A proposal seeking the inclusion of robotic and bariatric surgeries under the Mahatma Jyotirao Phule Jan Arogya Yojana (MJPJAY) has remained pending with the Maharashtra government for more than two years, even as concerns have been raised over the future sustainability of providing robotic procedures free of cost to economically weaker patients. The proposal was submitted by Mumbai's Sir J. J. Group of Hospitals after the introduction of robotic surgery services, but no final decision has yet been announced.
Although the robotic surgical system has already been provided by the government, the major financial challenge has been associated with the recurring replacement of specialised instruments and disposable consumables. These accessories are required for every robotic procedure and are designed with fixed usage limits that are electronically monitored by the robotic platform. Once the permitted number of uses has been reached, the instruments are automatically disabled and fresh replacements are required. As a result, recurring expenditure has been estimated at approximately Rs 1 lakh to Rs 1.5 lakh for each surgery.
Robotic surgery services were formally introduced at Sir J. J. Group of Hospitals on April 9, 2025, making it the only state-run hospital in Mumbai to offer such advanced procedures. Since then, more than 260 surgeries have been completed across multiple specialties, including gastrointestinal surgery, colorectal surgery, urology, hernia repair and gynaecology. An initial stock of consumables capable of supporting around 500 procedures was supplied along with the robotic platform, and more than half of that inventory has already been utilised.
In an effort to sustain free treatment, reimbursements have been sought under existing laparoscopic surgery packages wherever eligible. However, this mechanism has been described by hospital authorities as only a temporary solution because dedicated reimbursement for robotic surgery has not yet been approved. It has been cautioned that once the available consumables are exhausted, the financial burden will either have to be absorbed by the hospital or transferred to patients unless a long-term funding mechanism is established.
The proposal has also sought the inclusion of bariatric surgery under MJPJAY. Despite bariatric procedures having been performed at the hospital for more than a decade, insurance coverage has not yet been extended under the state scheme. Comparisons have been drawn with other states where similar procedures have already been incorporated into public health insurance programmes.
The proposal has been confirmed by the State Health Assurance Society (SHAS) to be under examination. While the potential patient benefits have been acknowledged, the higher costs associated with robotic procedures have been cited as a key factor requiring detailed financial assessment before any decision is taken.
Under the existing MJPJAY framework, eligible beneficiaries are entitled to cashless treatment worth up to Rs 5 lakh annually at empanelled hospitals. Doctors have maintained that the inclusion of robotic and bariatric surgeries would help ensure that advanced surgical care continues to be made available to financially vulnerable patients without additional out-of-pocket expenditure while also supporting the long-term sustainability of these specialised services within the public healthcare system.