Where should one lodge a complaint if an empanelled hospital refuses treatment despite the patient holding an Ayushman card?

If an empanelled hospital refuses to provide treatment despite you holding an Ayushman card (Ayushman Bharat PM-JAY), it is a violation of the rules. The Ayushman Bharat scheme is a government initiative that guarantees free medical treatment worth ₹5 lakh annually. It is the right of Ayushman cardholders to avail themselves of the benefits provided under this scheme. However, there are frequent complaints of patients being denied admission or free treatment despite possessing the card. In such situations, you can lodge a complaint through various channels.

According to the Ayushman Mitra Help Desk, you can seek assistance or file a complaint via the helpline numbers, the online grievance portal, local administrative officials, or the State Health Agency. Additionally, a High Court advocate noted that assistance can also be sought from the District Legal Services Authority.

Where and how to file a complaint?
According to the Ayushman Mitra Help Desk, you can immediately register your complaint by calling the Ayushman scheme's national toll-free numbers—14555 or 1800-111-565—from your phone. In many states, you can also contact the alternative number 1800-1800-4444. Provide the call center representative with details such as the hospital's name, the doctor's name, and the reason given for the refusal. They will immediately alert the District Nodal Officer (DNO) of that district, who will then seek a response directly from the hospital.

There is also an Ayushman grievance box located within the hospital premises where you can drop a written complaint; these are regularly inspected by a government team. You may also submit a written complaint to your district's Chief Medical Officer (CMO) or District Magistrate (DM), as the implementation of the Ayushman scheme in each district falls under their supervision.

Complaints can be filed online.
If your grievance is not being addressed at the hospital, you can register a case on the government grievance portal using your mobile phone in just five minutes. You can file a complaint online by visiting the National Health Authority's (NHA) official Ayushman grievance portal (cgrms.pmjay.gov.in).

On the official portal, click on "Register Your Grievance" and select the PM-JAY option. Enter your name, Ayushman card number (PMJAY ID), hospital name, state, district, and a brief description of your grievance. If the hospital has provided a written slip or a written notice of rejection, upload a photo of it. Once the grievance is registered, you will receive a unique number that allows you to track the status of your complaint.

**Whose legal assistance can you seek?**
High Court Advocate Ramesh Chandra Pal stated that if you require free or immediate legal aid—particularly if you are from an economically disadvantaged background—you can obtain assistance from a free government lawyer through the District Legal Services Authority (DLSA); this body helps in taking legal action against arbitrary actions by hospitals. Special government officials are appointed in every district to oversee this scheme. You can also approach the District Nodal Officer (DNO) or the Chief Medical Officer (CMO) directly at the district's Chief Medical Officer's office and submit a written complaint at the Ayushman Bharat help desk.

Additionally, you can lodge a complaint with the State Health Agency (SHA). Every state has its own State Health Agency, which holds the authority to revoke the licenses of such hospitals.

**What action can be taken against the hospital?**
If your complaint is found to be valid and it is proven that the hospital deliberately refused treatment, the government can remove that hospital's name from the Ayushman panel. Furthermore, a heavy financial penalty is imposed on the hospital. The hospital is required to refund the patient's family for any expenses incurred during treatment, along with interest.