SEHAT corruption hoax: Hitman targeting honest officers
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SEHAT corruption hoax: Hitman targeting honest officers

No wrongdoing in J&K's SEHAT contract, contradicts 'the wire' claims: ACB Report

Post by RK News on Saturday, October 14, 2023

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New Delhi, Oct 13: In a recent turn of events, a controversial article published by a Delhi-based website has come under scrutiny for its alleged inaccuracies and ulterior motives, official sources said.
The article titled, "J&K Admin ignored own departments advice to amend multi-crore contract to favour Private Co: IAS Officer," raised concerns about the Universal Health Scheme 'SEHAT' in Jammu and Kashmir.
Official sources said the article primarily relied on a letter from IAS officer Ashok Parmar, who has been embroiled in controversy due to allegations of incompetence and corruption.
Sources said that Parmar's letter, submitted to the National Commission of Scheduled Caste (NCSC), accused the government of bending rules to award a contract to Bajaj Allianz Group Insurance Company (BAGIC), resulting in a purported loss of Rs 500 crore to the exchequer.
However, a thorough investigation by ‘Rising Kashmir’ uncovered that the Anti-Corruption Bureau (ACB) had already conducted a probe in this case and found no irregularities in the contract award process and no loss to the government's coffers.
In fact, the government profited out of the deal, the treasury disbursement figures listed in this report later would make it amply clear.
The ACB report revealed: “Allegation pertaining to conferring undue favour upon BAGIC by State Health Agency and causing loss to the exchequer to the tune of Rs. 500 to Rs. 600 Crore was probed. It revealed that the total premium paid to the BAGIC during the whole policy period, with effect from 26 December 2020 to 14 March 2022 including interim arrangement on stop loss basis was Rs.304.59 Crore. The total claims payout to hospitals by BAGIC was Rs.398.41 crore. This simply means that the insurance company has suffered a loss of Rs.93.82 crore.  Given the figures, the allegation is without any evidence as the company instead of earning profit has on the contrary incurred monetary loss. Therefore, no loss accrued to the state exchequer”.
The findings of the ACB which had duly examined the files of the health department have made it amply clear that irregularities or quid pro quo were not found in the execution of the scheme.
A senior official on the condition of anonymity said that SEHAT Universal Insurance Scheme is considered one of the best health schemes in the country and ‘The Wire’ reportage appears to be a hit job to discredit the insurance scheme and disempower the people.
“You have to understand that J&K was a jungle raj prior to August 2019. There was no system for awarding the government contracts. Now, with complete transparency and weeding out of pro-separatists elements from the system, the previous beneficiaries are rattled. There was no such insurance scheme earlier because previous regimes of never cared for people but only strengthened anti-India players at the expense of taxpayers' money,” the Official said.
The investigation report has also noted that since the launch of SEHAT Insurance scheme, the government of J&K has paid Rs. 982.59 Crores in premium to insurance companies. In return, insurance companies have disbursed a total of Rs.1226.68 Crores in claims to empanelled hospitals for the treatment of entitled patients.
 “A total of around 5.50 Lakh patients have availed treatment for various conditions under the scheme which includes cancer patients, patients with cardiac ailments and patients suffering from chronic diseases. The model adopted under the scheme shifts risk to insurance companies as evidenced by the disbursal to hospitals by insurance companies. The model has strengthened the health care system within the UT and has reduced out of pocket expenses preventing catastrophic payments and poverty for families in need of hospitalization,” the report observed.
Another fallacy in ‘The Wire’ story is that it also misquoted the clause on termination of the contract and interpreted it to suit a particular narrative.
As per the contract between BAGIC and the State Health Agency, the duration of the contract was fixed for 3 years but renewable every 12 months. The provision of clauses 9 and 27 of the contract makes it clear that the continuation of the contract beyond the first year was through mutual agreement between the parties and not otherwise. The insurance company as per the terms and conditions served the notice expressing unwillingness to continue with the contract beyond completion of one year.
A health department official said there was no violation of the contract, however, since the government cannot abandon the scheme mid-way, an interim arrangement was made with BAGIC until the government found a new insurance company to run the scheme. He said that after BAGIC served the notice, a fresh tender was floated on November 7, 2021. Four companies participated and IFFCO TOKIO was the considered L1 @ Rs. 2299 per family per annum. However, it was realized by the government that the proposal was on the higher side and subsequently another tender was floated on December 18, 2021, wherein IFFCO TOKIO was again declared L1 at the premium of Rs.1840 per family per annum and the company was awarded the contract in March 2022 and it is continuing till date.
“The news portal alleged that the interim arrangement was made to give undue favour to BAGIC. But if you look at the money paid to BAGIC it will be clear that things were transparent. During 79 days of interim arrangements Rs.124.26 Crore was paid as premium to BAGIC while BAGIC paid Rs.118.41 Crores as claims to the hospitals. During its contract period including interim arrangement, total payement to BAGIC was Rs.304.59 Crore while BAGIC paid to hospitals Rs.398.41 Crore, hence BAGIC has suffered loss to the tune of Rs.93.82 Crore,” the health department official said.
The official also questioned the allegation that current Chief Secretary AK Mehta's son was given a job by the BAGIC as a quid pro quo.
“This is completely malicious. First of all, AK Mehta was Finance Secretary in 2020 and in no way any person can influence the tendering process which is completely transparent and awarded to the companies after following all rules and regulations. He had no role in finalization of insurer in 2020. He was not the Chief Secretary at the time of finalization of the contract. Moreover, BAGIC was L1. No favour is needed to award a contract to L1. Question of favour would have arisen, had the award been made to L2 or L3. Period after August 2019 is not the same that was prevalent before here when the contract was given to a select few without e-tendering and even terrorists were given jobs. Things have changed and since people have realized this, the ecosystem will try to damage the reputation of those honest officers, who are driving this change,” the official said.

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