Ayushman Bharat PM-JAY Fraud Alert: The Ayushman Uttar Pradesh authorities have issued an important warning regarding fraudulent activities related to hospital empanelment and claim payments under the Ayushman Bharat scheme.

According to an official communication from PMJAY-UP, the entire process of hospital empanelment and claims payment under Ayushman Bharat is fully digital.

The authorities have advised people to remain cautious if anyone offers special assistance, guaranteed approvals or financial benefits in exchange for money or other favours.

Anyone encountering such offers can report the matter through the toll-free complaint number 1800-1800-4444.

The advisory is particularly relevant to hospitals, healthcare administrators and other stakeholders involved in the implementation of Ayushman Bharat.

What Is the Latest Ayushman Bharat Warning?

Ayushman Uttar Pradesh has reminded stakeholders that hospital empanelment and claim payment procedures are conducted through authorised digital systems.

This means that hospitals seeking empanelment or processing eligible treatment claims must follow the prescribed official procedures.

The advisory warns against individuals who attempt to influence these processes by offering inducements or claiming that they can secure favourable outcomes.

Such offers should be treated with suspicion, especially when someone demands money or personal information outside the authorised process.

The department has encouraged people to report these incidents promptly.

Hospital Empanelment Under Ayushman Bharat Is Digital

Hospital empanelment refers to the process through which eligible healthcare facilities are approved to provide treatment under the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY).

Hospitals seeking participation must meet the applicable eligibility and quality requirements.

The process involves submitting the required information and completing verification through authorised systems.

According to the Uttar Pradesh authorities, the empanelment process is fully digital.

Therefore, hospitals should avoid relying on unauthorised intermediaries who promise guaranteed empanelment in return for payments.

Approval depends on the prescribed criteria and verification process, not on private assurances.

How Are Hospital Claims Paid Under PM-JAY?

Under Ayushman Bharat, empanelled hospitals provide eligible cashless treatment to beneficiaries according to the scheme's rules.

After providing treatment, hospitals submit claims through the designated digital system.

These claims are subject to the applicable checks, documentation requirements and approval procedures.

Once a claim is processed and approved, payment is made according to the scheme's established mechanism.

The Uttar Pradesh advisory makes clear that claim payment procedures are digital.

Hospitals should therefore be cautious if someone claims to have special influence over payment approvals or offers to accelerate claims through unofficial arrangements.

Beware of These Fraudulent Offers

Fraudsters may attempt to exploit confusion about government healthcare procedures by presenting themselves as officials, consultants or intermediaries.

Potential warning signs include:

• Demanding money in exchange for guaranteed hospital empanelment.

• Promising immediate approval of pending hospital claims.

• Claiming to have personal connections with officials who can influence payments.

• Requesting confidential login credentials, passwords or OTPs.

• Asking hospitals to transfer money to personal bank accounts.

• Offering unofficial shortcuts to bypass verification requirements.

These are examples of suspicious conduct to watch for, rather than specific incidents confirmed in the department's announcement.

Hospitals and individuals should verify any such communication through official channels before taking action.

Where Can You Report Ayushman Bharat-Related Fraud?

OFFICIAL COMPLAINT NUMBER SHARED BY PMJAY-UP

1800-1800-4444

Toll-free helpline for reporting suspicious offers relating to hospital empanelment and claims payment, as stated in the Uttar Pradesh advisory.

Copy helpline number

If someone offers an improper benefit connected with hospital empanelment or claims payment, the department advises reporting the matter immediately.

When making a complaint, provide relevant details such as the nature of the offer, the date of contact and any available supporting evidence.

Avoid sharing sensitive information publicly.

What Should Hospitals Do to Avoid Fraud?

Hospitals participating in or applying for Ayushman Bharat should ensure that authorised staff handle official applications and claims.

They should use only designated government systems and maintain proper records of submissions, approvals and payments.

Employees should be instructed not to disclose passwords, OTPs or other confidential information to unknown callers.

Any unexpected payment demand or promise of preferential treatment should be independently verified.

Hospitals should also maintain records of suspicious communications so that relevant information can be provided to the authorities when reporting a complaint.

Does This Warning Affect Ayushman Card Holders?

The official advisory specifically concerns hospital empanelment and claim payment procedures.

It does not announce any change to Ayushman Bharat beneficiary eligibility or the existing treatment entitlement rules.

Under AB-PMJAY, eligible beneficiaries can receive cashless hospital treatment for covered services at empanelled hospitals, subject to scheme conditions.

The scheme generally provides health coverage of up to ₹5 lakh per eligible family per year for covered secondary and tertiary hospitalisation.

Beneficiaries should continue using authorised channels to verify eligibility, find empanelled hospitals and obtain information about covered treatment.

They should not pay unofficial agents who promise special benefits or guaranteed treatment approvals.

Why Is Digital Processing Important?

Digital hospital empanelment and claim processing can help maintain records, improve traceability and support consistent administrative procedures.

Such systems can also make it easier for authorities to review applications and identify irregularities.

However, digital processing does not eliminate every possibility of fraud.

Awareness, secure account management and prompt reporting remain important for hospitals and other stakeholders.

The Uttar Pradesh advisory highlights the need to avoid unofficial arrangements and follow the authorised process.

How to Check Official Ayushman Bharat Information

People seeking reliable information about the scheme should refer to government-authorised resources.

The official PM-JAY website provides information about the programme.

Eligible beneficiaries can also use the Ayushman beneficiary portal for supported eligibility and beneficiary-related services.

For matters involving hospital empanelment or claim processing, hospitals should follow the instructions issued by the relevant State Health Agency and authorised PM-JAY systems.

Conclusion

Ayushman Uttar Pradesh has issued a clear warning against inducements and suspicious offers connected with hospital empanelment and claims payment under Ayushman Bharat.

The department has emphasised that these processes are fully digital and should be completed through official channels.

Hospitals, healthcare administrators and other stakeholders should remain alert to anyone promising special approvals, faster payments or other advantages through unofficial means.

Anyone encountering such activity has been advised to report it immediately on the toll-free number 1800-1800-4444.

Source Credit: PMJAY-UP (Ayushman Uttar Pradesh) — Official Advisory, November 3, 2026; Ayushman Bharat PM-JAY Official Website. Article independently rewritten and expanded from the official Uttar Pradesh advisory.