UP inspects 21 Ayushman hospitals, finds overcharging and package manipulation

Uttar Pradesh's state agency that runs the Ayushman Bharat health insurance scheme has inspected 21 private hospitals empanelled under the scheme, six in Lucknow and 15 in Gonda, and reported serious irregularities, according to reports published between October 13 and 15, 2026. Teams of the state agency, known as SACHIS, said they found patients being charged money for treatment that should have been free, manipulation of treatment packages, and shortfalls in required medical facilities. Some patients had been kept in intensive care without need, one report said. Notices have been issued to the hospitals, according to the reports.

Ayushman Bharat, the Pradhan Mantri Jan Arogya Yojana, is meant to give eligible families cashless hospital treatment at government and empanelled private hospitals. Its value depends on hospitals honouring that promise. When a hospital asks a card holder for money, bills for a more expensive package than the treatment given, or admits patients to ICU without need, the scheme loses money and patients lose trust in it.

The inspections show the state agency moving from paperwork to field checks. A four-member SACHIS team began surprise visits in late September, looking at infrastructure, staffing, biomedical waste handling and ICU and operating theatre arrangements. In Bijnor, the earlier round of checks found lapses such as repeated admissions of patients from the same family and ICU bookings without medical need, and led to suspensions and penalties. The Lucknow and Gonda findings suggest such problems are not limited to one district.

For beneficiaries, the message is that they should not have to pay for covered treatment at an empanelled hospital. Patients who are asked for money can raise a complaint through the scheme's grievance channels, and inspections like these depend partly on patients speaking up.

Short-term: Hospitals that received notices must respond, and those found at fault may face suspension from the scheme, recovery of wrongly claimed money and penalties, as happened in Bijnor.

Long-term: Regular surprise inspections can deter fraud and improve care for Ayushman card holders. They may also lead some private hospitals to leave the scheme if they find the checks or rates difficult, which could reduce choice in some districts.

Who is affected: Ayushman Bharat card holders in Uttar Pradesh, especially in Lucknow and Gonda; private hospitals empanelled under the scheme; and the state health agency managing public money.

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