The Gauhati High Court, Kohima Bench, has issued an interim order directing the Nagaland Private Doctors Association (NPDA) to continue providing healthcare services under the Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) and the Chief Minister’s Health Insurance Scheme (CMHIS). The directive follows concerns raised over the alleged non-payment of claims by Future Generali Indian Insurance Company Ltd., the insurer responsible for settling bills under the scheme.

The order was passed in response to a Public Interest Litigation (PIL) PIL/2/2025 filed by petitioner S.T. Yapang. The petitioner sought the unhindered implementation of AB-PMJAY/CMHIS in Nagaland, arguing that the schemes, aimed at providing cashless treatment to eligible beneficiaries, were at risk due to financial disputes and allegations of fraud.

The NPDA, In a letter dated February 11, 2025, had announced a temporary suspension of services starting February 15, 2025, citing unpaid claims by Future Generali. The NPDA’s letter raised three key concerns:

1. The association decided to halt services due to financial constraints caused by non-payment of claims. Despite repeated appeals, the dues remained unpaid, impacting their ability to operate.
2. The NPDA objected to accusations against private hospitals regarding alleged fraud and service denial, demanding a public apology from the Nagaland Health Protection Society (NHPS).
3. The NPDA resolved not to enter into new agreements for the scheme without its final approval, emphasizing the need for private healthcare stakeholders to be included in decision-making.

Download Nagaland Tribune app on Google Play

During the hearing, petitioner’s counsel Kezhosano Kikhi argued that discontinuation of services would severely impact healthcare access in the state. The court acknowledged the gravity of the situation and issued a notice to the respondents, including the State of Nagaland, NHPS, Future Generali Indian Insurance Company Ltd., and NPDA. The petitioner also sought directives for the insurance company to clear outstanding claims.

NHPS’s standing counsel, N. Mozhui, informed the court that Future Generali had been urged to clear pending dues but had not yet complied. Meanwhile, E. Thiba Phom, Government Advocate, represented the State of Nagaland.

In light of the financial impasse, the court, led by Justice L.S. Jamir and Justice Kakheto Sema, stayed the NPDA’s decision to suspend services and directed the association to continue providing treatment to beneficiaries under AB-PMJAY/CMHIS until the next hearing. Court has scheduled the next hearing in four weeks, during which the respondents must submit compliance reports regarding the directives.