Guide · last checked 9 October 2026
Haryana Government Hospital Empanelment Form — Which One You Need, and How the Process Actually Runs
There is no single Haryana government hospital empanelment form. That is the first thing worth knowing, and it is where most hospitals lose weeks.
Haryana runs four separate empanelment routes — Ayushman Bharat and Chirayu, the state employees' cashless scheme, ESI Haryana, and CGHS. Each has its own form, its own portal and its own authority. Applying on the wrong one is the commonest reason an application goes nowhere.
Which empanelment form you actually need
Match your intended patient base to the right scheme before you fill in anything. These are four different systems, not four doors to the same room.
| Scheme | Who it covers | Where you apply | Authority |
|---|---|---|---|
| Ayushman Bharat PM-JAY and Chirayu Haryana | Low-income and extended Chirayu beneficiary families | Hospital Empanelment Module (HEM) at hospitals.pmjay.gov.in | State Health Agency, Haryana |
| Haryana state employees' cashless scheme | Serving Haryana government employees and pensioners | Health Department, Haryana — see the cashless portal | Dept. of Health & Family Welfare |
| ESI Haryana | Insured workers and their dependants | hryesi.gov.in | ESI Health Care Dept., Haryana |
| CGHS | Central government employees and pensioners | HEM portal, CGHS track — requires a signed MoU with CGHS | Central — not a state scheme |
Most hospitals searching for a hospital empanelment form in Haryana want the first row. Chirayu Haryana is the state's extension of Ayushman Bharat, and empanelment for it runs through the same HEM portal under the Haryana State Health Agency.
Eligibility and bed criteria
The criteria split into two tiers. Category 1 (Essential) covers minimum standards for general hospitals. Category 2 (Advanced) adds requirements for specialties such as cardiology, oncology, neurosurgery, nephrology and neonatal care.
| Requirement | Standard | Notes |
|---|---|---|
| Inpatient beds, general hospital | Minimum 10 | With adequate spacing and staffing |
| Inpatient beds, aspirational districts | Minimum 5 | Relaxed criterion |
| Dental and day-care facilities | Bed criterion exempt | Covers eye, ENT, standalone dialysis |
| Standalone dialysis centres | At least 5 dialysis units | With prescribed space and equipment standards |
| Medical staffing | Qualified doctors and nurses, round the clock | Not on-call only |
| Surgical services | On-call surgeon and anaesthetist | Required where surgery is offered |
| Maternity services | Obstetrician, paediatrician and anaesthetist | All three |
| Specialty empanelment | Advanced criteria per specialty | ICU or NICU support and qualified specialists |
Partial specialty empanelment is generally not allowed. You cannot be empanelled for the profitable half of a specialty and skip the rest. The exception is certain tertiary specialties in designated X and Y cities. Hospitals that plan around cherry-picking packages find this out at the inspection stage, after the fit-out spend is already committed.
Documents checklist
| Document | Status |
|---|---|
| Registration under the applicable central or state establishment or nursing home act | Mandatory |
| State licences required for your services | Mandatory |
| Income Tax Department registration (PAN) | Mandatory |
| NEFT-enabled bank account and cancelled cheque | Mandatory |
| Biomedical waste management compliance | Mandatory |
| Fire safety measures | Mandatory |
| 24-hour electricity with generator backup | Mandatory |
| Manpower details — at least one medical and one technical staff member | Mandatory |
| Latitude and longitude of the facility | Mandatory |
| NABH or PM-JAY quality certification | Strongly advantageous |
| ROHINI ID (private) or NIN (public) | Encouraged |
| Signed MoU with CGHS | CGHS track only |
| Self-declarations, Annexures 5 and 6 | Dialysis centres only |
Latitude and longitude being mandatory surprises people. Take the coordinates at the facility entrance, not from a rooftop map pin — the figure is used for geotagged verification later.
How to apply, step by step
- Register on the HEM portal. Open pmjay.gov.in, find Hospital Empanelment Management (HEM) and create an account. Use a mobile number and email you actually monitor.
- Collect the reference number and temporary password sent by SMS. The SMS password works once only.
- Activate the account at hospitals.pmjay.gov.in. Set three security questions and a password of 8 to 12 characters with upper case, lower case, a number and a special character.
- Fill Basic Information, including the mandatory coordinates.
- Enter financial details — the account that will receive reimbursements, with a cancelled cheque uploaded.
- Select your specialties. Declare only what you can evidence at inspection.
- Complete licences, certifications, civil and medical infrastructure, and general services. NABH-certified hospitals are exempt from the civil and medical infrastructure sections — a meaningful saving in effort.
- Add manpower, at minimum one medical and one technical staff member.
- Upload attachments per the checklist above.
- Open "Check Eligibility and Submit." Fields shown in red need correction; everything must be green before submission is allowed.
- Tick the declaration and submit. A confirmation email goes to your registered address. Track status under Hospital Basic Information.
You can save at any point and return later with the same credentials, so there is no need to assemble everything before you start.
The three verification routes
This is the part almost no guide explains, and it decides how long your empanelment takes.
| Route | Who qualifies | What happens | Speed |
|---|---|---|---|
| Option 1 Full verification |
Standard applicants | District Empanelment Committee scrutinises documents, then physically inspects equipment, staff, services and quality standards | 15 working days at DEC |
| Option 2 Fast track, auto-approval |
Already-empanelled or certified hospitals — NABH or PM-JAY Bronze | System matching, no physical verification | 5 working days |
| Option 3 Fast track, deferred inspection |
Non-QCI hospitals | Desktop verification using geotagged photos and video; physical verification follows within 3 months | Approval first, inspection later |
NABH accreditation is the single biggest lever on this whole process. It moves you from Option 1 to Option 2 — five working days instead of a document scrutiny plus a physical inspection — and it exempts you from the civil and medical infrastructure sections of the form entirely. If you are weighing whether accreditation is worth the cost, empanelment speed belongs in that calculation.
The District Empanelment Committee is chaired by the district Chief Medical Officer, with the State Health Agency's district programme manager and, under insurance models, an insurer representative. It recommends approval or rejection with reasons. The State Empanelment Committee, chaired by the SHA Chief Executive Officer, supervises the DEC and handles rejections. Final approval rests with the State Health Agency.
Statutory timelines
These are prescribed, not approximate. If your application is sitting beyond them, you have grounds to follow up with a specific reference rather than a general enquiry.
| Stage | Timeline |
|---|---|
| DEC processing, Option 1 | 15 working days |
| SHA final decision after DEC report | 15 working days |
| Overall decision from application receipt | 30 working days |
| Auto-verification, Option 2 | 5 working days |
| Decision notification to the hospital | 3 working days |
| Rectification window for minor lacunae | 30 working days |
| Adding missing specialties after inspection | 15 working days |
| Signing the MoU after the decision is posted | 7 working days |
| Physical verification after fast-track approval | 3 months, or 1 month via third-party agency |
| Requesting review of a rejection | 15 working days |
| Responding to a show-cause notice | 5 working days |
| Notice to withdraw voluntarily | 30 days, re-entry after 6 months |
| Re-empanelment after de-empanelment | Not before 1 year |
The seven-day MoU window catches hospitals out. Approval is not empanelment. Once the decision is posted on the portal you have seven working days to sign the memorandum of understanding. Hospitals that treat approval as the finish line, and only check the portal a fortnight later, find themselves restarting a process they had already cleared.
If your application is rejected
You have 15 working days from rejection to request a review from the State Empanelment Committee. The SEC must reach a final decision within 30 working days of its first meeting on the matter. The State Health Agency reviews all rejections as a matter of course.
Where the problem is a minor lacuna rather than an outright failure, there is a separate 30-working-day rectification window. Read the rejection reason carefully to see which of the two you are in — the remedies and the clocks are different.
Grounds for de-empanelment
Worth reading before you apply, not after. Empanelment can be withdrawn for:
- Failing to meet or maintain the empanelment criteria.
- Having been wrongfully empanelled — failing minimum criteria, misconduct or fraud.
- Wilful suppression or misrepresentation of facts in the application.
- Taking illegal cash payments from beneficiaries — a repeat offence, typically actioned at the second or third instance.
- Billing for services not provided.
- Upcoding, unbundling, or performing unnecessary procedures.
- Wrongful beneficiary identification where the hospital is found to be in connivance.
- Not responding to a show-cause notice, which can trigger suspension.
The cash-payment ground deserves particular attention. These schemes are cashless by design, and charging a beneficiary at the counter — even for something the hospital genuinely considers outside the package — is the most frequently actioned violation.
If you are a government employee, not a hospital
A good share of people searching this term are not hospital administrators at all. They are Haryana government employees and pensioners trying to find which hospitals they can use cashlessly.
You do not need an empanelment form. You need the empanelled hospital list, which is published district-wise on the Health Department's cashless portal. Check it before admission rather than after — a hospital that was empanelled last year may not be now, and the reverse is equally true.
If you are weighing a government job partly on benefits like this, our salary calculator covers how CGHS and other deductions work against gross pay, and the 8th Pay Commission page covers what is and is not yet decided on the next revision.
Official links
| Ayushman Bharat Haryana — policy, guidelines, process flow | ayushmanbharat.haryana.gov.in |
| HEM portal — apply and track | hospitals.pmjay.gov.in |
| National Health Authority — empanelment guidelines | nha.gov.in |
| Haryana Health Department | haryanahealth.gov.in |
| Empanelled hospitals, district-wise list | cashless.haryanahealth.gov.in |
| ESI Haryana empanelled hospitals | hryesi.gov.in |
Questions
Where do I get the Haryana government hospital empanelment form?
There is no single downloadable form. For Ayushman Bharat and Chirayu Haryana, the application is completed online on the Hospital Empanelment Module at hospitals.pmjay.gov.in. The state employees' cashless scheme, ESI Haryana and CGHS each run separate routes.
What is the minimum bed requirement?
Ten inpatient beds for a general hospital, reduced to five in aspirational districts. Dental and day-care facilities, including eye, ENT and standalone dialysis, are exempt from the bed criterion.
How long does empanelment take?
The prescribed overall timeline is 30 working days from receipt of the application — 15 at the District Empanelment Committee and 15 for the State Health Agency decision. NABH or PM-JAY Bronze certified hospitals can be auto-approved in five working days.
Does NABH accreditation help?
Substantially. It routes you to fast-track auto-approval instead of a physical inspection, and exempts you from the civil and medical infrastructure sections of the application.
Is there a physical inspection?
Under Option 1, yes — the DEC inspects equipment, staff, services and quality standards. Option 2 skips it. Option 3 defers it, with desktop verification by geotagged photos and video first and physical verification within three months.
What happens after approval?
You must sign the MoU within seven working days of the decision being updated on the portal. Approval alone does not make you empanelled.
Can I appeal a rejection?
Yes. Request a review from the State Empanelment Committee within 15 working days of rejection. For minor lacunae there is a separate 30-working-day rectification window.
Can a de-empanelled hospital reapply?
Not before one year. A hospital that withdraws voluntarily must give 30 days' notice and may re-enter after six months.
I am a government employee — how do I find empanelled hospitals?
Use the district-wise list on the Health Department's cashless portal. Check it before admission, since the list changes.
Source. Compiled on 9 October 2026 from the National Health Authority's revised guidelines on hospital empanelment and de-empanelment, the NHA Hospital Empanelment Module self-help guide, and the Ayushman Bharat Haryana portal. The bed criteria, three verification routes, committee structure, statutory timelines and de-empanelment grounds come from those documents.
Note. Empanelment criteria and timelines are revised periodically, and state-specific conditions may apply on top of the national framework. Confirm the current position on ayushmanbharat.haryana.gov.in and in the relevant guideline PDF before acting. This page is informational and is not affiliated with any government department.
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