Ayushman Bharat hospitals face major crackdown as govt de-empanels 2,359 and suspends 1,200 hospitals
The government has de-empanelled 2,359 hospitals and suspended another 1,200 under the Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) for violating scheme guidelines, Union Health Minister J.P. Nadda said in a written reply in the Lok Sabha on 7 August.
The government has also lodged 29 FIRs against errant hospitals and imposed penalties totalling ₹328.49 crore, as it steps up efforts to prevent fraud and unauthorised billing under the government’s flagship health assurance scheme.
For beneficiaries, the action is important because de-empanelled or suspended hospitals cannot provide treatment under PM-JAY during their exclusion. Beneficiaries should therefore check the current empanelment status of a hospital before seeking cashless treatment under the scheme.
How the government is detecting Ayushman Bharat fraud
The National Health Authority (NHA) has strengthened its anti-fraud mechanism by using artificial intelligence and machine learning to identify suspicious claims.
The National Anti-Fraud Unit generates automated triggers when it detects unusual patterns, including duplicate claims, misuse of beneficiary identities, suspicious billing and potentially unnecessary medical procedures.
According to the government, these triggers can be generated within 24 hours of a claim being submitted. This allows suspicious claims to be examined before payments are released to hospitals.
The government said this technology-driven mechanism helped prevent losses of ₹676.14 crore as of 31 July 2026.
The action against hospitals forms part of the government’s stated zero-tolerance approach towards fraud under PM-JAY. Apart from financial penalties, hospitals can face suspension, de-empanelment and criminal proceedings if violations are established.
Ayushman Bharat authorised 2.74 crore admissions in FY26
The crackdown comes even as the health scheme continues to expand its reach.
During financial year 2025-26, 3.75 crore new Ayushman cards were created, while 2.74 crore hospital admissions were authorised under the scheme, according to the government’s latest figures.
The Centre also released ₹8,438.27 crore to state health agencies during FY26 to support expenditure under PM-JAY. Uttar Pradesh recorded the highest number of authorised hospital admissions at 30.6 lakh and received ₹1,047.53 crore in central funds during the year.
Ayushman Bharat provides eligible beneficiaries with cashless health cover of up to ₹5 lakh per family per year at empanelled hospitals. The scheme covers more than 1,900 procedures, although states can add procedures for their beneficiaries.
As of 8 August 2026, the National Health Authority portal showed 38,437 hospitals empanelled under the scheme. Of these, 20,363 were public hospitals and 18,074 were private hospitals.
For beneficiaries, the latest action highlights the importance of checking a hospital’s empanelment status before undergoing treatment under PM-JAY, particularly when seeking cashless care.
