J&K private hospitals to halt services over unpaid Rs 160 crore

Srinagar, Aug 31: In a development that could significantly impact healthcare access, private hospitals and dialysis centres across Jammu and Kashmir have announced their decision to suspend medical services under the Ayushman Bharat free health insurance scheme starting September 2.

A spokesman 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,” he 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, will likely affect numerous patients who rely on this programme for affordable healthcare at private facilities.

The private hospital association expressed regret over the situation and its impact on the people of Jammu and Kashmir.

They emphasised their commitment to the Ayushman Bharat Scheme but cited the inability of their distributors and suppliers to extend further credit as a key factor in their decision.

“We remain committed to the Ayushman Bharat Scheme and are dedicated to providing the best possible care to all our patients. However, until the funds are released and our suppliers and creditors resume their services, we will only be able to offer services on a cash basis," the spokesman said.

The High Court of J&K and Ladakh has temporarily directed IFFCO TOKIO General Insurance Company Limited to continue with the existing arrangement as regards the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana-SEHAT Scheme to provide free of cost universal health coverage to all the residents of J&K including the serving and retired employees and their families through a network of Empanelled Health Care Providers (EHCPs).

A bench of Justice Rajesh Sekhri said this while allowing a petition by the J&K government.

J&K administration’s free health insurance scheme, SEHAT (Social Endeavour for Health and Telemedicine), has saved residents of J&K a staggering Rs 2285 crore in medical expenses.

This universal health coverage initiative, providing each family with Rs 5 lakh annual insurance entirely free of cost, has emerged as a game-changer in J&K’s healthcare landscape.

Since its launch in August 2020, SEHAT has demonstrated remarkable reach and impact.

Over 85.49 lakh individuals have been issued Golden Cards, granting them access to the scheme’s benefits.

This widespread adoption represents a significant portion of the J&K’s population, indicating high acceptance and utilisation of the programme.

The scheme’s infrastructure is robust, with approximately 251 hospitals empanelled under the AB-PMJAY-SEHAT scheme.

This extensive network ensures beneficiaries have access to a wide range of quality healthcare services across the region.

The impact has been substantial, with about 12.90 lakh treatments facilitated, directly benefiting 3.60 lakh individuals since the scheme’s inception.

“About 12.90 lakh treatments have been provided so far worth Rs 2285 crore which has provided services to 3.60 lakh beneficiaries since August 2020. The scheme has been a game changer for the public at large as it provided financial support to treatment seekers for 48 availing timely intervention required for leading a healthy life. Telemedicine services have also been introduced,” an official note of the government reads.