Payments running in crores not paid by SHA
Govind Sharma
JAMMU, May 11: The hospitals empanelled with Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana (AB PMJAY) SEHAT Scheme in Jammu and Kashmir are experiencing cash crunch and are in fix as their dues running in crores have not been paid by the State Health Agency (SHA) since March 2024.
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Official sources told Excelsior that AB- PMJAY Sehat Scheme was launched in J&K with an aim to provide healthcare coverage to all residents of J&K irrespective of their financial condition. The scheme was initially implemented through private insurer Bajaj Allianz General Insurance Company, whose contract ended in 2022, after which IFFCO-TOKIO was roped in.
However, citing financial loss, the IFFCO-TOKIO attempted to exit the scheme in November 2023, a year ahead of its three-year term contract. The SHA requested the company to continue the contract in the interest of patient care, but the request was refused.
The SHA then approached the High Court to stay the exit. In its plea, the SHA urged the court to order the insurance company to fulfill the contract until its expiry on March 14, 2025, citing the importance of “patient care” and public well-being. It also 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.
Meanwhile, due to the ongoing dispute between SHA and IFFCO-TOKIO General Insurance Company, many hospitals in J&K are facing cash crunch as in last 2 months as they did not receive even a penny from the SHA.
“Our payment running in crores is yet to be paid by the SHA. Since March 2024, we are getting only assurances from the SHA that all our dues will be cleared but it was difficult for us to proceed further with Ayushman cases. Today also, we had a meeting with CEO SHA but nothing substantial came out of the meeting except consolation by the CEO,” said owner of a private hospital in Jammu.
He said despite cash crunch, “we are still providing the benefits of this scheme to the public but if our dues are not cleared soon, we will not be in a position to accept new admissions. Our vendors of medicines, implants and allied things have stopped supply to us seeking pending dues. We are even unable to pay salary to our staff. If the ongoing dispute is not resolved and our dues are not paid by SHA, we will have no option except discontinuing the scheme in our hospital.”
When contacted, CEO SHA J&K, Sanjiv M Gadkar told Excelsior that the dispute between SHA and IFFCO-TOKIO will not have any impact on the scheme and the patients continue to take benefits from it. He said the scheme is currently functioning normally, and the dispute between the Government and the insurance company does not affect its implementation.
“Empanelled hospitals are aware that the funds are documented for them, though there may be delays due to the ongoing dispute,” Gadkar added.
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