Dimapur: The Kohima bench of Gauhati High Court directed the private hospitals in Nagaland to continue health services under the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMAY) and Chief Minister Health Insurance Scheme (CMHIS).
The HC asked for the continuation as an interim measure in the interest of the public and to keep the health care system uninterrupted.
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Hearing a PIL filed by a health activist on hindered implementation of the schemes in the state and non-payment of claims to empanelled hospitals by the insurance company concerned, a division bench of Justice LS Jamir and Justice Kakheto Sema on Friday directed the NPDA to continue all the services to the eligible beneficiaries under the AB-PMJAY/CMHIS in the larger interest of public till the next returnable date, scheduled after four weeks.
“In the interim, the letter dated February 11, 2025, written by Respondent No. 6 [NPDA], shall remain stayed, and accordingly, the Respondent No. 6/Nagaland Private Doctors’ Association is directed to continue providing all the facilities to the eligible beneficiaries under the AB-PMJAY/CMHIS in the larger interest of public till the next returnable date,” the order said.
The Nagaland Private Doctors Association (NPDA) in a letter to Nagaland Health Protection Society (NHPS) on February 11 said it decided to suspend PMJAY/CMHIS services from February 15, citing non-payment of claims by the insurance company Future Generali India (FGI) Insurance Company Ltd.
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The NHPS, under the Nagaland Health and Family Welfare Department, is responsible for managing public health protection schemes in the state.
During the court proceedings, the NHPS stated that it had already informed FGI to clear genuine claims, but the insurance company had not complied.
The PIL highlighted concerns regarding the implementation of the AB-PMJAY/CMHIS, which provides cashless health coverage of Rs 5 lakh per family per year for secondary and tertiary care hospitalisation.
The AB-PMJAY scheme, launched in Nagaland in 2018, was merged with the state government’s CMHIS in 2022 to expand cashless healthcare coverage to government employees, pensioners, and indigenous residents not covered under AB-PMJAY.