The J&K Private Hospitals & Dialysis Centres Association (JKPHDA) today expressed serious concern regarding persistent delays in reimbursements under the Ayushman Bharat–SEHAT Scheme, stating that the continued non-payment of legitimate claims is placing significant strain on healthcare institutions across the Jammu and Kashmir UT and affecting their ability to sustainably deliver quality healthcare services to the beneficiaries.
Despite repeated representations to the relevant authorities, payments to empanelled private hospitals and dialysis centres have reportedly remained pending for extended periods, resulting in substantial operational and financial challenges.
“Delivering critical healthcare services such as dialysis, intensive care, surgical procedures, emergency treatment, oncology care, cardiac interventions, and trauma services requires uninterrupted availability of medicines, consumables, skilled healthcare personnel, and well-maintained medical equipment,” a JKPHDA spokesperson said.
“Extended delays in reimbursement, coupled with the rejection or deduction of claims without an effective review mechanism, create considerable difficulties for healthcare providers. While our primary commitment remains the welfare of patients, sustaining the required standards of care becomes increasingly challenging under such circumstances.”
The Association further stated that the issue has assumed greater significance in view of the ongoing conflict in the Middle East, which has led to an increase in global healthcare costs and disruptions in the supply chain of several critical medical products.
“At this crucial juncture, when geopolitical developments have adversely impacted the availability and pricing of essential cancer medicines such as Cisplatin and Carboplatin, private hospitals empanelled under Medical Oncology have effectively been rendered incapable of maintaining adequate inventories because of the prolonged blockage of legitimate reimbursements under the scheme. Similar challenges are being faced in cardiology and orthopaedics, where the procurement of cardiac stents and orthopaedic implants requires substantial working capital. The continued withholding of payments has severely constrained the ability of private healthcare institutions to procure these life-saving and life-enhancing medical products, thereby placing patient care and, in certain cases, human lives at risk,” the Association stated.
The Association further noted that, despite financial constraints within the Union Territory, more than ₹180 crore of Ayushman Bharat funds are reportedly lying unutilized with public hospitals, while private hospitals and dialysis centres continue to face delays in receiving payments for approved claims.Paying public hospitals at the cost of private hospitals is like putting money from one pocket of Government to Another with no significance.
“Such a situation raises serious concerns regarding the efficiency of fund utilization and reimbursement processes. The Association believes that payment mechanisms for public and private healthcare institutions should be clearly segregated and streamlined to promote transparency, accountability, and timely disbursement of funds,” JKPHDA stated.
The Association also expressed concern that prolonged delays in access to certain procedures may adversely affect public confidence in the scheme. According to JKPHDA, procedures such as gall bladder surgery and haemorrhoidectomy have increasingly been restricted to public hospitals, where waiting periods have reportedly extended beyond ten months in several cases.
JKPHDA further stated that the delays in claim settlement are inconsistent with the timelines prescribed under National Health Authority (NHA) guidelines and the contractual provisions governing the scheme.As per Section 6 of the MOU, we are entitled for 1% interest per week for the delayed period but have been deprived of the same.
In light of these concerns, private hospitals and dialysis centres across Jammu & Kashmir have resolved to initiate de-empanelment from the Ayushman Bharat–SEHAT Scheme with effect from July 1, 2026, unless immediate and meaningful corrective measures are implemented.
The Association has called for:
1. Immediate settlement of all pending claims and reimbursements, along with applicable interest in accordance with the governing agreements, MoUs, and NHA guidelines.
2. Establishment of a transparent, fair, and time-bound mechanism for the review of rejected or deducted claims.
3. Strict compliance with National Health Authority (NHA) guidelines relating to claim processing, payment timelines and empanelment criteria.
4. Segregation and streamlining of payment procedures to public and private hospitals.
5. Restoration of patient choice and improved access to timely treatment under the scheme.
6. Immediate engagement with representatives of private healthcare institutions to address operational concerns and prevent disruption of patient services.
JKPHDA reiterated that private healthcare providers remain committed to serving the people of Jammu & Kashmir and continue to support the broader objectives of the Ayushman Bharat–SEHAT Scheme.
However, the Association emphasized that quality healthcare services cannot be sustained indefinitely without timely reimbursement of claims. The present situation has reached a stage where the financial viability of many empanelled institutions is under severe stress, threatening the continuity of services for thousands of beneficiaries who depend upon private hospitals and dialysis centres for critical care.
The Association has therefore appealed to the UT Administration, the State Health Agency, and all concerned authorities to intervene urgently, clear outstanding dues, adhere to NHA payment norms, and resolve the matter in the larger public interest so that healthcare services under the Ayushman Bharat–SEHAT Scheme continue uninterrupted for the people of Jammu & Kashmir.