Odisha Govt Warns Private Hospitals: No Denial of Treatment Under PM-JAY and GJAY

Odisha Govt Warns Private Hospitals: No Denial of Treatment Under PM-JAY and GJAY

The Odisha government has firmly directed all empanelled private hospitals not to deny treatment to any eligible patient under the Ayushman Bharat - PM Jan Arogya Yojana (PM-JAY) and the state’s Gopabandhu Jan Arogya Yojana (GJAY). The directive follows increasing tensions between the government and private hospitals over technical glitches and low treatment package rates.

Health and Family Welfare Minister Mukesh Mahaling issued a clear warning on Tuesday, stating that any negligence or refusal of care to Ayushman cardholders would lead to strict legal consequences. The response came a day after several private hospitals expressed reluctance to continue offering treatments due to what they termed “unsustainable” pricing models and procedural complications under the new schemes.

Many hospitals claim that the treatment package rates are too low to maintain quality care, citing significant cost gaps compared to previous schemes. The All Odisha Private Medical Establishments Forum (AOPMEF) has demanded a 30% hike in treatment package rates, arguing that the current structure—at least 15–20% lower than the earlier Biju Swasthya Kalyan Yojana (BSKY)—is financially unviable.

Forum secretary Dr. Indramani Jena highlighted specific challenges such as:

Rs 75,000 allowed for pacemakers, while market prices are higher.

Rs 10,000 for spine implants, significantly below actual cost.

Knee replacement and neuro surgery rates reduced by 15%.

Only Rs 800 offered for Teflon mesh which costs at least Rs 1,700.

Minister Mahaling acknowledged these concerns and assured that both technical issues—like OTP verification for Aadhaar-linked PAN-India integration—and cost feedback from hospitals are under active review. The government is studying similar schemes in other states to arrive at a revised, acceptable pricing structure.

Addressing concerns about health card availability, Mahaling stated that any ration card holder with Aadhaar authentication is automatically eligible. Until they receive their physical cards, beneficiaries can use their Aadhaar for verification at hospitals. He also added that e-KYC drives are being used to bring more eligible individuals into the system.

The government remains committed to ensuring no patient is denied care under these health schemes, promising both reforms and strict accountability.