Ask the government to restore insurance mode for Ayushman Bharat, cite huge pending dues
Mansoor Peer
Srinagar, May 13: Private hospitals in Jammu and Kashmir on Wednesday demanded the restoration of the ‘insurance mode’ under the Ayushman Bharat scheme, alleging that crores of rupees remain unpaid under the existing ‘trust mode’ for months and, in some cases, years.
The J&K Private Hospitals and Dialysis Centres Association (JKPHDA) urged the government to implement the Ayushman Bharat–Sehat Scheme through the insurance mode in the UT instead of the present trust mode, claiming that it has affected private healthcare institutions.
President of JKPHDA, Mir Faizan, said that under the trust mode, payments to private hospitals remain pending for prolonged periods, causing serious financial strain.
“Private hospitals have dues running into hundreds of crores, with some payments pending since 2021. This has pushed many centres, especially dialysis units, to the brink of closure,” he said.
He added that the insurance mode, adopted by several other states, ensures timely reimbursement through professional insurance companies, enhances accountability, and protects both patients and hospitals from financial uncertainty. “It also prevents disruption of life-saving services such as dialysis, oncology, and cardiac care,” Faizan said.
General Secretary of the association, Dr Masood-ul-Hassan, said that although the PS8 period expired last month, nearly 60 percent of the payments are still pending.
“A robust and transparent payment system will restore the confidence of hospitals and ensure that Golden Card beneficiaries continue to receive treatment without fear of suspension. Our only interest is uninterrupted patient care,” he said.
The association has appealed to the Lieutenant Governor and the Chief Minister to shift J&K back to the insurance mode at the earliest, stating that the present crisis has exposed the trust mode as “unsustainable” and risky for patients.
Initially, the health insurance scheme in J&K was implemented through private insurer Bajaj Allianz General Insurance Company Limited, whose contract ended in 2022. Later, IFFCO-TOKIO was engaged but exited the scheme in November 2023.
Subsequently, the State Health Agency (SHA) shifted to the trust mode under the Ayushman Bharat scheme, a move that private healthcare providers claim has led to severe financial distress.
Last month, private hospitals empanelled under the Pradhan Mantri Jan Arogya Yojana (PMJAY) announced suspension of services over prolonged non-payment of dues. The private hospitals said payments worth crores remain pending following the SHA’s policy shift to the trust mode, leaving them under acute financial stress.