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Centrally Sponsored Health Insurance Rates Need Urgent Review, Says Fortis CEO, ETHealthworld

New Delhi: Package rates under centrally sponsored health insurance schemes need to be reviewed periodically to reflect rising treatment costs, said Ashutosh Raghuvanshi, Managing Director and CEO, Fortis Healthcare.

Speaking at the 20th edition of FICCI Heal 2026, Raghuvanshi said, “Central Government Health Scheme and PMJAY package rates, need a periodic review to reflect the changes in treatment costs, medical technology, and the requirements of quality care. Timely settlement of hospital claims is equally important. A predictable reimbursement framework will encourage greater private sector participation in support of the delivery of quality services as well as creating newer, much-needed infrastructure.”

This comes a year after the Union health ministry revised rates for nearly 2,000 procedures under the Central Government Health Scheme in October 2025, the first major revamp since 2014.

At the time, private hospitals body, Nathealth welcomed the move while also urging that rates under government-sponsored schemes be benchmarked periodically to the Consumer Price Index.

Meanwhile, major listed hospital chains such as Fortis Healthcare, Max Healthcare and Apollo Hospitals do not participate in the Ayushman Bharat scheme, with the industry maintaining that ‘reimbursement rates need to be viable for corporate hospitals which are based in urban localities to join the programme.’

Raghuvanshi also asked the government to rationalise the tax framework for hospitals.

He said, “While healthcare services are GST exempt, hospitals are generally unable to claim input tax credit on input used for exempt services. This creates embedded costs and affects investment capacity. A review of the framework would help reduce these cost pressures while supporting affordable care.”

  • Published On Oct 28, 2026 at 07:49 AM IST

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