Unlocking the Mystery: Why Ayushman Bharat Payments are Delayed in Jharkhand

The future of Ayushman Bharat in Jharkhand is looking uncertain. Launched in 2018 by Prime Minister Narendra Modi, this healthcare scheme aims to provide affordable medical services to low-income families. So far, over 2.3 million people in Jharkhand have benefited, but issues are surfacing that could undermine its success.

Currently, hospitals in Jharkhand are waiting on ₹190 crore in payments. More than 200 hospitals have not received any compensation since last June, while another 538 are awaiting payments from February this year. This delay threatens the viability of the program. Facilities in Hazaribagh, Koderma, Palamu, and Deoghar have already opted out due to these financial issues.

Ayushman Bharat, recognized as the world’s largest health insurance scheme, offers up to ₹5 lakh per family annually for hospitalization. With around 750 hospitals signed up under the scheme, it covers about 28 lakh families in Jharkhand. The scheme primarily targets the bottom 40% of households, based on data from the 2011 census.

Despite the scheme’s ambitious goals, administrative hurdles are creating significant strain. Officials report that more than ₹2,284 crore has been allocated over the past seven years, yet payments have stalled.

Reasons for the Stalemate

Two main factors contribute to these payment delays:

1. Investigations and Irregularities: The National Anti Fraud Unit flagged 212 hospitals for suspected irregularities. As a precaution, disbursements to these facilities stopped pending investigation by the Enforcement Directorate (ED). In April, the ED conducted raids at several hospitals, focusing on issues such as suspected ghost beneficiaries.

2. Technical Changes: Another setback stems from the launch of a new management portal called HEM 2.0. Doctors report that this system has introduced complications, causing additional delays because it lacks essential filtering capabilities. Payments are also processed on a First In, First Out (FIFO) basis, which means older claims can take longer to resolve.

Dr. Anant Sinha, a surgeon and hospital board president, highlights the impact of these delays. He shared that many hospitals are struggling to pay their staff. Some, including 60 flagged hospitals, have been forced to close. Without urgent action, more facilities may be affected.

Political Ramifications

The situation has sparked a political dispute in Jharkhand. Babulal Marandi, an opposition leader, has criticized the state government for failing to manage the Ayushman Bharat scheme effectively. He claims that many hospitals have stopped offering services because they haven’t been paid. In response, Health Minister Irfan Ansari has insisted that payments will remain on hold until the investigations conclude, emphasizing the need to address potential corruption.

Looking Ahead

As these disputes unfold, public reactions show growing frustration. Social media conversations have exploded, with many expressing concerns that patients may suffer from the ongoing delays. The Ayushman Bharat scheme was intended to be a lifeline for many families, providing essential healthcare access. However, if these issues remain unresolved, its impact could be drastically diminished.

In summary, while the Ayushman Bharat scheme has the potential to transform healthcare in Jharkhand, it now faces significant challenges. Stakeholders at all levels must work together to find solutions before it becomes a case study in what could have been.

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