Bhubaneswar: The Odisha Health and Family Welfare Department has issued a strict advisory to all empanelled hospitals under the Ayushman Bharat–Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) and the Gopabandhu Jan Arogya Yojana (GJAY), cautioning them against levying unauthorised charges on beneficiaries for pre- and post-hospitalisation services.
In a communication issued by the State Health Assurance Society (SHAS), Chief Executive Officer Dr. Brundha D stated that the department has received multiple complaints alleging that some hospitals are charging patients for diagnostics, consultations, and medicines that are already included under the scheme packages.
The advisory clarified that, as per scheme guidelines, medical expenses incurred up to three days prior to hospital admission—including consultations, diagnostic tests, and medicines—are covered within the treatment package, provided the services are availed from the same hospital where treatment is initiated.
It further stated that post-hospitalisation benefits extend up to 15 days after discharge, covering follow-up consultations, medicines, diagnostic tests, and post-operative care. Hospitals have been instructed to ensure that such services are provided free of cost during the eligible period.
The department has reiterated that beneficiaries must not be charged for any services already covered under the government health insurance schemes. Hospitals have also been directed to provide uninterrupted follow-up care and post-operative management without imposing any additional financial burden on patients.
The advisory also noted that in cases of surgical complications or readmission linked to the original treatment, such care will continue to be covered under the same treatment package.
The SHAS has directed all empanelled hospitals to comply strictly with these guidelines, warning that any violation will be viewed seriously and may attract punitive action under the scheme regulations.
