This batch of writ petitions was filed by various private hospitals empanelled under the Ayushman Bharat Pradhan Mantri Jan Arogya Yojna (AB-PMJAY) and the Mukhya Mantri Himachal Health Care Scheme (HIMCARE), seeking directions to the respondents to clear substantial pending payments for medical treatments already provided to beneficiaries. While the respondents did not dispute that these claims were due and duly verified/approved, payments were withheld due to a dispute over financial sharing limits between the State and Central Governments under AB-PMJAY, as well as a newly initiated vigilance inquiry into the hospital bills under HIMCARE. The High Court held that the State cannot evade its financial liabilities or withhold duly approved, legitimate claims under the pretext of ongoing vigilance inquiries or funding constraints, especially when such withholding severely impacts the operational viability of these healthcare providers.
- Liability Under AB-PMJAY: The Court observed that under the AB-PMJAY scheme and the Memorandum of Understanding (MoU), any financial liability exceeding the maximum annual central ceiling limit rests with the State Government, and the State cannot escape this liability by citing unworkability or lack of funds.
- Impermissibility of Withholding Dues: The Court ruled that a newly initiated vigilance inquiry cannot be used as an arbitrary tool or justification to indefinitely withhold payments for bills that have already been verified and approved, noting that financial constraints or lack of funds do not excuse public authorities from performing their duties.
- Clearance of Pending Bills: The Respondent-State was directed to clear all duly approved pending bills under both the AB-PMJAY and HIMCARE schemes within three weeks.
- Statutory Interest: The released payments must include penal interest at the rate of 1% of the claim amount per week after 15 days of delay, in accordance with the provisions of the schemes.
- Future Timelines: The respondents must ensure that all future claims under both schemes are processed, verified, and cleared strictly within the prescribed timelines, carrying the same penal interest for any future delays.
- Liberty for Recovery: The Court clarified that if any amount is ultimately found recoverable from the hospital petitioners upon the conclusion of the ongoing vigilance inquiry, the respondents remain at liberty to initiate recovery proceedings in accordance with the law.
STPL (Web) 2026 HP 394
M/S Maatri Medicity & Orthocare Hospital V. State of Himachal Pradesh & Ors. (D.O.J. 21.07.2026)
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