Excelsior Correspondent
Srinagar, Mar 25: The transition to the new “trust mode” under the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) has led to significant delays in claim settlements in J&K, the J&K Private Hospitals and Dialysis Centres Association said today.
In a statement issued here, the association said pending dues have mounted to around Rs 240 crore, pushing private healthcare providers to the brink of a financial crisis.
The association said payments to private hospitals and dialysis centres have remained pending for months, following the State Health Agency’s (SHA) shift to the “trust mode” earlier this year, triggering a severe financial crisis in the sector.
It said that the SHA adopted the new policy (PS-8) under AB-PMJAY and AB-PMJAY SEHAT from April 17, 2025, ending its earlier arrangement with a private insurance company.
However, the association alleged that the transition has led to significant delays in claim settlements.
Association president Sandeep Mengi said payments amounting to “hundreds of crores” have been pending for nearly a year, with less than 30 percent of dues cleared since the introduction of the new system.
He added that additional payments from earlier policy periods-PS4, PS5 and PS6-also remain unsettled, along with what he termed “ingenuine deductions and rejections.”
He noted that the payments are severely delayed despite a 98.8 percent case acceptance rate.
“We request an audit of payment timelines and scheme aspects and urge corrective action to ensure sustainability,”
He warned that the prolonged delays have pushed private healthcare providers to the brink, making it difficult to pay vendors and procure essential medical supplies
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