Odisha cracks down on hospitals denying care under Ayushman Bharat, GJAY schemes

Bhubaneswar, May 2: The Odisha government has issued a strict warning to private hospitals empanelled under the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PMJAY) and the Gopabandhu Jan Arogya Yojana (GJAY) for refusing treatment to eligible patients.

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Health Minister Mukesh Mahaling emphasized that hospitals found guilty of denying care or showing negligence will face stringent legal consequences.

This move comes amidst growing concerns over technical challenges and the low reimbursement rates under these health schemes. Many hospitals have expressed dissatisfaction, claiming that the treatment package rates are 15–20% lower than those offered under the previous BSKY scheme.

The All Odisha Private Medical Establishments Forum (AOPMEF) has called for a 30% increase in package rates, citing rising inflation and the high costs of medical implants. For example, hospitals point out that the Rs 75,000 allocated for pacemakers and Rs 10,000 for spine implants fall well short of the actual costs, making treatment unsustainable for many facilities.

In response, Minister Mahaling assured that both technical issues and pricing concerns are under review. He also clarified that Aadhaar-linked ration cards are sufficient proof of eligibility for beneficiaries, with ongoing e-KYC drives aimed at enrolling more individuals under the schemes. The state government is actively working on improving coverage and addressing the gaps in the healthcare system.