Key Takeaways

• An elderly citizen’s refund was denied at Ramkrishna Sevashram Hospital, revealing an unresolved crisis in Ayushman Bharat.
• Despite submitting evidence, the hospital failed to process the refund, highlighting systemic failures within the PM-JAY scheme.
• Allegations include the hospital’s misconduct, suppression of bills, and discrepancies in admission dates, all contributing to ongoing issues.
• There is a call for immediate action, including refund processing, document investigation, and disciplinary measures against the hospital.
• The grievance has been forwarded to the Ministry of Health & Family Welfare for further resolution regarding the unresolved crisis in Ayushman Bharat.

🚨 Unresolved Crisis in Ayushman Bharat: A Old age Citizen’s Refund Denied Despite Evidence 🚨

Grievance Follow-up: DHLTH/E/2025/0029098 (Original Grievances: DHLTH/E/2025/0021922 & DHLTH/E/2025/0012477) The unresolved crisis in Ayushman Bharat continues to be a major concern.

The Pradhan Mantri Jan Arogya Yojana (PM-JAY), or Ayushman Bharat, is a flagship scheme, designed to offer cashless, quality healthcare to the most vulnerable. However, the case of an old age citizen at Ramkrishna Sevashram Hospital, Mirzapur highlights a systemic failure. The hospital allegedly charged a patient, denied the refund, and potentially misreported the facts. This directly undermines the scheme’s integrity and highlights an unresolved crisis.

1. Core Issue is, Unresolved Crisis in Ayushman Bharat: Refund Denial Despite Submission of Payment Proof

The hospital fails to adhere to its own condition for a refund, as acknowledged in a previous Nodal Officer’s report, highlighting the unresolved crisis in Ayushman Bharat, which is a significant concern for many patients relying on this essential healthcare scheme. Even with the provided evidence detailing numerous instances where patient rights have been compromised, they leave issues unaddressed, demonstrating a troubling pattern of negligence and a lack of accountability that undermines public trust in the healthcare system. This ongoing situation not only impacts individuals seeking care but also poses broader implications for the overall effectiveness of Ayushman Bharat as a crucial lifeline for millions.

The Hospital’s Condition and Submitted Evidence:

• Hospital/Nodal Officer’s Report: The hospital reportedly agreed to process a refund. This was conditional on submitting the bill for the date of the Ayushman Vay Bandana card issuance (June 5, 2025) or afterward.
• Complainant’s Proof: The complainant submitted the bill evidence for the medicine purchase dated June 5, 2025.
  • Total Documented Payment (June 5, 2025): ₹7,587 (Breakdown: ₹6,850 + ₹737 for medicine alone).
• Unresolved Action: The hospital has not processed the refund for this amount. This directly contradicts the assurance mentioned in the Nodal Officer’s report. Again, an unresolved crisis in Ayushman Bharat.

Demand: Immediate directive to Ramkrishna Sevashram Hospital, Mirzapur, to refund the documented charges of ₹7,587.

2. Allegations of Hospital Misconduct and Suppression of Facts

Beyond the immediate refund, the grievance raises serious concerns about the hospital’s transparency and compliance with scheme protocols. This further highlights an unresolved crisis in Ayushman Bharat.

A. Suppression of Prior Bills

• The Allegation: The hospital has allegedly failed to provide all receipts/bills for other payments made on June 3rd and June 4th, 2025.
• The Implication: This suggests a potential attempt to conceal the total charges levied from the patient prior to the card’s official issuance. This impacts the full assessment of undue charging and evidences an unresolved crisis within Ayushman Bharat.

B. Discrepancy in Admission Date

• Incorrect Record: The hospital continues to maintain an incorrect admission date of 04/06/2025. This highlights unresolved issues within the Ayushman Bharat framework.
• Actual Date: The actual admission date was 03/06/2025 at 5:00 PM.
• The Impact: This discrepancy is critical because the admission date affects the entire claim record. It may determine eligibility for cashless treatment under the scheme, thereby contributing to the unresolved crisis in Ayushman Bharat.

3. The Call for Accountability and Action in matter of Unresolved Crisis in Ayushman Bharat

The persistence of these issues across multiple grievance registration numbers (DHLTH/E/2025/0012477 & DHLTH/E/2025/0021922) highlights a need for decisive action from the competent authorities. The unresolved crisis within Ayushman Bharat continues to affect beneficiaries significantly.

Requested Actions:

• Immediate Refund: Direct the hospital to refund the ₹7,587 as per their prior commitment.
• Enquiry into Withheld Documents: Initiate a formal investigation into the hospital’s failure to provide all financial receipts/bills for payments made on June 3rd and 4th, 2025.
• Correction of Admission Date: Mandate the hospital to officially correct the patient’s admission date to 3rd June 2025.
• Disciplinary Action: Take strict punitive measures against the hospital for:
  • Charging an eligible Ayushman card holder and exemplifying part of the unresolved crisis in Ayushman Bharat.
  • Misreporting official facts.
  • Allegedly withholding bills, thereby “maligning the image of the scheme.”

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The Ministry of Health & Family Welfare has officially received the grievance and has forwarded it to Ms. Poonam Meena (Director) in Room No. 211, D Wing, Nirman Bhawan, New Delhi (Contact: 011-23062205, Email: poonam.22@gov.in). The current status is, “Grievance received,” dated 05/11/2025, with a reminder filed on 06/11/2025.

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Conclusion

The complainant submitted more than a dozen grievances, but unfortunately, no viable solution was ever approached or offered to the complainant, who sought resolution and accountability. It is hard to call this situation anything resembling good governance. Instead, it appears that the authorities involved are only making efforts to cover this matter of irregularity and corruption under the carpet, rather than addressing the root causes of the issues raised.
This lack of action not only undermines public trust but also perpetuates a culture where such grievances go unheard, further complicating the path to justice for those affected. Moreover, this pervasive inaction casts a shadow on the integrity of the institutions that are supposed to protect the rights of the citizens, breeding a climate of disillusionment and frustration among the populace.
As time passes with no resolution in sight, the complainant, along with many others experiencing similar grievances, may feel increasingly marginalised, ultimately resulting in a breakdown of confidence in the mechanisms designed to uphold justice and fairness within society. This escalating discontent could potentially lead to greater societal unrest, as individuals begin to realise the systemic issues inhibiting meaningful change and accountability.

Hospital is not providing free treatment to Physical challenged Ayushman Card holder Pankaj Kumar

Corruption in government hospitals and arbitrariness in cure of Ayushman card holders can be, overlooked