Ayushman Bharat Scheme Faces Challenges in Jharkhand
The Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY) launched in 2018 aims to provide affordable healthcare to low-income families in India. Despite its noble intentions, the scheme is currently facing challenges in Jharkhand. With over 23 lakh beneficiaries and 750 hospitals registered, issues surrounding delayed payments threaten its effectiveness.
Background of Ayushman Bharat
The AB PM-JAY is the world’s largest health insurance scheme. It offers coverage of Rs 5 lakh per family annually for hospitalisation expenses. Initially aimed at the bottom 40% of households, eligibility is based on data from the 2011 Socio-Economic Caste Census. The Prime Minister announced an extension of coverage to citizens aged 70 and above in 2024.
Financial Strain and Payment Delays
The implementation cost of the scheme is shared between the Central and State Governments at a 60:40 ratio. In Jharkhand, 28 lakh families are enrolled under AB PM-JAY. However, hospitals are facing payment delays amounting to Rs 190 crore. Some hospitals have not received payments since June 2024, causing many to withdraw from the scheme.
Investigations and Irregularities
The National Anti Fraud Unit (NAFU) flagged 212 hospitals for alleged irregularities, halting fund disbursements. The Enforcement Directorate (ED) is currently investigating these hospitals for potential fraud, including ghost beneficiaries. This has led to a broader financial crisis affecting all empanelled hospitals, even those not implicated in the fraud investigations.
Technological Challenges
The introduction of the new web portal HEM 2.0 has compounded payment issues. This platform is intended to streamline operations but has instead resulted in procedural delays. Critics argue that the portal lacks essential features, causing backlogs in payment processing. Payments are processed on a First In, First Out (FIFO) basis, further complicating the situation.
Political Implications
The financial woes of the Ayushman Bharat scheme have sparked political controversy in Jharkhand. Opposition leaders accuse the state government of mismanagement, while the ruling party defends its actions as necessary until investigations conclude. The ongoing disputes highlight the intersection of health policy and political accountability.
Impact on Healthcare Providers
Healthcare providers are feeling the strain of delayed payments. Many hospitals have reported an inability to pay staff or maintain services for Ayushman Bharat beneficiaries. The situation has led to closures of some facilities, raising concerns about patient access to necessary healthcare services.
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