Private hospitals in Rajasthan have warned of suspending cashless treatment under the Rajasthan Government Health Scheme (RGHS) from August 25, citing unsustainable financial gaps and operational inefficiencies. The Rajasthan Alliance of Hospital Associations (RAHA), which represents private hospitals, has asked the state government to address payment delays and systemic shortcomings to ensure the scheme’s continuity.
According to The Economic Times, RAHA stated that hospitals and pharmacies under RGHS generate monthly bills of about ₹350 crore, translating into an annual requirement of nearly ₹4,200 crore. However, the current state budget allocates only ₹3,000 crore, leaving a ₹1,200 crore shortfall. This gap, the association said, results in delayed reimbursements, arbitrary deductions, and frequent disputes over claims. Hospitals have demanded that the government commit to a 45-day payment cycle or revert to a reimbursement model that would restore financial discipline and reduce operational uncertainties.
The association has also urged the state to develop medical decision protocols for outpatient and inpatient admissions, establish standard operating procedures for billing and payment, and recalibrate the scheme’s budget to match actual expenditures. RAHA argued that without these measures, private hospitals are burdened with unstable cash flows that affect service delivery.
Former chief minister Ashok Gehlot also weighed in on the issue, recalling that RGHS was originally modeled on the Central Government Health Scheme (CGHS) to provide cashless treatment for government employees, pensioners, and their families. He said the scheme functioned smoothly until December 2023 but has since run into difficulties due to delayed payments and unresolved disputes. Gehlot added that lakhs of beneficiaries are being inconvenienced and urged the current administration to demonstrate stronger policy commitment to sustain the scheme.
The standoff between private hospitals and the government highlights growing concerns over the financial sustainability of state-funded health insurance models. For industry stakeholders, the outcome will shape not only hospital operations and patient access but also the credibility of public-private healthcare partnerships in Rajasthan. If unresolved, the suspension could impact thousands of beneficiaries relying on RGHS for essential treatments, raising broader questions on healthcare financing and policy execution at the state level.
