Under Ayushman Bharat, for alleged fake billing show cause notices were served to 23 hospitals, 11 hospitals were suspended, 8 hospitals were de-empanelled and fines worth Rs. 1.18 crore have been recovered from private hospitals for claiming money under the scheme using unscrupulous modus operandi
Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) and Ayushman Bharat – Mukhya Mantri Jan Arogya Yojana (AB-MMJAY) in Assam are currently providing services to around 66 lakh families in the state. Of these, approximately 30 lakh families are enrolled under PMJAY, while 36 lakh families are covered under MMJAY. Beneficiaries can avail of free treatment up to ₹5 lakh per year from empanelled hospitals, both private and public. However, there is an ongoing "rift" between some private hospitals and the government. An association representing the hospitals has claimed that many hospitals have expressed serious concern over the non-payment of dues under Ayushman Bharat in Assam, which they argue could severely impact the ability of hospitals to deliver seamless services to patients without compromising the quality of healthcare. Media reports suggest that the government owes around ₹750 crore to the hospitals.
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Meanwhile, government authorities have rejected these allegations, claiming that private hospitals are dissatisfied because many procedures or packages in these hospitals have been curtailed due to the unscrupulous practices of some private hospitals in generating inflated bills to claim dues under Ayushman Bharat.
Representatives of the Association of Health Care Providers (India) North East 1 Chapter recently met with the Minister for Medical Education and Research, Prasanta Phukan, and submitted a letter outlining their concerns. The letter stated, “Our member organisations have expressed serious concern over the non-payment of dues, which will have a major impact on the ability of hospitals to deliver seamless services to patients without impacting the quality of healthcare. Many hospitals are facing a liquidity crunch and are unable to clear staff salaries, vendor payments, and statutory payments on time.”
A source within the Atal Amrit Abhiyan Society, speaking with GPlus, disputed the allegations, stating, “The accusation is incorrect, and the majority of members of such associations in Assam are from Guwahati. A member of the organisation who frequently visits Atal Amrit Abhiyan Society, and his hospital receives many benefits from the government, but he has never raised such an issue with the officials.” The source also questioned the authenticity of the association and denied that hospitals were owed ₹750 crore by the government.
The source further clarified that due to pre-authorisation, hospitals provide services to beneficiaries and then raise the bills. Around ₹75 crore is generated every month, and payments are made after thorough verification. “There are two levels of verification, and hospitals must submit all necessary documents. If any discrepancies are found, extra supporting documents may be requested,” the source added. At present, the dues amount to approximately Rs. 200 crore, which is expected to be cleared by March.
The source also explained that some private hospitals are upset because many packages and procedures have been curtailed. The original scheme allowed both private and public hospitals to provide 1,949 packages to beneficiaries. However, it was discovered that some private hospitals had been raising fake bills using unscrupulous methods to claim public funds without providing the services. As a result, actions were taken against some hospitals: show-cause notices were issued to 23 hospitals, 11 hospitals were suspended, 8 were de-empanelled, and fines worth approximately ₹1.18 crore were recovered. Some prominent private hospitals in Guwahati were also fined.
The source clarified that while government hospitals continue to offer all 1,949 packages, private hospitals are now only allowed 263 high-end packages, such as neurosurgery. “Other packages are readily available in government hospitals across the state,” the official stated.
A total of 308 hospitals are empanelled under PMJAY and MMJAY, including 174 public hospitals and 134 private ones, covering medical colleges, district hospitals, ACCF centres, BBCI, and premier private hospitals in the state. From April 2024 to January 2025, hospital claims amounting to ₹550.47 crore have been disbursed, and all pending dues are expected to be cleared by March.
A senior member of the Association of Health Care Providers (India) North East 1 Chapter told GPlus that they approached officials at the Atal Amrit Abhiyan Society in September 2024 but received no assistance. Regarding the curtailment of private hospital packages, the senior member questioned why this was done in Assam, especially since it is a central government scheme. They insisted that the ₹750 crore figure in pending dues is accurate for both private and government hospitals.
The Atal Amrit Abhiyan Society source rejected these claims, calling the ₹750 crore figure false. The source emphasised that public hospitals operate on a revenue model, with hospital claim funds being utilised to ensure self-sufficiency. To date, no complaints have been made by government hospitals.
Regarding the success of Ayushman Bharat in Assam, the Atal Amrit Abhiyan Society source described it as a “glorious success.” Approximately 13.73 lakh beneficiaries have been treated so far, with 6.22 lakh males, 7.51 lakh females, and 2.70 lakh senior citizens among them. The source also reported that e-KYC for 1.73 crore beneficiaries has been completed, and Ayushman cards have been delivered to 1.20 crore beneficiaries.
While timely disbursement of dues is crucial for hospitals, it is equally important for hospitals to operate ethically and not manipulate the system.
