The Nagaland Health Protection Society has addressed recent concerns regarding the suspension of services under the Pradhan Mantri Jan Arogya Yojana (PM-JAY) and the Chief Minister Health Insurance Scheme (CMHIS) by some empanelled hospitals in the state. The Department clarified that both schemes are fully operational, and there has been no disruption in services. A statement issued by the Department attributed the confusion to a miscommunication from the Insurance Company (FGI), which has now been resolved. This misunderstanding led to concerns about service suspension, but the Department reassured the public that all empanelled hospitals have been instructed to continue offering services under the PM-JAY and CMHIS without interruption.
“Services under both schemes remain active unless a hospital decides unilaterally to suspend them, which would violate the signed Memorandum of Understanding (MoU),” the Health Protection Society emphasized. The Department also highlighted the significant financial disbursements made for treatment under both schemes. For the fiscal year 2023-24, a total of Rs. 53.64 crores for claims under AB PM-JAY and CMHIS (General) and Rs. 34.54 crores for claims under CMHIS (EP) were paid to empanelled hospitals. For the ongoing fiscal year 2024-25, Rs. 38.92 crores for PM-JAY and CMHIS (General), and Rs. 33.52 crores under CMHIS (EP) have already been disbursed within Nagaland. Additionally, claims paid for treatment outside Nagaland amounted to Rs. 3.99 crores under PM-JAY and Rs. 3.81 crores under CMHIS (EP) in FY 2023-24, and Rs. 1.95 crores under PM-JAY and Rs. 10.16 crores under CMHIS in FY 2024-25.
The Department also noted that the utilization of premiums for both schemes has been growing at a compounded rate of 17% annually, reflecting the increasing popularity and success of these healthcare programs, which have benefitted patients across Nagaland.
