Government-sponsored health insurance schemes need regular revisions in reimbursement rates to keep pace with rising treatment costs, medical technology and quality care requirements, said Ashutosh Raghuvanshi, Managing Director and CEO of Fortis Healthcare.

Speaking at the 20th edition of FICCI Heal 2026, Raghuvanshi highlighted the need to periodically review package rates under the Central Government Health Scheme (CGHS) and Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PMJAY). He also stressed the importance of timely hospital claim settlements and a predictable reimbursement framework to encourage greater participation from healthcare providers.

The Union Health Ministry revised rates for nearly 2,000 procedures under CGHS in October 2025, marking the first major revision since 2014. Private hospitals had welcomed the move while calling for regular benchmarking of government healthcare scheme rates against the Consumer Price Index.

Major hospital chains, including Fortis Healthcare, Max Healthcare and Apollo Hospitals, have not participated in the Ayushman Bharat scheme, citing concerns over the viability of reimbursement rates, particularly for hospitals operating in urban areas.

Raghuvanshi also called for a review of the tax framework applicable to hospitals. Although healthcare services are GST-exempt, hospitals generally cannot claim input tax credit on inputs used for exempt services, increasing operational costs and affecting investment capacity.

He said a more supportive tax framework could help reduce cost pressures, encourage healthcare infrastructure investment and support the delivery of affordable, quality medical services.