Private Hospitals Under State Health Scheme Struggle As Maharashtra Govt Fails To Clear ₹182 Crore Pending Bills

Mumbai: A large number of private hospitals empanelled under the Mahatma Jyotiba Phule Jan Arogya Yojana (MJPJAY) — which covers over 1,600 medical and surgical procedures — are reeling under financial strain as the Maharashtra government has failed to clear pending bills worth over Rs 182 crore. The dues have remained unpaid for several months, with many hospitals claiming that payments have been stuck since last year.

Smaller Hospitals Worst Hit

According to official data, of the 1,792 hospitals participating in the scheme, 1,144 are private. The backlog has hit smaller hospitals the hardest, especially in tier-2 and tier-3 cities, where MJPJAY beneficiaries form a major share of patients.

Many hospitals are now reluctant to admit new patients under the scheme due to uncertainty over reimbursements. In some cases, essential surgeries have been reportedly postponed as suppliers have stopped providing medical implants and consumables amid unpaid dues.

Transition To New Payment Model Causing Delays

An official from the Health Department said the government has so far disbursed around Rs1,550 crore. However, as of the last week of September, about Rs 182 crore remained pending.

The delay has been attributed to the scheme’s transition from an insurance-based model—where private insurers settled hospital claims—to an “assurance mode,” under which the state government directly manages payments.

Health Minister Admits Technical Issues

State Health Minister Prakash Abitkar admitted there were some technical issues that led to the delay. “The finance department has already approved the payments, and they will be cleared gradually before the end of the year,” Abitkar said. He added that as of now, only Rs 182 crore remains pending.

Experts Warn Of Credibility Risk

While the government claims to have cleared most payments under various health schemes, hospital associations argue that the settlement process remains slow and inconsistent. Verification and approval of claims often take months, disrupting cash flow and routine hospital operations.

Healthcare experts warn that such payment delays undermine the very purpose of MJPJAY—to provide free, cashless treatment to low-income families. They caution that unless the government expedites bill clearances and ensures timely reimbursements, the credibility of the state’s flagship health assurance scheme could be at risk.

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Monthly Settlement Plan From Next Year

Abitkar has assured that pending dues will be cleared soon and announced that, starting next year, all MJPJAY bills will be settled on a monthly basis to prevent future backlogs.

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