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Indian Express
05-07-2025
- Health
- Indian Express
‘Ayushman card helped my mother get timely treatment': Months after launch, how has the scheme fared in Delhi?
It was June 27, a Friday. Jai Prakash was finally admitted to a private hospital in South Delhi. Since December last year, he has been complaining of severe chest pain and palpitations. A check-up revealed that two of his heart valves were not functioning. He needed heart valve replacement surgery, and his local doctor suggested he go to Delhi. But the cost — over Rs 3 lakh — was far beyond his means. A 70-year-old farmer from Agra's Anguthi village, Prakash grew wheat on a 200-yard plot and made money based on how the crop performed. Then came a lifeline: the announcement that the Ayushman Bharat scheme was launched in Delhi. For Prakash, that meant access to a good private hospital, empanelled under the scheme, in the national capital — something previously out of reach. His cousin Ram Singh, who accompanied him from the village, said that 'the surgery and hospital admission, amounting to Rs 3.5 lakh, was covered under Ayushman Bharat. All Prakash had to pay was Rs 1,500 for the doctor's consultation fee and Rs 10,000 for diagnostic tests. It was Prakah's doctor in Agra who suggested he get the surgery done at the Delhi hospital, which specialises in heart health. 'Doctors are not that good where we live… Delhi is close by, a four-hour road journey from the village, and doctors here are more reliable. So, we came to the city,' says Singh, adding that Prakash underwent the surgery on June 28. Singh, also a farmer, said if not for the Ayushman card, they would have had to sell a part of their land to pay for the surgery. On April 11, the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) — the Central government's flagship health programme — was flagged off by the BJP Delhi government, promising health coverage of up to Rs 10 lakh per family per year. It was the BJP's biggest poll promise in the run-up to the Delhi Assembly elections. Three months following its rollout, the scheme has emerged as a crucial support system for low-income families like Prakash struggling with the rising cost of private healthcare. But there are some hiccups. First, big private players are yet to come on board, citing the pricing difference. Second, officials have pointed to a lack of staff and infrastructure in hospitals for the scheme to take off. So far, 69 private hospitals (including 7 daycare centres) and 39 central and state government hospitals (as per the have been empanelled under the scheme. Among these, a majority of facilities offer Ophthalmology services, followed by General Medicine, General Surgery, Obstetrics & Gynaecology, and Orthopaedics. Nodal officers have been appointed in these hospitals, and their numbers are provided on the website of the National Health Authority (NHA). The NHA is the apex body responsible for the scheme's implementation. Since Delhi was onboarded onto the PMJAY, a total of 3,92,181 Ayushman cards have been issued to residents, and over 20,000 hospital admissions have taken place so far. Top procedures conducted in Delhi include chronic hemodialysis, cataract surgery, cesarean delivery, and common bile duct laparoscopic surgery. To understand the early impact of AB-PMJAY in Delhi, The Indian Express visited 15 private hospitals empanelled under the scheme and spoke to patients and officials about the benefits and challenges. Over the course of a week, The Indian Express found several patients from Delhi and nearby states availing of the scheme's benefits. Many also stopped by Ayushman kiosks set up at some hospitals to inquire about eligibility and services. At one such hospital was Mahendri Devi. The 73-year-old had to undergo surgery for a broken leg — she had been hit by a bull at her home in Narela's Kheda Khurd village. Her son, Manoj, a farmer, rushed her to a nearby private hospital and inquired whether the Ayushman card could be used. The hospital confirmed her eligibility under the scheme. He said he had to pay Rs 15,000 for initial diagnostic tests, which were not covered, but the cost of the surgery and hospital admission was taken care of under the scheme. 'Thanks to the card, my mother received timely treatment,' he said. 'Otherwise, we would have spent lakhs.' Devi received her Ayushman card from Delhi Chief Minister Rekha Gupta on April 28; she was among 40 elderly beneficiaries who were given the card at the launch of the Ayushman Bharat Vaya Vandana Yojana, a scheme for those aged 70 and above. Manoj had one grouse, though — he said he was yet to receive any official confirmation detailing how much of the scheme's benefit was utilised for his mother's treatment. At many hospitals, however, patients faced issues. They complained that the scheme was not prominently advertised — The Indian Express also found no posters or display charts explaining its benefits. Many were also unclear about which services were actually covered. Saaki Ram Lal from Jhansi, who recently underwent a bypass surgery at a private hospital in South Delhi, said he wasn't aware that the hospital provided coverage under Ayushman Bharat. 'There was no board or poster we could refer to. We did not inquire either,' he said. Some patients reported information gaps. Manohar Lal (45), a prostate cancer patient, was undergoing treatment at a major cancer care hospital in West Delhi. He had been advised to undergo chemotherapy. But the hospital told him that it wasn't covered under Ayushman Bharat and would be billed for it — forcing him to stop treatment. 'I didn't know it wasn't covered. I will now go to a government hospital,' he said. An official in the state health department said cancer care is one of the biggest challenges when it comes to coverage under Ayushman Bharat, owing to how expensive it is. 'Since investment in cancer care is very high, hospitals are not very keen to cater to such patients.' 'Chemotherapy drugs can cost anywhere between Rs 40,000 and Rs 1.50 lakh,' he added. In a similar case, Ram Singh (73) had taken his wife, Kalawati, to a private hospital in Southeast Delhi to get her cataract treated. He was charged Rs 1,500 for an OPD consultation in the ophthalmology department — he didn't know it wasn't covered under the scheme. 'They should have told me. I had no money… My son lives in Faridabad, while we live in Sangam Vihar. We are on our own,' he said. Singh used to work as a contractor. He gets by with occasional support from his son. He then reached out to the area MLA, who asked him to visit the hospital again with his ration card to avail of the OPD consultation under the EWS scheme for free. Seventy-two-year-old Ashok Pandey and his wife Sita Devi faced trouble paying for diagnostic tests at a private hospital in Central Delhi. Devi was diagnosed with a tumour in her stomach. The couple, who lives in Karawal Nagar, said the doctor had prescribed several tests, but they were not covered by the hospital under PM-JAY. 'We'll have to spend thousands on a CT scan and biopsy… Only after these tests are done will the treatment begin,' said Ashok, a retired MCD school teacher. At some facilities, services under PMJAY have not started due to numerous reasons. When The Indian Express contacted hospitals listed as empanelled on the official PMJAY website, it found that: -Registrations at several hospitals were still pending. -Some hospitals were in the process of setting up a portal for the billing system. -Several were hiring new staff before beginning operations under the scheme. -A few hospitals reported issues on the 'backend' of the system. -Many were yet to sign the memorandum of understanding. -Some were still completing the required documentation. An official in the state health department acknowledged the issues. He said, 'Earlier, before the scheme was implemented in Delhi, it was the National Health Authority (NHA) that oversaw hospitals treating patients from other states. After the scheme was rolled out in Delhi, hospitals had to sign a fresh MoU with the state government, which has caused delays in the start of services.' 'We are facing challenges in the empanelment process, which we are actively working to resolve. Key issues include setting up the required infrastructure in each Delhi hospital, hiring staff for the scheme, deciding their salary structures, and establishing the billing portal,' added the official. While Delhi government hospitals will provide services free of cost, implants and consumables for patients will be covered under the scheme. According to sources in the state health department, a major challenge is that many empanelled hospitals are dissatisfied with delayed payments, reduced incentives from the NHA, and ongoing discussions over low tariffs. 'Hospitals have raised these issues with us, and we are trying to resolve them,' the official added. He said this is also why many big players are not on board with the scheme. 'Officials have been in constant touch with private hospitals. Even hospitals providing services in other states, but not in Delhi, have shown reservations owing to the low tariff,' the official added. Delhi Health Minister Pankaj Singh and the Delhi Health Secretary did not respond to calls and messages seeking comment. To be sure, when the BJP government completed 100 days in power on May 31, Singh had said that all 'big hospitals' of Delhi would be brought under the Ayushman Bharat insurance umbrella in the next '20-25 days'. At the time, Singh had said private hospitals were hesitant to sign up because the previous AAP government did not clear pending payments under other schemes: 'They did not make the payment on time from Delhi Arogya Nidhi (the financial assistance scheme run by the Directorate General of Health Services). Now I ensure that in the next 20-25 days, all big hospitals will be empanelled under Ayushman Bharat.' The previous AAP government had refused to implement Ayushman Bharat in Delhi on the grounds that its own schemes were better. The AAP's schemes included free treatment for all citizens in government hospitals and free surgeries in 81 private hospitals for those who had to wait a long time for diagnoses and treatment in government-run hospitals. Dr Vipender Sabherwal, convenor for Ayushman Bharat, who is also representing the Association of Healthcare Providers India (APHI), said the association is planning to issue a white paper to the NHA on the issues being faced. AHPI represents about 15,000 private hospitals, including Fortis, Max Healthcare, Manipal, Medanta, Narayana and Apollo. 'We will do it in the next 10 days… There has been no headway so far, because of which major private players are not on board. Even those who are providing services are not very happy and are reconsidering their decision,' he added. Despite the issues around coverage and services, beneficiaries are happy with the scheme. Manoj, who is the sole breadwinner of his family comprising his parents, wife, and two children, said it took a load off his chest. He earns Rs 25,000 a month growing wheat and a few vegetables in the village. 'I was relieved. Otherwise, I would have been forced to take a loan or run around to arrange money for my mother's surgery,' he said.
The Hindu
02-07-2025
- Health
- The Hindu
Fake cardiologist row: NHRC directs Centre for nationwide verification of cath labs
The National Human Rights Commission (NHRC) has directed the Union Ministry of Health and Family Welfare (MoHFW) to verify all catheterisation laboratories (cath labs) across the country in view of the case of a 'fake cardiologist' who was arrested in April after multiple deaths were reported at a hospital in Madhya Pradesh's Damoh. Also Read | 'Fake' cardiologist row: Damoh Mission Hospital management booked for forgery In a report dated July 1, seen by The Hindu, the NHRC has also issued a set of directions to Madhya Pradesh authorities, including an inspection of all cath labs functional in the State and verification of qualification of doctors working in the labs, and a departmental action against the Chief Medical and Health Officer (CMHO), Damoh. The human rights body issued directions based on its enquiry that was initiated in March on a complaint from Damoh Child Welfare Committee president, Deepak Tiwari, who had alleged that at least seven patients treated by Narendra Vikramaditya Yadav, who posed as a United Kingdom-based cardiologist identifying as Dr. N. John Camm, had passed away at Mission Hospital, Damoh. A three-member team of the NHRC had also visited Damoh in April to investigate the matter. Mr. Yadav had been arrested from Uttar Pradesh's Prayagraj in April, about two months after he worked at the hospital in Damoh, after an FIR was filed against him for fraud and forgery. Over the course of the investigation, the local police had revealed that Mr. Yadav had been posing as a cardiologist for about 20 years and impersonating Dr. John Camm, a famous cardiologist, for about 10 years and had worked in various hospitals across India, including Apollo Hospital, Raipur, Chhattisgarh; Fortis Hospital, Kota, Rajasthan; and Wockhardt Hospital, Hyderabad, Telangana. The police had claimed that while his MBBS degree from University of North Bengal, Siliguri, in 1996 had been verified, various other degrees and certificates such as MD and DM were found to be 'forged'. However, the NHRC said that the principal of the North Bengal Medical College has denied that Mr. Yadav studied there. In its report, the NHRC has also flagged 'serious irregularities' in the implementation of Ayushman Bharat-Pradhan Mantri Jan Aarogya Yojana (AB-PMJAY) at Mission Hospital and alleged that the hospital had been charging patients for services covered under the Scheme. 'It was observed that the hospital have systematically misused the scheme by issuing fraudulent bills for treatments. It has also been brought to the notice of the inquiry team, through the statements made by multiple family members of the patients, that there has been a pattern of overcharging, particularly in relation to high-cost procedures such as angiography,' the report said, asking the Union Health Ministry to issue directions to all State Governments to check the implementation of the Scheme in 'its letter and spirit'. 'Further, it was observed that accused Ajai Lall was allegedly collecting foreign funding from aboard in the name of poor patients treatment at Mission Hospital,' it added. The NHRC has also asked the Income Tax department to probe the 'alleged fund raising and donations from aboard' at the hospital. The body asked Madhya Pradesh authorities to initiate departmental action against Damoh CMHO for 'negligence and dereliction of duty' over issuing the licence of cath lab to Mission Hospital in the name of Jabalpur-based cardiologist Akhilesh Dubey, who 'denied giving his consent'. Further, the NHRC also directed the State Director-General of Police Kailash Makwana to ensure registration of separate FIRs in the cases of seven deaths, an FIR against hospital trustee Ajay Lall under relevant criminal provisions, and departmental action against police officers involved in 'negligence in registration of FIR and investigation'.
The Print
02-07-2025
- Health
- The Print
NHRC orders nationwide audit of cath labs by Centre after 7 die in MP at ‘hands of fake cardiologist'
In April this year, MP Police had arrested a man named Narendra Vikramaditya Yadav who impersonated Dr N. John Camm, a well-known cardiologist in London, by faking documents as a interventional cardiologist and performing procedures such as angiography and angioplasty that led to several fatalities at a Mission Hospital in Damoh. It is estimated that there are about 1,600 cardiac catheterisation laboratories or cath labs—specialised medical facilities equipped to perform minimally invasive procedures to diagnose and treat heart conditions—across 140 cities in India. Moreover, nearly 220 new such labs are being added in India annually. New Delhi: The National Human Rights Commission (NHRC) has instructed the Union Health Ministry to conduct an audit of cath labs across India following its enquiry into the case of a fake cardiologist performing cardiac procedures in Damoh, Madhya Pradesh, that resulted in at least seven deaths, ThePrint has learnt. Yadav had previously worked with several hospitals in different states as a doctor—including the Apollo hospital in Raipur—and his name had figured in a list of doctors whose registrations were suspended by the Medical Council of India several years earlier following complaints of fraud. It is not yet clear how Yadav managed to establish himself as a doctor and received a licence in medicine to practise. The 8-page NHRC report, a copy of which is with ThePrint, says that not only did Yadav not have the specialisation to work as a cardiologist, there was no record of even his MBBS degree. According to local media reports, the police had found that his documents showed Yadav had studied MBBS at the North Bengal Medical College, Darjeeling, but the Commission says that in response to its notice, the College said Yadav had not studied there. In MP, the Commission has said, qualifications of all doctors working in cath labs, should be verified. The NHRC report has also pointed out massive irregularities in the implementation of Ayushman Bharat-Pradhan Mantri Jan Aarogya Yojana (AB-PMJAY) at the Mission hospital, underlining that the patients were forced to pay for procedures despite the hospital also raising claims for these with the government. In view of these findings, the Commission has also asked the health ministry to take steps to prevent misuse of the central health insurance scheme. Under AB-PMJAY, over 50 crore Indians, from low socio-economic strata, are offered cashless hospitalisation worth up to Rs 5 lakh a year through a network of empanelled hospitals. The report says that the Damoh Mission Hospital management allegedly misrepresented Yadav's qualification and presented questionable documents to both public and relevant authorities to show him as an interventional cardiologist. 'This shows that the hospital also has completely failed to comply with medical regulations, patient safety standards and ethical practice,' the Commission has said. It has asked the state police to file an FIR against the hospital management on charges related to culpable homicide, fraud, cheating and forgery. NHRC, in its letter to the Union Health Secretary, MP Chief Secretary and the state police head on July 1, has asked for an action taken report within the next four weeks. 'Our enquiry has unearthed massive systemic issues that led to loss of lives of hapless patients and accordingly we want action at multiple levels to ensure that such episodes are not repeated in future,' NHRC member Priyank Kanoongo told ThePrint. Also read: Damoh deaths row: MP's 'fake UK doctor' was banned by MCI for misconduct in 2014 Illegal authorisation for cath lab The Commission during its enquiry found that while one qualified cardiologist worked as a consultant at the hospital and visited once every month to see OPD patients, he denied having given consent to establish a cath lab at the centre. Yet, the lab was registered in his name, found the NHRC team. 'This clearly shows the fraudulent activities continuously taking place in the Mission Hospital,' the report says. The report goes on to mention that no inspection of the lab was carried out by the district health officer, Damoh, or his team, to verify the degree and registration of the doctor and the establishment. Noting that there has been negligence and dereliction of duty on the part of the district health officer, the report has instructed the MP chief secretary to carry out appropriate departmental action against him. Massive frauds under Ayushman Bharat Multiple family members of patients undergoing treatment at the faculty informed the team that they had paid up to Rs 2.80 lakh for procedures such as angioplasty at the hospital. Under the health insurance scheme, empanelled hospitals are supposed to provide services free of cost to the patient while the government reimburses the cost to the hospital at specified rates. The report noted that the malpractices by the hospital defeated the health insurance scheme's core objective of providing accessible and affordable healthcare to economically vulnerable individuals. The NHRC team also found that the hospital was collecting funds from abroad in the name of treating poor patients while indulging in malpractices and forcing patients to pay. These transactions should be thoroughly investigated, the Commission has instructed the state government, also directing it to examine the operation and running of the hospital in detail. The Commission has said that the next of kin of all 7 patients who died following surgeries by Yadav should be paid Rs 10 lakh each as compensation, which can be recovered from the hospital management or the fake doctor. (Edited by Viny Mishra) Also read: Warned imposter, decided against pursuing case legally, says British cardiologist Dr John Camm
Hindustan Times
13-06-2025
- Health
- Hindustan Times
Ayushman Bharat services start at private hospital in Delhi
Delhi chief minister Rekha Gupta on Thursday launched Ayushman Bharat services at Dharamshila Narayana Superspeciality Hospital. At an event to mark Cancer Survivor Month, Gupta also inaugurated a new 3D digital mammography unit and announced a major push toward preventive care for women. The hospital will offer 10,000 free cancer screenings — 5,000 mammography and 5,000 Pap smear tests — as part of a women's health campaign. The move enables eligible patients to access free cancer care under the Centre's Pradhan Mantri Jan Arogya Yojana (PM-JAY), which provides health insurance cover of up to ₹5 lakh per family per year to vulnerable populations. 'This unit is specially designed for the early detection of breast cancer in women, enabling timely treatment. Equipped with fully digital technology, it ensures quick and accurate diagnosis using the latest medical equipment. Cancer is a disease that causes emotional turmoil for entire families when it strikes. However, advancements in medical science today have made early detection and effective treatment possible,' Gupta said. To improve outreach, the hospital also announced the rollout of a mobile diagnostic van equipped with mammography and lab services. It will travel across Delhi to underserved areas, offering clinical breast exams, cervical cancer screening, and lifestyle counselling. Ayushman Bharat is a flagship health scheme of the government aimed at achieving health coverage. On April 5, an MoU was inked with the Union ministry of health and family welfare to implement the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY). With this, Delhi has become the 35th state to adopt the scheme. Dr Emmanuel Rupert, managing director and group CEO of Narayana Health, said the new initiatives aim to combine advanced technology with strong community outreach to improve early detection.
The Print
10-06-2025
- Health
- The Print
How Bihar is ramping up AB-PMJAY heath infra to keep patients from turning to Delhi, Vellore
As the state heads for a high-stakes assembly election later this year, the Bihar government has now intensified efforts to ramp up medical infrastructure, reaching out to beneficiaries of the Centre's flagship health insurance scheme so they don't have to go outside the state seeking treatment. The reason: Lack of quality health services, which led a high number of AB-PMJAY beneficiaries to avail the scheme's portability feature—allowing beneficiaries from one state to access healthcare in any other—and seek treatment in hospitals outside the state, at the All India Institute of Medical Sciences (AIIMS) in New Delhi and the Christian Medical College (CMC) in Vellore, among others. Patna/New Delhi: In the last financial year, the central and Bihar governments paid nearly a third of Ayushman Bharat-Pradhan Mantri Jan Aarogya Yojana (AB-PMJAY) funds for the state, to facilities outside of it. In addition, efforts are on to provide medical facilities for complex cases within Bihar by tying up with a higher number of private health facilities under the scheme. The data shared by the Bihar health department shows that in 2024-25, the total spending on AB-PMJAY was Rs 1,010.38 crore, of which Rs 333 crore or 32.9 percent was spent through the portability feature. However, the national spending under the scheme's portability feature was just 2.8 percent or Rs 3,100 crore, out of a total Rs 1,07,125 crore spent overall under the scheme, but the government is trying every bit under AB-PMJAY till September 2024. Under AB-PMJAY—which is aimed at providing cashless hospitalisation worth up to Rs 5 lakh to the poorest and most vulnerable population through a network of empaneled hospitals—the Centre and state bear the cost of treatment in a 60:40 ratio. Sheshank Shekhar Sinha, chief executive officer of Bihar Swasthya Suraksha Samiti (BSSS), which oversees the implementation of AB-PMJAY in the state, said efforts were on to provide required medical care to patients closer to home. 'A large number of patients from Bihar have been going to places like Delhi, Mumbai and Chennai for seeking care, but the government is trying every bit to strengthen specialty and superspeciality care in the state apart from primary health services,' he said. AIIMS, Patna, which is a centrally-run institute, was also being supported by the state government in every possible way, said Sinha, to emerge as a mega health hub in the state. Bihar Swasthya Suraksha Samiti figures show that in 2024-25, 145 hospitals had been onboarded under the scheme. An additional 100 hospitals—mostly private hospitals offering single or multi-specialty care—are in the pipeline to be empanelled under the scheme, according to Shailesh Chandra Diwakar, administrative officer with the BSSS. Since last year, according to details shared by the state government, authorities mapped all the registered hospitals in the state and districts and have been conducting field visits to assess potential empanelment readiness. According to the AB-PMJAY dashboard maintained by the National Health Authority—the agency under the Union Health Ministry responsible for the scheme's implementation—of the total 9.05 crore hospital admissions under the scheme since its 2018 launch, only 18 lakh admissions have involved patients from Bihar. For perspective, Tamil Nadu is among the states with the highest admissions, at over 1 crore. Also read: Why nearly dozen multi-speciality private hospitals in Delhi aren't too keen on AB-PMJAY empanelment Strong focus on beneficiary identification A key challenge, state government health officials said, has been relatively low awareness around AB-PMJAY. Initially, beneficiaries were based on the deprivation and occupational criteria of Socio-Economic Caste Census 2011 (SECC 2011) for rural and urban areas, respectively, as per the central government norm. However, in 2024, the state decided to expand it to all those covered under the National Food Security Act, 2013, or all those with ration cards. Following this, a major drive has been initiated to create Ayushman cards for the estimated beneficiaries. This includes door-to-door campaigns by ASHA workers, whose incentives were revised from Rs 5 per card to Rs 15 per card; and the engagement of panchayati raj executive assistants for the purpose, apart from intensified awareness campaigns. A total of 2.83 crore Ayushman cards were created in 2024, Diwakar pointed out. The statistics shared by the state government also showed that the government spending on the scheme jumped from about Rs 307 crore in 2023-2024 to 1010.38 crore in the last fiscal. 'This is a remarkable rise and testament to our commitment to let the needy take utmost advantage of the scheme,' a government official said. Also while in 2023-24 the government had settled claims against 3.03 lakh hospital admissions in Bihar, in the next financial year, this number crossed 7.5 lakh hospital admissions. But some public health specialists underlined that the state needs to work harder on improving the referral and primary health care. 'A 10-year-old rape victim recently succumbed to her injuries due to delay in treatment at two leading medical colleges in Bihar,' Amulya Nidhi, national convenor of Jan Swasthya Abihyan, a group that advocates patients' rights, told ThePrint. Without improving the referral and primary health care, Ayushman cards won't be of much help, he stressed. The death of the 10-year-old Dalit girl from Muzaffarpur following her alleged rape by a neighbour, outside the Patna Medical College and Hospital—one of the state's biggest government-run tertiary care centres—as she waited in an ambulance for admission, had triggered national outrage. She was earlier reportedly denied treatment at Sri Krishna Medical College and Hospital in Muzaffarpur. The episode, which took a political turn, saw the suspension of two senior doctors at these facilities by the state administration on charges of dereliction of duty. (Edited by Viny Mishra) Also read: Chirag targets Nitish over Muzaffarpur case, flags 'breakdown' in Bihar law & order, healthcare
