‘Insurer IFFCO Tokio main cause of disruption’
Irfan Tramboo
Srinagar, Aug 23: With funds totalling crores of rupees not released since March, J&K Empanelled Hospitals and Dialysis Centres announced today that they will cease services under the AB-PMJAY scheme starting September 1.
The decision from the private hospitals and dialysis centres across J&K has come due to the lack of funds, which, they said, has caused significant “financial strain” on their resources.
The heads of these facilities stated: “Since March 15, 2024, funds under the Ayushman Bharat Scheme, amounting to approximately Rs 300 crore, have not been released, leading to severe financial strain on our resources.”
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They emphasized that over the past six months, they have “exhausted” all available means to continue providing services under this scheme.
The situation has been originally complicated by a “prolonged legal battle” between the Government and the insurance company, IFFCO Tokio, after the latter decided to exit from the scheme, delaying release of funds, and creating difficulties for private healthcare facilities.
“Despite the issue being of utmost public health importance, payments for wrongfully rejected and deducted cases have not been released by IFFCO Tokio, even though the State Health Agency (SHA) has issued orders for the same,” the group stated.
They noted, “We will not be able to serve Golden Card patients beyond August 31, 2024, until the payments are released. Our suppliers, who have supported us on credit until now, have categorically denied extending credit beyond this date.”
The stakeholders expressed their commitment to the Ayushman Bharat Scheme and providing the best possible care, but added, “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.”
In June, the empanelled hospitals and dialysis centres had decided to exit the scheme due to non-payment of outstanding funds. However, after receiving assurances from authorities, they reconsidered, only to find themselves facing the same difficulties.
Top officials from the H&ME Department told Excelsior that the matter between the Government and the insurance company is sub judice, and an order in this regard has been reserved by the court.
“The issue was created by the insurance company; otherwise, all stakeholders were seamlessly working for patient care across J&K; the court has reserved its order for judgement regarding the matter, let it come.”
The Empanelled Hospitals and Dialysis Centres mentioned that its members met with the Chief Executive Officer (CEO) SHA in April, who assured them that the issue would be resolved by early May.
After payments were not released, the group submitted an application to the Chief Secretary through the CEO of Ayushman Bharat on May 18, requesting the release of funds by May 31, or the hospitals would be forced to stop services due to a lack of funds.
On May 31, following a meeting with the Medical Education (H&ME) Department, assurances were given that the money was secure and the issue would be resolved soon.
They also submitted a letter to the DC Srinagar, highlighting the lack of funds and the potential collapse of the entire system if emergency funds under the DC’s jurisdiction were not released, but received no response.
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