PMJAY-MA and ABDM readiness for Gujarat private hospitals

What is changing

• HEM 2.0: the NHA’s Hospital Empanelment Module 2.0, introduced in February 2025, strengthens verification and transparency for empanelled hospitals, with more structured data about facilities, staff and infrastructure.
• State mandates are following: Uttar Pradesh required Ayushman Bharat hospitals to comply with HEM 2.0 from January 2026. Expect other states, including Gujarat, to align their own timelines.
• ABHA everywhere: with more than 93 crore ABHA accounts, beneficiaries increasingly arrive with a health ID, and scheme workflows increasingly expect ABHA-linked records and facility registration in the HFR.
• Claims digitisation: the National Health Claims Exchange (NHCX) is the direction of travel for provider and payer claims.

What it means for a Gujarat hospital

Practically, three things. Your facility and your clinicians need to be correctly registered (HFR and HPR). Your front desk needs to create or verify ABHA at registration and link each admission to it. And your records for scheme patients, from admission to discharge summary and bills, need to be structured enough to produce clean claims and, when asked, FHIR-format records. Hospitals that still run scheme patients on paper and a spreadsheet will feel the verification tightening first.

Readiness checklist

• HFR registration complete and matching your empanelment details; HPR entries for your doctors
• ABHA creation and verification at the OPD and admission counters, with Scan and Share for walk-ins
• Admission, pre-authorisation and discharge workflows that capture the data fields the scheme portal asks for, once, inside the HMS
• Package and rate mapping for PMJAY-MA so bills are generated against the correct package codes
• A document trail per case: consent, investigations, operative notes, discharge summary, attached to the ABHA-linked record
• Claims tracking: submitted, queried, approved, paid, with ageing reports so money is not left on the table
• Audit trail and role-based access, which both NABH and scheme audits expect
• A plan for HL7 FHIR record sharing (ABDM Milestone 2) so you are not retrofitting it under a deadline

What to require from your HMS

Ask every vendor to demonstrate, live:

• ABHA creation at the counter and Scan and Share check-in
• Scheme patient registration with package selection and pre-authorisation data capture
• Discharge summary generation that pulls from the clinical record rather than retyping
• A claims dashboard with ageing and query management
• FHIR R4 output for the record types ABDM expects
• Offline or on-premise operation if your connectivity is unreliable; a cloud outage should not stop admissions
• Gujarat-based implementation and support, because go-live and staff training happen on site

How MedCore HMS fits

MedCore HMS is built and supported from Ahmedabad. It covers ABHA-linked registration, admission and discharge workflows with structured documentation, billing with insurance and scheme claims tracking, and HL7 FHIR R4 output, and it runs on-premise or offline where the connection is poor. We will configure a demo around a PMJAY-MA admission from your own hospital, end to end, so you can judge the fit on your workflow rather than on a slide.

Scheme rules, package rates and portal requirements change. Treat the official PMJAY and Gujarat MA Yojana portals as the source of truth for the current process; this page explains readiness, not the rules themselves.