Pune: Major private hospitals run by charitable trusts in the city have refused to comply with the government resolution to implement the state health insurance scheme Mahatma Jyotirao Phule Jan Arogya Yojana (MJPJAY), as instructed by health minister Prakashrao Abitkar in 2025. The scheme ensures health insurance for everyone in the state up to a certain capping based on the disease.
Government's Stance
Chairperson of Ayushman Bharat Mission, Maharashtra committee, Omprakash Shete stated, "In the last one year, close to 800 hospitals have been empanelled under the scheme. However, it is true that major hospitals have not responded the way we wanted. We have held several meetings with private hospitals and repeatedly issued directives regarding the implementation of the MJPJAY." He further added, "Last week, we had a meeting with such hospitals in Mumbai. We issued an ultimatum for them to get empanelled and implement the scheme. We will once again meet the hospitals in Pune and take strict action if these hospitals do not respond positively within the next one month."
Shete emphasized that the scheme will become mandatory soon irrespective of the ongoing case, as the court has not granted a stay on the GR. Under Article 21, the implementation of such schemes along with the provision of free medical treatment will be made mandatory.
Hospitals' Concerns
The Association of Hospitals in Pune had earlier filed a petition in the Bombay High Court challenging the decision that all charitable hospitals implement health schemes run by the Centre and state. The association claims they face significant financial and administrative hurdles while attempting to implement such schemes.
President of the association’s Pune chapter, Dr. H.K. Sale, said, "It is not feasible to implement the MJPJAY in corporate hospitals, because the infrastructure and equipment required for surgical procedures are extremely expensive. We raised the issue in a meeting with all hospital representatives on Wednesday. We are concerned with the low costs promised under the scheme. The government rates for a surgery are not enough to even buy the consumables required. It is a costly affair to run a hospital. Implementing the government scheme won’t work for us."
Government's Response
Shete responded to the statement: "We have revised the cost to make it economically viable for hospitals to implement the scheme. It would not be sufficient for some hospitals, even if we raised the capping to Rs 50 lakh."
Background of the Scheme
The government resolution on April 21, 2025, made it mandatory for charitable hospitals to implement the integrated health insurance scheme, the Pradhan Mantri Jan Arogya Yojana (PMJAY) and the MJPJAY. Private hospitals refused to follow suit citing lower rates under these schemes, despite government appeals and meetings presided over by ministers. The associations argue that the package rates offered under government schemes are low and their expenses high owing to high-end technology, specialist doctors, trained staff, and daily operational expenses.
There are 468 charitable hospitals in Maharashtra, including 58 in Pune and 74 in Mumbai. Currently, charitable hospitals must reserve 2% of their billings and deposit it into the indigent patient fund, which must be exclusively spent on treatment of poor patients. The PMJAY-MJPJAY is a flagship, cashless health insurance scheme of the Maharashtra government, providing coverage up to Rs 5 lakh per family per year for over 1,300 secondary and tertiary illnesses. It offers universal coverage to all residents of Maharashtra from July 1, 2024.
