The Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY), meant to provide affordable and accessible healthcare to low-income families, was launched by Prime Minister Narendra Modi in Ranchi in 2018. More than 23 lakh people in Jharkhand have availed treatment under the scheme since then.But pending payments to the tune of Rs 190 crore and mounting are jeopardising the future of Ayushman Bharat in Jharkhand. Some 212 hospitals have not received payments since last June, and the rest 538 hospitals empanelled under the scheme await reimbursement since February this year.Hospitals in the districts of Hazaribagh, Koderma, Palamu, and Deoghar have already pulled out of the scheme citing the hold up in payments. And this may just be the beginning.An ambitious schemeAB PM-JAY is the largest health insurance scheme in the world.It provides a cover of Rs 5 lakhs per family per year to eligible beneficiaries for hospitalisation expenses in both government and empanelled private hospitals. At the moment, some 750 hospitals in Jharkhand are registered under the scheme, according to the Association of Healthcare Providers of India (AHPI) and the Indian Medical Association (IMA).Current eligibility extends to the bottom 40% households, which is calculated based on deprivation and occupational data from the Socio-Economic Caste Census of 2011. The Prime Minister last year announced that coverage will soon be extended to all citizens aged 70 years and above.Story continues below this adThe cost of implementation of AB PM-JAY is shared between the Central and State Governments in a 60:40 ratio.According to Jharkhand officials, around 28 lakh families (some 1.5 crore people) are enrolled under AB PM-JAY in Jharkhand, with another 38 lakh families (roughly 2 crore people) covered through the state-run Mukhyamantri Swasthya Bima Yojana, for which the state bears the full cost.The way these schemes work is that beneficiaries are issued insurance cards, using which they can avail healthcare services in empanelled hospitals. These hospitals are then reimbursed on actuals by the government from the funds allocated under the scheme.Officials have confirmed to The Indian Express that there is no shortage of funds under the AB PM-JAY scheme, with Rs 2,284 crore allocated to the hospitals over the last 7 years. The problem is that beginning last year, the disbursement of these funds to hospitals has stalled.This is due to two main reasons.Story continues below this adIRREGULARITIES & ED CASES: Last year, the National Anti Fraud Unit (NAFU), using AI, flagged 212 hospitals — 180 private and 32 government — for alleged irregularities in the implementation of Ayushman Bharat. These hospitals were subsequently placed “on hold”, which means that the further disbursement of funds to them was halted until the Enforcement Directorate (ED) completes its investigation.In April 2025, the ED conducted raids at 21 locations across Jharkhand, including prominent hospitals in Ranchi localities like Ashok Nagar, PP Compound, and Lalpur. These raids were linked to a CAG audit, which flagged alleged fraud, including the existence of ghost beneficiaries. The ED investigation is ongoing.Meanwhile, funds to the other 538 hospitals empanelled under the Ayushman Bharat scheme in Jharkhand, have also been stopped since earlier this year. This has been at the heart of the growing frustration in the state with the scheme.“The ED is investigating 212 hospitals, till then the remaining hospitals also have to suffer,” said Dr Sayeed Ahmad Ansari, president of the AHPI, Jharkhand. Ansari and others have questioned why the hospitals not flagged by NAFU have also had their funding stopped.Story continues below this adOn Tuesday (June 3), Jharkhand Health Minister Irfan Ansari chaired a meeting with representatives of at least 200 hospitals and other senior officials. After the meeting he announced that the process to release funds to hospitals not under the ED scanner will be started at the earliest.Read | Why PM is expanding Ayushman Bharat to senior citizensA NEW GLITCHY PORTAL: Dr Anant Sinha, senior surgeon and president of the Jharkhand chapter of the IMA-affiliated Hospital Board blamed the stalling of payments on the introduction of a new web portal earlier this year. “We were told the things would be streamlined by March… We are still waiting,” he said.Sinha is talking about HEM 2.0 which replaced the older Health Entitlement Management portal, a digital platform used for identifying, verifying, and managing beneficiaries under health schemes like AB PM-JAY.Doctors and officials claim that payments are held up at multiple stages, mostly because of procedural changes and technical shifts in the new web portal. Much of the current logjam is attributed to the launch of HEM 2.0, and the increased insurance cap which accompanied its introduction in February.Story continues below this ad(The Jharkhand government increased the insurance coverage from Rs 5 lakh to Rs 15 lakh per family under the Mukhyamantri Abua Swasthya Suraksha Yojana, the state’s co-branded version of AB PM-JAY, which has also expanded coverage to 38 lakh families in Jharkhand, including all ration card holders in the state).Critics say HEM 2.0 lacks essential filters which has led to backlogs and missing data. As per the officials, another problem is that the payment follows FIFO (First In, First Out) mode where bills are cleared in the order they were approved, not the order in which they are filed. This rigid flow has further slowed claim settlements.A political slugfestDr Sinha said that non-payment of Ayushman Bharat dues has meant that he has been unable to pay his staff since March. He added that if the payments did not come in, he would stop taking Ayushman Bharat card holders as patients. “The real loss is to the government and the public,” Sinha warned.AHPI and IMA have claimed that 60 of the 212 NAFU-flagged hospitals have shut down under financial duress. More closures may be on the way if the situation is not sorted out soon.Story continues below this adAlso Read | Lancet study shows Ayushman Bharat helped more people access timely cancer therapyThis has made Ayushman Bharat a growing political issue in Jharkhand as well. Babulal Marandi, the state chief of the BJP and the Leader of the Opposition in the state Assembly, accused Hemant Soren’s government of failing to implement the Ayushman Bharat scheme in the state. “Ayushman Bharat, launched by PM Modi from Jharkhand, is now barely functional here,” Marandi said.He claimed that over 500 hospitals have not been paid since February 25, and more than 200 haven’t received dues for the past 10 months. “Hospitals are shutting Ayushman services. Patients are being left in the lurch,” he said.Health Minister Ansari, while countering the former CM’s allegations, said that until the ongoing investigation is completed, no hospital will be paid. Ansari claimed that several hospitals linked to BJP leaders are under scrutiny. “Let me be clear — those misusing the Ayushman scheme for corruption will not be spared,” he said.