Are Private Hospitals De-Empanelling From Ayushman Bharat Yojana?

The Pradhan Mantri Ayushman Bharat Yojana offers free health insurance of Rs 5 lakh to the eligible beneficiaries, including senior citizens aged 70 years and above. The beneficiaries can avail of the insurance benefit at the empanelled government and private hospitals. However, these empanelled hospitals can be de-impanelled by the government, or they themselves can seek de-empanelment. When Rahul Gandhi, Leader of the Opposition, asked in the Lok Sabha about whether private empanelled hospitals have withdrawn from the Ayushman Bharat scheme and the number of hospitals that have withdrawn from the scheme since its inception, Prataprao Jadhav, Minister of State in the Ministry of Health and Family Welfare, gave a written reply.

Per the reply, there were a total of 36,229 empanelled hospitals comprising 19,483 public and 16,746 private hospitals as of February 28, 2026. The reply highlighted the growth in empanelled hospitals over the years, from 6,917 hospitals (3,013 public and 3,904 private) in the financial year 2018-19 to over 36,000 by February 2026, but didn’t provide the data about the de-empanelled hospitals.

In the separate reply in the LoK Sabha, the Minister of Health and Family Welfare, Jagat Prakash Nadda, replied that the public healthcare scheme Ayushman Bharat Yojana, provides secondary and tertiary care hospitalisation to around 12 crore people from the economically weaker section of the society, and 6 crore senior citizens (70 years and above) irrespective of their economic background, and around 37 lakh families of the Accredited Social Health Activists (ASHA) workers, anganwadi workers and anganwadi Helpers, private healthcare providers are encouraged to participate in the scheme to extend their service.  

National Health Authority (NHA) Monitors Fund Utilisation

Nadda replied that the National Health Authority (NHA) monitors the utilisation of the fund under the scheme. “As of January 31, 2026, a total of 11.46 crore hospital admissions, amounting to Rs 1.69 lakh crore, have been authorised under the scheme. Out of these, 5.77 crore hospital admissions amounting to Rs 1.15 lakh crore, have been authorised in private empanelled hospitals.” Notably, the government reimburses the private hospitals for performing the approved procedures under the Ayushman Scheme for the beneficiaries.

The State Health Agencies (SHA) settle the claims on a regular basis, which is 15 days from the claim submission for hospitals located within the State and within 30 days for hospitals situated outside the State. The SHA examines the reimbursement claims made by the empanelled hospitals, checks the clinical documents, investigation reports, and other supporting records as per the guidelines of the prescribed standard treatment, replied Jadhav.

How To Make a Complaint When Treatment Is Denied

The empanelled hospitals cannot deny treatment to the eligible beneficiaries. In case a hospital denies the treatment, beneficiaries can make a complaint against that empanelled hospital online through the Centralised Grievance Redressal Management System (CGRMS). They can also lodge a complaint by calling the 24-hour help line number 14555, clarified Jadhav, in his reply.

The complaints are monitored at different levels, and the redressal process works at three levels, starting at the District level, and then the State and National levels. The respective nodal officers and Grievance Redressal Committees are responsible for examining and resolving the complaints.

Per the reply, Rs 2,802 crore have been authorised towards 12.48 lakh hospital admissions under the Ayushman Vay Vandana category beneficiaries, as of February 28, 2026.