GURGAON: Cardiac treatment under the Ayushman Bharat scheme has been suspended for nearly nine months at Gurgaon’s Sector 10 civil hospital, raising concerns over governance and access to care.The public-private partnership-run cardiac centre, operated by Meditrina Group, stopped admitting Ayushman beneficiaries in June 2025, citing unpaid dues and administrative issues. Officials said around Rs 1.25 crore was pending at the time, though nearly Rs 1.5 crore had been paid earlier.Director general of health services (DGHS) Manish Bansal told TOI that a committee was constituted on March 19 to probe the halt. “The committee will examine why treatment is not being provided. We will act accordingly,” he said.However, doctors familiar with the matter said payment delays alone could not explain a nine-month suspension. They pointed to discrepancies in billing patterns and claim submissions by the private operator that had been flagged internally over time.Meditrina denied the allegations. Manager Mandeep Kumar said dues of around Rs 1.5 crore had been pending for nearly three years, 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 said 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 said.Under the scheme’s guidelines, each hospital is permitted only one unique registration ID linked to its physical location, infrastructure and approved facilities. Private operators running specialised units within government hospitals under PPP arrangements cannot seek separate registration if services are provided from the same premises.Such units are required to function under the parent hospital’s registration. Officials said the 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, and any mismatch can lead to claims being withheld.The halt has significantly affected access to 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 turn to costlier private hospitals or travel to other districts.Beneficiaries, especially from outside Haryana, are also being turned away. Civil surgeon Lokveer Singh said, “Ayushman beneficiaries are being accommodated under the BPL category for limited treatment.”Despite the prolonged disruption, officials admitted that no formal escalation or corrective action was initiated for months, raising questions over monitoring of PPP-run facilities and enforcement of scheme norms.Under scheme rules, empanelled hospitals are mandated to provide cashless treatment to eligible beneficiaries and cannot deny services without valid grounds. Claims must be processed through a defined digital system, and deviations can invite scrutiny. The committee is expected to examine both payment bottlenecks and registration and billing practices, and recommend steps to restore services.
