Suspension of Cashless Health Services in Rajasthan and Other States

Private hospitals in Rajasthan are set to suspend cashless treatment under the Rajasthan Government Health Scheme (RGHS) starting July 15. This decision follows the state’s failure to address pending dues of around Rs 980 crore owed to hospitals. 

Private hospitals have not received payment for their services for the past five to six months, leading to the suspension of cashless treatment options. Dr. Vijay Kapoor, the president of the Private Hospitals Association, highlighted that many hospitals are facing financial issues due to these unpaid dues. 

The non-payment has forced multiple hospitals to be de-empanelled from the RGHS and face penalties based on AI-generated data, although legitimate dues remain unpaid. The ongoing situation is described as unsustainable by hospital representatives. 

The Private Hospitals Association proposes a shift from a cashless treatment model to a reimbursement-based system. In this new model, patients would pay for treatments upfront and then submit necessary documentation to claim their expenses back from the government. 

The association is calling for automatic empanelment of all hospitals registered under the Clinical Establishments Act for inpatient services under RGHS to improve accessibility. Additionally, they recommend that patients be allowed to purchase medicines from any licensed pharmacy, reducing dependency on specific providers. 

The issue of unpaid dues leading to the suspension of cashless treatment services under government health schemes is a recurring problem across multiple Indian states. Several states have faced similar challenges with their health schemes, leading to disruptions in healthcare services.

Punjab

In Punjab, private hospitals suspended cashless services under the Ayushman Bharat scheme due to pending dues. The Nursing House Cell (NHC) announced the suspension, citing unpaid dues of ₹600 crore for the last six months. The NHC stated they would not resume services until the dues were cleared and a standard operating procedure (SOP) was established to prevent future occurrences. The state government claimed the pending amount was ₹364 crore. The association highlighted that the non-payment of dues was pushing hospitals into debt, affecting their ability to pay staff and suppliers.

Andhra Pradesh

In Andhra Pradesh, all cashless health services under Dr. NTR Vaidya Seva in private network hospitals were discontinued from April 7, 2025, due to unpaid dues of around ₹3,200 crore. The A.P. Speciality Hospitals’ Association stated that the dues had been accumulating since the previous government’s tenure. Despite the government releasing ₹300 crore, the association decided to discontinue services due to the financial strain. 

Other States and Schemes

Similar issues have been reported in other states and schemes. Top private hospitals, including Fortis, Max, BLK, and Medanta, warned the government of suspending cashless treatment under the Central Government Health Scheme (CGHS) and Ex-servicemen Contributory Health Scheme (ECHS) if their dues were not paid within 15 days. The pending dues amounted to ₹650 crore. The Ayushman Bharat scheme, a national health insurance scheme, has also faced challenges with pending claims, with hospitals decrying the non-payment for services rendered. One report indicated that ₹1.21 lakh crore in claims were pending under the Ayushman Bharat Yojana. 

The common thread across these states is the financial strain on private hospitals due to delayed or non-payment of dues under government health schemes. This has led to the suspension of cashless services, impacting beneficiaries’ access to healthcare.

Final Note: Say No to Cashless!

Additional Information:

Digital India: Tech Talk on Next Generation Services – Faceless, Paperless & Cashless

A Seminar on Next Generation Services – Faceless, Paperless and Cashless has been conducted by Ministry of Electronics and IT at IITF 2016, Pragati Maidan.

Speakers:

1. Ms. Marina Walter, Deputy Country Director, UNDP
2. Shri Madhivanan Balakrishnan, Chief Technology and Digital Officer, ICICI
3. Shri Gagan Rai, MD and CEO, National Securities Depository Limited (NSDL)
4. Shri V Srinivasan, CEO, e-Mudhra
5. Shri A.P. Hota, MD and CEO, National Payments Corporation of India (NPCI)
6. Shri N. Nawin Sona, IAS, Director General, Vasantrao Naik State Agricultural Extension Management Training Institute (VANAMATI)

Also Read:

Ref:

1. Pvt hosps to stop cashless RGHS services from July 15 over unpaid dues. [https://timesofindia.indiatimes.com/city/jaipur/pvt-hosps-to-stop-cashless-rghs-services-from-july-15-over-unpaid-dues/articleshow/122372929.cms]
2. Pending payments Pvt hospitals suspend cashless services under Ayushman scheme. [https://www.hindustantimes.com/cities/chandigarh-news/pending-payments-pvt-hospitals-suspend-cashless-services-under-ayushman-scheme-101726937835595.html]
3. Ayushman Bharat scheme: Private hospitals refuse cashless treatment, clear ₹600 crore dues first. [https://indianexpress.com/article/cities/chandigarh/ayushman-bharat-scheme-private-hospitals-refuse-cashless-treatment-clear-600-crore-dues-first-9575722/]
4. Services under Dr. NTR Vaidya Seva in all private network hospitals in Andhra Pradesh to stop from April 7. [https://www.thehindu.com/news/national/andhra-pradesh/services-under-dr-ntr-vaidya-seva-in-all-private-network-hospitals-in-andhra-pradesh-to-stop-from-april-7/article69422043.ece]
5. Fortis, Max hospitals to stop cashless treatment if Modi govt doesn’t clear dues in 15 days. [https://theprint.in/health/fortis-max-hospitals-to-stop-cashless-treatment-if-modi-govt-doesnt-clear-dues-in-15-days/337946/]
6. First low Rates, then No Payments! Hospitals decry Ayushman Bharat Yojana, point to Rs 1.21 LAKH crore dues. [https://medicaldialogues.in/news/health/hospital-diagnostics/first-low-rates-then-no-payments-hospitals-decry-ayushmanbharatyojana-point-to-rs-121-crore-dues-144310]