Govt steps in as private hospitals halt free medical services over unpaid dues

Srinagar, Sep 03: Amid the suspension of medical services by private hospitals and dialysis centres under the Ayushman Bharat Jan Arogya Yojana (AB-PMJAY) SEHAT scheme, the government has stepped in to reassure patients that their healthcare needs would be met.

The disruption is primarily due to the non-payment of Rs 160 crore dues by the insurance company responsible for the scheme’s implementation to empanelled healthcare institutions.

According to the statement of the State Health Agency, the issue arose after IFFCO Tokio, the insurance provider, ceased implementing the scheme on March 15.

This decision left Empanelled Health Care Providers (EHCPs) without payments for the services they rendered under the scheme, leading to a halt in the provision of free medical services to patients.

“Despite a judgment from the High Court (HC) mandating the continuation of the scheme, the insurance company has yet to comply, resulting in difficulties for patients, particularly those requiring regular dialysis,” the statement said.

In light of these developments, the Jammu and Kashmir government moved swiftly to mitigate the impact on patients.

The J&K government has worked with private EHCPs to ensure that treatments continue under the scheme while simultaneously strengthening its public healthcare infrastructure to handle any overflow of patients.

“The administration has assured that no patient will be left without care and that all necessary treatments will be provided free of charge under the Golden Card,” the statement said.

To assist those facing issues with private EHCPs, the government has established a toll-free helpline (104).

Patients experiencing denial of treatment have been asked to register their grievances through this number, and the State Health Agency will coordinate to provide them with the required care at nearby public hospitals.

The J&K government said that it remains committed to the principles of the AB-PM JAY and SEHAT scheme, emphasising its goal of providing accessible and affordable healthcare to all residents.

The administration has reaffirmed that the health and wellbeing of the J&K citizens remains a top priority and patients have been encouraged to reach out for support and assistance as needed.

The government has urged all affected individuals to utilise the toll-free number 104 for further information and help in accessing the services they are entitled to under the Ayushman Bharat - Jan Arogya Yojana and SEHAT scheme.

A spokesperson for the Ayushman Bharat empanelled hospitals and dialysis centres said that the suspension of services is “due to non-compliance with court orders by IFFCO Tokio.”

Private healthcare providers claim that payments have been pending for the last six months, amounting to approximately Rs 160 crore.

“This delay in payments has led to severe financial pressure on healthcare facilities, affecting our ability to maintain services,” they said. “Despite a High Court directive instructing IFFCO Tokio to ‘continue with the existing arrangement as per terms and conditions of the contract agreement,’ the insurance company allegedly failed to comply. Following the court order, the State Health Agency had communicated with IFFCO Tokio to adhere to the court's instructions, but to no avail.”

The suspension of services under the Ayushman Bharat scheme, also known as the Golden Card, has affected numerous patients who rely on this programme for affordable healthcare at private facilities.