The payment of pending dues under the Himcare scheme to private hospitals in Himachal Pradesh has been halted as the state government awaits the outcome of an ongoing vigilance inquiry into an alleged scam linked to the health insurance scheme. The decision has stalled the release of more than ₹200 crore in pending payments to private healthcare institutions across the state.
Private hospitals have been demanding clearance of long-pending bills for treatment provided under the Himcare scheme. However, the Health Department has now suspended all pending payments until the Vigilance Department completes its investigation into alleged irregularities involving fraudulent billing, discrepancies in treatment records and suspected manipulation in the payment process.
Sources said the government fears that releasing payments before completion of the probe could increase the risk of financial irregularities and weaken the investigation. A final decision regarding valid claims and possible punitive action against hospitals or other entities involved will reportedly be taken only after the vigilance report is submitted.
The Himcare scheme, which was launched to provide cashless treatment to eligible families in Himachal Pradesh, has remained an important healthcare support mechanism in the state. The issue has also raised concerns over the functioning of the scheme and its financial management at a time when the Himachal Pradesh government is already facing a difficult financial situation.
According to sources, the Vigilance Department has intensified its investigation into the alleged Himcare scam, estimated to involve more than ₹110 crore. On Wednesday, officials conducted a second round of questioning involving six employees associated with audit and health agencies linked to the scheme. The interrogation reportedly lasted several hours and focused on record maintenance, verification of medical bills, and the process followed for approving payments.
Investigators are said to be cross-verifying hospital claims with medical bills and treatment records submitted to the government. During questioning, several employees allegedly failed to provide satisfactory replies regarding suspicious bills and payment files.
Preliminary findings of the vigilance inquiry have reportedly indicated possible manipulation of software data and physical records to project certain hospital claims as compliant with rules. Investigators are also examining allegations that bills submitted by some private hospitals were cleared on a priority basis without detailed scrutiny.
The Vigilance Department is now probing possible collusion between agency personnel and private hospitals in the approval of inflated or fraudulent claims. Digital records, payment trails and other electronic evidence are also under examination. Sources said investigators are looking into alleged commissions and financial transactions at multiple levels connected to the payment process. The scope of the inquiry may now expand further to include officials, agencies and individuals associated with hospital management as the investigation moves toward a crucial stage.
