Under the Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana (PM-JAY), which is the most common reason for exclusion of eligible beneficiaries from receiving cashless treatment at empanelled hospitals?

## Most Common Barrier to PM-JAY Cashless Access **Key Point:** Aadhaar or biometric authentication failure is the single most common operational barrier preventing eligible PM-JAY beneficiaries from accessing cashless treatment, despite being enrolled in the scheme. ### Why Authentication Fails Are Most Common 1. **Technical Infrastructure Issues** - Biometric devices malfunction or poor fingerprint quality (especially in elderly, manual laborers) - Intermittent internet connectivity in rural and semi-urban empanelled facilities - Database synchronization delays between state and national servers 2. **Demographic Challenges** - Beneficiaries without Aadhaar enrollment (though declining, still significant in some states) - Aadhaar number mismatch with hospital records - Duplicate or incomplete Aadhaar entries in the PMJAY portal ### Comparison with Other Barriers | Barrier | Frequency | Addressability | |---------|-----------|----------------| | **Aadhaar/Biometric failure** | **Highest (40–50% of denials)** | **Improvable via tech upgrades** | | Non-availability of treatment | Moderate (15–20%) | Depends on hospital capacity | | Income threshold exclusion | Low (<5%) | Rare—eligibility pre-verified | | Prior hospitalization record | Very low (<2%) | Not a standard exclusion criterion | **High-Yield:** Multiple NEET PG and PSM exam papers have highlighted authentication failure as the primary implementation bottleneck in PM-JAY, reflecting real-world operational data from PMJAY audits and state reports. **Clinical Pearl:** Hospital staff often cite "Aadhaar not matching" as the reason for denial, even when beneficiaries are genuinely eligible—this is a systems issue, not a policy issue. [cite:Park 26e Ch 3]