Ayushman Bharat Cardiac Services Suspended for Nine Months at Gurgaon Hospital
Cardiac treatment under the Ayushman Bharat scheme has been suspended for nearly nine months at Gurgaon's Sector 10 civil hospital, raising significant concerns over governance and access to critical healthcare services. The public-private partnership-run cardiac centre, operated by Meditrina Group, stopped admitting Ayushman beneficiaries in June 2025, citing unpaid dues and administrative complications.
Payment Disputes and Administrative Issues
Officials revealed that approximately Rs 1.25 crore was pending at the time of suspension, though nearly Rs 1.5 crore had been paid earlier. Director General of Health Services (DGHS) Manish Bansal confirmed that a committee was constituted on March 19 to investigate the halt in services. "The committee will examine why treatment is not being provided. We will act accordingly," he stated.
However, medical professionals familiar with the situation argued that payment delays alone could not justify a nine-month suspension. They pointed to discrepancies in billing patterns and claim submissions by the private operator that had been flagged internally over an extended period.
Private Operator's Response and Registration Challenges
Meditrina Group denied allegations of irregularities. Manager Mandeep Kumar explained that dues of around Rs 1.5 crore had been pending for nearly three years, severely affecting operational sustainability. "If there are any irregularities, they should be put in the public domain. We have raised issues. In some cases, we received objections after two years, which is why cases are still pending," he said.
Bansal highlighted that the issue also involved non-compliance with Ayushman Bharat registration norms. "There were irregularities in document submission, as a result of which payments were not processed. The centre is seeking direct registration under Ayushman Bharat, which is not possible as it operates within Sector 10 civil hospital. One hospital can have only one registration," he emphasized.
Scheme Guidelines and Registration Rules
Under Ayushman Bharat guidelines:
- Each hospital is permitted only one unique registration ID linked to its physical location, infrastructure, and approved facilities.
- Private operators running specialized units within government hospitals under PPP arrangements cannot seek separate registration if services are provided from the same premises.
- Such units must function under the parent hospital's registration.
Officials explained that this rule ensures a single claim trail, prevents duplication, and enables effective auditing of billing patterns, procedures, and patient records. Registration is also tied to approved bed strength, equipment, and manpower, with any mismatch potentially leading to withheld claims.
Impact on Patients and Healthcare Access
The suspension has significantly affected patient access to cardiac care. Cardiac procedures at the centre typically cost between ₹60,000 and ₹65,000 under Ayushman Bharat packages. With scheme admissions closed, many patients are being forced to seek treatment at costlier private hospitals or travel to other districts.
Beneficiaries, particularly those from outside Haryana, are also being turned away. Civil surgeon Lokveer Singh noted, "Ayushman beneficiaries are being accommodated under the BPL category for limited treatment."
Governance Concerns and Committee Investigation
Despite the prolonged disruption, officials admitted that no formal escalation or corrective action was initiated for months, raising serious questions about the monitoring of PPP-run facilities and enforcement of scheme norms.
Under Ayushman Bharat rules:
- Empanelled hospitals are mandated to provide cashless treatment to eligible beneficiaries.
- Services cannot be denied without valid grounds.
- Claims must be processed through a defined digital system, with deviations inviting scrutiny.
The committee is expected to examine both payment bottlenecks and registration and billing practices, with recommendations aimed at restoring services and ensuring compliance with healthcare scheme regulations.
