Jammu Tawi, Jun 9: The J&K Private Hospitals and Dialysis Centres Association (JKPHDA) has announced its proposed de-empanelment from the Ayushman Bharat–SEHAT Scheme with effect from July 1, 2026, citing prolonged delays in reimbursement of claims, financial distress, and alleged non-compliance with National Health Authority (NHA) guidelines. The development could significantly impact healthcare delivery across Jammu and Kashmir.
JKPHDA said that despite repeated representations, empanelled private healthcare institutions continue to face long delays in receiving payments for services already rendered under the scheme.
“Private hospitals have continued to provide critical healthcare services in good faith and in the larger public interest. However, the prolonged blockage of legitimate reimbursements has reached an unsustainable level and is severely affecting the functioning of healthcare institutions across Jammu and Kashmir,” a spokesperson of the Association said.
The Association said that private hospitals play a crucial role in delivering specialised healthcare services, including dialysis, oncology treatment, intensive care, emergency services, cardiac interventions, trauma care, and major surgical procedures. “Maintaining these services requires uninterrupted procurement of medicines, consumables, implants, diagnostic equipment and the retention of skilled healthcare professionals. Delayed reimbursements directly affect our ability to meet these obligations,” the spokesperson added.
JKPHDA expressed particular concern over the impact of global geopolitical developments on healthcare costs, saying that ongoing tensions in the Middle East have disrupted international supply chains and significantly increased prices of essential medical products, including cancer medicines such as Cisplatin and Carboplatin, as well as cardiac stents and orthopaedic implants.
The Association also raised concerns over what it described as an imbalance in fund utilisation, claiming that while private hospitals struggle with unpaid claims, more than Rs 180 crore of Ayushman Bharat funds are reportedly lying unutilised with public hospitals.
“Paying public hospitals at the cost of private hospitals is like transferring money from one government pocket to another without serving the intended objective,” it said.
JKPHDA further contended that delays in claim processing violate contractual provisions, noting that, as per Section 6 of the Memorandum of Understanding, empanelled hospitals are entitled to receive one per cent interest per week on delayed payments, a provision from which hospitals have been deprived.
In view of the worsening situation, JKPHDA announced that private hospitals and dialysis centres across J&K have collectively resolved to begin the process of de-empanelment from July 1, 2026, unless immediate corrective measures are taken.
The Association has demanded immediate clearance of all pending claims with applicable interest, a transparent time-bound mechanism for reviewing rejected claims, segregation of payment systems for public and private hospitals, restoration of patient choice under the scheme, and structured engagement with private healthcare providers.
JKPHDA cautioned that without timely reimbursements and adherence to agreed payment norms, the financial sustainability of many empanelled hospitals and dialysis centres could be severely compromised, urging authorities to intervene urgently to prevent any disruption in patient care under the scheme.
