Nishikant Khajuria
JAMMU, June 11: Hospitals in Jammu have stopped taking new cases under Ayushman Bharat Scheme due to ongoing tussle between State Health Agency (SHA) and the concerned insurance company resulting in non-payment issues.
This has been formally conveyed to CEO of the State Health Agency, Jammu, through a letter by Jammu province hospitals, empanelled under Ayushman Bharat Scheme, under which Government provides free of cost health insurance cover to all the residents of J&K Union Territory.
In the letter, empanelled hospitals have stated that despite previous multiple correspondences, there has been no response or payment received for cases under the Ayushman Bharat Scheme since March 15, 2024.
“It is crucial to mention that hospitals have exhausted their funds over the past two and a half months and cannot sustain operations without the promised payments,” said a spokesperson of the hospitals, adding that assurances from the Health Secretary, dated May 31, 2024 have yet to translate into actual payments.
The spokesperson further said that the situation has become dire with many hospitals facing severe financial crises while a few have been compelled to sell essential equipment, such as Dialysis machines to manage daily expenses. The inability to pay salaries has also put immense stress on hospital management.
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“We assure the public that emergency services will remain operational till 15th June .We are committed to resuming full services under Ayushman Bharat as soon as the funds are released,” said the spokesperson for the hospitals.
The hospitals have urged the concerned authorities to address this issue promptly to ensure smooth running of this scheme.
Pertinent to mention that Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) SEHAT scheme was launched in Jammu and Kashmir in the year 2020. It provides free of cost insurance cover to all the residents of the UT of J&K and It also provides financial cover up to Rs 5 Lakh per family on a floater basis to all residents of the UT of J&K and an operational extension of PM-JAY to 15 lakh (approximately) additional families.
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.
Due to the dispute between SHA and IFFCO-TOKIO General Insurance Company, many hospitals in J&K are facing cash crunch as in last three months, they did not receive even a penny from the SHA.
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