Srinagar: Hundreds of patients in Jammu & Kashmir have called for immediate government intervention after private hospitals in the union territory halted services under the Ayushman Bharat scheme starting September 1.
The decision has raised serious concerns among patients who rely on these services for essential medical treatments, though the government claims steps have been taken to ensure no patient suffers.
Patients at several private hospitals in Srinagar appealed the government to step in and ensure the resumption of these crucial healthcare services.
The private hospitals in Jammu & Kashmir have ceased operations under the Ayushman Bharat scheme due to the non-receipt of funds, amounting to around Rs 200 crore, since March this year.
In November of last year, IFFCO-TOKIO General Insurance Company, the insurer for Ayushman Bharat in J&K, informed the State Health Agency (SHA) that they would not renew the contract after it expires on March 14, 2025. Initially, the scheme was managed by Bajaj Allianz GIC, whose contract ended in 2022. IFFCO-TOKIO was brought in as a replacement but has since sought to withdraw from the scheme, citing financial losses. Despite requests from the SHA for the company to continue operations in the interest of patient care, IFFCO-TOKIO has refused.
The SHA approached the high court to prevent the company from exiting the scheme, but the petition was dismissed on February 2, further complicating the situation. The government later appealed to the division bench to stay the single bench’s order, making the issue sub-judice.
Recently, the high court directed IFFCO-TOKIO General Insurance Company to continue with the existing arrangement as per the terms and conditions of the contract agreement for Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana-SEHAT (AB-PMJAY-SEHAT) pending resolution of the dispute with the UT Government by the Arbitrator. However, the company has yet to start implementing the scheme, prompting authorities to file a contempt petition against it.
Sanjiv M Gadkar, Chief Executive Officer (CEO) of the State Health Agency, Jammu and Kashmir said that they have filed a contempt petition against the company. “We have asked public hospitals to operate 24×7, including starting night shifts, and dialysis patients are being referred there for treatment,” he said.
He said the patients can call the toll-free number 104 to provide their details, and the agency will arrange their treatment free of charge.
Gadkar said that private hospitals’ dues currently amount to around Rs 165 crore. “We have assured all private hospitals that they have been paid regularly for the last four years without delay. However, due to the ongoing case, payments are delayed, and we have assured them that they will be paid immediately once the issue is resolved,” he added.
Meanwhile, the government on Tuesday assured uninterrupted treatment under Ayushman Bharat JAY SEHAT.
The statement was issued following various news articles and reports regarding dialysis patients suffering due to the refusal and charging of cash by private hospitals to provide treatments under the Ayushman Bharat Jan Arogya Yojana (ABJAY) SEHAT.
The government informed the public that IFFCO-TOKIO discontinued the implementation of the scheme effective March 15, 2024, resulting in Empaneled Health Care Providers (EHCPs) not receiving payments for treatments provided under the scheme. Despite the High Court’s judgment directing IFFCO-TOKIO to implement the scheme, the company has not done so, causing significant hardships for patients.
The government said it has made every effort to ensure free treatment for patients under the scheme with the support of private EHCPs. “The government remains committed to providing the best health services to all patients and beneficiaries in Jammu & Kashmir,” a government spokesperson said.
He said the government has already mobilised its resources to provide treatment to all patients through robust public hospitals, ensuring that no patient is left without care.
“Patients facing denial of treatment at private EHCPs should call the toll-free number 104 to register their names. The State Health Agency (SHA) will ensure these patients receive treatment at nearby public hospitals free of charge under the scheme,” the spokesperson said.
He added, “There is no need for dialysis patients to panic or worry about treatment refusals by private EHCPs under the Golden Card. The government of J&K assures that all patients will receive free and timely treatment under the Golden Card at EHCPs.”
He said the government of J&K remains committed to the principles of the AB-PM JAY/SEHAT scheme, which aims to provide accessible and affordable healthcare to all. “The health and well-being of citizens remain a top priority, upholding the objectives of the Ayushman Bharat – Jan Arogya Yojana/SEHAT,” the spokesperson said. “Patients are urged to call 104 for further details, support and assistance.
