AB-PMJAY: Empanelled hospitals in J&K warns to suspend ops alleging funds non-clearance

AB-PMJAY: Empanelled hospitals in J&K warns to suspend ops alleging funds non-clearance


Jammu, May 22 : Alleging non-clearance of outstanding dues by the regulating authorities and the insurance company, the hospitals empanelled under the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) SEHAT scheme may suspend their operations of treating the beneficiaries from June 1, 2024 across the Union Territory of Jammu and Kashmir.

Notably, more than 160 private hospitals and nursing homes are empanelled under the AB-PMJAY in Jammu and Kashmir.

Prime Minister Narendra Modi in December 2020 launched Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) SEHAT scheme for the people of Jammu and Kashmir.

The main aim behind the scheme is to extend health insurance coverage to all residents of Jammu and Kashmir UT.

As per the letter dashed to the Jammu and Kashmir Chief Secretary, the members of the Empanelled Hospitals have stated, “We, the private hospitals and dialysis centres of the UT of Jammu and Kashmir, which are empanelled under the ‘SEHAT Scheme’ have not received any payment of PS7 Scheme since March 15, 2024.”

“With regards to this, an email has already been sent to the office of the CEO State Health Agency (SHA) and we will be unable to continue with the said scheme beyond June 1, 2024,” the letter signed by the owners of various empanelled hospitals from across Jammu and Kashmir further stated.

“AB-PMJAY, launched by PM Modi, is an amazing scheme covering both APL and BPL categories, and it is rather providing additional benefits to the people of Jammu and Kashmir,” one of the members of the All J&K Empanelled Hospitals Association, pleading anonymity, said.

“But the problem is that after March 15, 2024, no single penny is received from the concerned insurance company. As per an agreement, the payment has to be made on a monthly basis,” he said.

He stated that most of the operations in the empanelled hospitals are being carried out on AB-PMJAY scheme, which is a cashless process, adding, “we are not supposed to take the cash and simultaneously, funds are also not being cleared that led to financial burden on us.”

“The matter is sub-judice, but still, no buffer is being provided and despite directions from the Court to release funds, the same was not obeyed,” he claimed.

The High Court of Jammu and Kashmir and Ladakh at Srinagar through Hybrid Mode notably, in its order on April 29, 2024 in UT of J&K through Amit Gupta, Additional Advocate General (AAG) (Appellants/Petitioners) V/s IFFCO TOKIO, General Insurance Company Limited (Respondents) stated that the petitioner UT is allowed to utilize the premium amount of Rs. 427.73 crores lying with it for reimbursement of medical claims. This, however, shall be subject to the outcome of the present petition and without prejudice to the rights of the parties.

“We are helpless. Suppliers have stopped giving us the raw material without cash payments,” he said, adding that the empanelled hospitals are in limbo over the prevailing situation.

Stating that in one of the cases, a private hospital in Jammu has been suspended from AB-PMJAY scheme for reportedly denying treatment to patients, the association member said, “the matter related to clearance of funds is taken up at various quarters. The CEO SHA during our previous meeting has assured that funds will be cleared, but to date, nothing is visible on ground.”

The court hearing was on May 15, followed by May 19, but nothing was decided, He added, “The next hearing is on May 24, and we are hopeful that the court will take note of our concern on a positive note in the welfare of the health sector vis-à-vis the patients, who are having high hopes from this scheme.”

Meanwhile, this correspondent tried to call the CEO, SHA, for a version, but the attempt remained futile.


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