Hospitals in AB-PMJAY SEHAT threaten to halt services over pending payments

Srinagar, May 21: Dismayed over the long pending payments, the private hospitals and diagnostic centres empanelled with Ayushman Bharat PradhanMantri Jan ArogyaYojana (AB-PMJAY) SEHAT Scheme in J&K have threatened to stop their services due to pending payments with the State Health Agency (SHA) since March 2024.
The health insurance scheme was started in J&K to provide healthcare coverage to all residents of J&K irrespective of their financial condition. The scheme was initially implemented through private insurance company Bajaj Allianz General Insurance Company Limited, whose contract ended in 2022, after which IFFCO-TOKIO was roped in.
However, citing financial losses, IFFCO-TOKIO attempted to exit the scheme in November 2023, a year before the end of its three-year contract. Despite the SHA’s request for the company to continue the contract in the interest of patient care, the request was denied.
Officials said later the SHA approached the High Court to stay the exit and urged HC to order the insurance company to fulfill the contract until its expiry on March 14, 2025.
It had requested to direct the company to restrain from opting out of the Contract of insurance but the petition was dismissed on February 2, causing further complications for SHA and beneficiaries across the Union Territory.
Due to the dispute, many hospitals and diagnostic centres in Jammu and Kashmir are facing financial issues; they have not received payments till date from the SHA due to which they suffer a lot.
Empanelled Private Hospital and Diagnostic Centres Association J&K have written to Chief Secretary J&K stating that they have not received the payments since March 15.
“We have already taken up the matter and sent a communication to CEO ABPMJAY SEHAT Scheme and we will be unable to continue with the said scheme from 01 June, 2024,” said a written communication signed by a group of 50 owners of private hospitals and diagnostic centres.
The association said that they have been facing several difficulties proceeding further with Ayushman cases due to financial crunch. Despite that they said they have continued to provide benefits to patients under the scheme.
“The previous meeting with concerned quarters has not got any result or response. We will be compelled to stop the services. In previous years also we have faced a lot in getting the payments. When our dues are not cleared, how can we provide services,” said one of the owners of a private hospital in Srinagar.
Some officials argue that the scheme is functioning normally and issues between government and the concerned insurance company would not affect its implementation.
However, despite repeated attempts to call and text Sanjiv M. Gadkar, Chief Executive Officer of the State Health Agency, J&K, for comments, he did not respond.