy. However, critics point out that data-driven reforms mean little to patients whose claims have been stuck for years.
Highlighting infrastructure expansion, the Chief Minister cited robotic surgery, the State Cancer Institute, PET and SPECT scan facilities, along with 70 Model Health Institutions, Rogi Mitra Scheme, Wellness Centres and the Trauma Centre at IGMC Shimla. On the ground, though, hospitals continue to complain of delayed payments choking day-to-day operations.
For now, the sharpest test before the government remains unresolved: will long-pending Himcare dues finally be cleared, or will patients continue to pay the cost of administrative paralysis?
