New Delhi, November 13
In a significant proposed overhaul of the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY), 112 treatment packages, including several surgeries and specialised medical procedures, may be reserved exclusively for government hospitals from December 1, 2026. The move could restrict beneficiaries from availing free treatment for these procedures at private hospitals empanelled under the scheme.
The National Health Authority (NHA) has already reserved 23 treatment packages for public healthcare facilities and has now asked State Health Authorities to consider adding another 89 packages to the list. The revised package list is proposed to be incorporated into the scheme’s Transaction Management System (TMS) from December 1.
However, the proposed arrangement does not automatically impose a uniform restriction across all states. State Health Authorities will retain the discretion to decide whether these packages should be withdrawn from private hospitals, making state-level decisions crucial to the rollout.
The proposed list covers seven major medical specialties including general medicine, general surgery, gynaecology, psychiatry, orthopaedics, ENT and ophthalmology. It includes procedures and treatments such as cataract surgery, hysterectomy, high-risk deliveries, medical termination of pregnancy, fracture management, biopsies, cyst and fistula treatment.
Several medical conditions, including severe anaemia, alcoholic liver disease, hepatitis, pancreatitis, acute bronchitis, malaria, chikungunya and diarrhoeal diseases, also figure in the proposed packages.
Mental healthcare is another significant component, with services covering anxiety, mood disorders, ADHD, stress management and other psychiatric conditions.
The proposed changes are aimed at reducing expenditure on private healthcare providers and strengthening government hospitals by directing more treatment procedures towards public healthcare institutions.
However, the proposed shift raises questions about the preparedness of government hospitals to handle an increased patient load. Availability of specialist doctors, operation theatres, diagnostic facilities, medical equipment and adequate hospital infrastructure will be critical to ensuring that beneficiaries do not face delays or difficulties in accessing treatment.
State authorities have begun reviewing the capacity of government hospitals and seeking information from healthcare institutions regarding the procedures currently being performed under the scheme.
Several states and Union Territories, including Punjab, Gujarat, Kerala, Karnataka, Rajasthan, Madhya Pradesh, Odisha, Tamil Nadu and Chandigarh, have already implemented reservations for selected treatment packages in public healthcare facilities.
For millions of Ayushman Bharat beneficiaries, the proposed change could alter the way they access cashless healthcare. While the government aims to strengthen public hospitals, the actual impact will depend on state-level implementation and the ability of government facilities to provide timely and quality treatment.
The December 1 deadline is therefore significant, with state decisions expected to determine the extent to which patients can continue accessing these 112 treatment packages at private empanelled hospitals.
