No AB PM-JAY, CMHIS services in Nagaland private hospitals from today

April 17, 2025 9 Views No Comment

Morung Express News
Dimapur | April 17

Private Empanelled Health Care Providers (EHCPs) in Nagaland have decided to go ahead with the suspension of the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana – Chief Minister’s Health Insurance Scheme (AB PM-JAY CMHIS) from April 17.

The Nagaland Private Doctors’ Association (NPDA) announced the suspension in a release, stating that it was forced to take the step due to the prolonged non-resolution of pending payments.

Earlier, the association had informed that it issued a one-month notice to the Nagaland Health Protection Society (NHPS), the agency implementing AB PM-JAY CMHIS in the State, on March 17 to resolve the issue.

With the expiry of the deadline, the NPDA announced the suspension of AB PM-JAY CMHIS services across Nagaland from April 17 with “profound regret and a heavy heart.”

According to the association, over the past several months, the EHCPs have persevered through immense challenges to sustain these vital healthcare schemes. Despite repeated setbacks and escalating operational pressures, services were continued in good faith, it maintained.

However, the NPDA asserted that due to prolonged non-payment of claims, the situation has reached an unsustainable point, both financially and operationally.
Stating that the crisis has been unfolding for over six months, the association said that suspending services was considered as early as February 2025, but it chose to continue, driven by a “commitment to public health and service.”

Unfortunately, despite multiple appeals and meetings with the concerned authorities, there has been no resolution, and the dues remain unpaid, it added.

The NPDA further pointed out that healthcare is a complex ecosystem that relies on timely and consistent funding—including regular salaries for health professionals and payments to drug suppliers. EMIs for life-saving medical equipment must be honoured, and daily operational expenses essential to running a healthcare facility must be met. Without these, the integrity and survival of healthcare institutions are at risk.

Thus, the NPDA emphasised that under the present circumstances, continuing AB PM-JAY CMHIS services without the necessary financial support is not only untenable but would also compromise the very existence of healthcare units.

Regretting the inconvenience the suspension may cause to the public, the NPDA stated that its commitment to the health and well-being of the people remains steadfast and expressed hope for an “immediate and constructive resolution that will allow us to resume services without further delay.”

It must be noted here that on April 2, the State Government informed the Gauhati High Court Kohima Bench (GHCKB) that it was considering a new insurer after its contract with Future Generali India Insurance Co. Ltd (FGI) ended on April 1.

Until an alternative arrangement is in place through a new contract, the government assured that it would continue making due payments for services provided by the NPDA through the “Trust Mode.”

Subsequently, a short tender notice was issued on April 5, seeking participation from both public and private insurers registered with the Insurance Regulatory and Development Authority of India (IRDAI) for providing insurance coverage to eligible families under the consolidated AB PM-JAY CMHIS initiative.

If the process goes as planned, the contract signing is scheduled for April 24.

In light of this submission, the Court suspended an earlier interim order directing the NPDA to continue providing services in the public interest.

The latest announcement suggests that the “Trust Mode” is not functioning seamlessly so far.