State Government Clears ₹1,299 Crore in Hospital Dues Under Health Schemes
Officials Reveal Shift from Insurance Model as Government Assumes Direct Responsibility for Hospital Payments
Maharashtra Government Pays ₹1,299 Crore in Hospital Dues Under Health Schemes
In a major boost for the health sector, the Maharashtra government paid its dues worth ₹1,299 crore against hospitals empaneled under the Mahatma Jyotirao Phule Jan Aarogya Yojana (MJPJAY) and Pradhan Mantri Jan Aarogya Yojana (PMJAY). It was established by officials that this payment against the hospital dues would be for the duration from March 1 to April 17, 2025.
Earlier, both schemes were run on an insurance model, where the government itself paid the insurance premium, enabling an insurance company to manage health claims for hospitals. But in July 2024, the state government changed the schemes from an insurance mode to an assurance mode, taking direct responsibility for payment of treatment charges. Officials said this change led to payment processing delays over the last few months.
Annasaheb Chavan, State Health Assurance Society Chief Executive Officer, said, “We have settled dues of ₹1,299 crore under both the MJPJAY and PMJAY schemes. All dues are settled, and the process is on.”
The Maharashtra state government revamped the scheme of MJPJAY in 2023 by increasing coverage from ₹1.5 lakh to ₹5 lakh per beneficiary, thereby making the scheme more inclusive. In the PMJAY scheme, families have an option to take coverage of up to ₹5 lakh annually. At present, there are 1,359 private and 672 government empanelled facilities under both schemes in the state, providing coverage for 1,352 medical procedures.
Dayanand Jagtap, State Health Assurance Society Deputy CEO, clarified, “In Maharashtra, there are 13.5 crore beneficiaries in 3.73 lakh families covered under these schemes. The delay in payments was because of the state’s shift in managing dues. The state government pays the total cost for MJPJAY, with 40% of the cost being borne by the state and 60% by the central government.”. The state government gave ₹1,162 crore to the society to settle these bills, and we are expecting to get more than ₹200 crore from the central government. Yet, the audit of bills and treatment records has caused the delay in making payments.
Dr. Omprakash Shete, chairman of Ayushman Bharat Mission Maharashtra committee, assured that all the dues are paid and that the schemes are running smoothly from March. “The system has now streamlined, and everything will be hunky-dory in the future. We have instructed all the empanelled hospitals to accept and treat patients without losing time and without demanding money upfront,” he said.
This move is a welcome trend for healthcare in Maharashtra, as hospitals are paid on time and beneficiaries can access required medical services without any constraints.
