The Kohima bench of Gauhati High Court has instructed private hospitals in Nagaland to continue offering health services under the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) and the Chief Minister Health Insurance Scheme (CMHIS).

The court’s directive serves as an interim measure to ensure uninterrupted healthcare services and protect public interest.

Court’s Decision on Insurance Dispute

The High Court issued this directive while hearing a Public Interest Litigation (PIL) filed by a health activist. The PIL raised concerns over the delayed implementation of insurance schemes and the non-payment of claims to empanelled hospitals by Future Generali India (FGI) Insurance Company Ltd.

A division bench comprising Justice LS Jamir and Justice Kakheto Sema ordered the Nagaland Private Doctors’ Association (NPDA) to continue offering health services under AB-PMJAY and CMHIS until the next hearing, scheduled in four weeks.

HC Stays NPDA’s Suspension Letter

The NPDA, in a letter dated February 11, 2025, had informed the Nagaland Health Protection Society (NHPS) about its decision to suspend insurance services from February 15 due to pending payments from FGI.

However, the court issued a stay on this letter and ordered NPDA to continue offering cashless health services to eligible beneficiaries.

NHPS Urges Insurance Firm to Clear Dues

During the court proceedings, NHPS stated that it had already directed FGI to clear genuine claims, but the insurance company failed to comply.

Key Features of AB-PMJAY & CMHIS in Nagaland

• AB-PMJAY was launched in 2018 to provide cashless healthcare coverage of ₹5 lakh per family per year for secondary and tertiary care hospitalization.
• In 2022, AB-PMJAY was merged with CMHIS to extend benefits to government employees, pensioners, and indigenous residents.

Future Course of Action

The Nagaland High Court has emphasized that the continuation of these health schemes is crucial for the well-being of the state’s residents. The matter will be reviewed again after four weeks to assess compliance and further actions.