Irfan Tramboo
SRINAGAR, Feb 6: With the Government reportedly considering reserving four surgical procedures exclusively for public hospitals, private hospitals and dialysis centers across J&K today announced their exit from the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY)-Sehat scheme starting next month.
The J&K Private Hospitals and Dialysis Centres Association has written to the Chief Executive Officer (CEO), AB-PMJAY-Sehat, highlighting “critical” decisions made during the recently held 9th Governing Council Meeting, which they say will further impact them.
“…We want to share that we have come to know that the 9th Governing Council Meeting was held on January 19, 2025, in which some critical decisions were taken, including the reservation of four procedures for public hospitals, a 10% reduction in UT-specific incentives, and the implementation of Health Benefit Package (HBP) 2.2 instead of HBP 2022,” reads the letter, a copy of which is with ‘Excelsior’.
The procedures, which are commonly sought, especially in the private sector, include laparoscopic cholecystectomy, hemorrhoidectomy, appendectomy, and fissure-in-ano surgeries.
Private healthcare providers are apprehensive that these might be made exclusive to public hospitals.
“We believe that all these decisions are not in our interest, are anti-private sector, and will surely push us to the verge of bankruptcy, as we have already been suffering for the past ten months,” the association stated.
It is to be noted here that the Governing Council Meeting was chaired by the Chief Secretary on January 19, 2025. However, no official statement has been issued by the Government regarding the matter or any possible policy shifts.
The private healthcare providers said that, “unfortunately,” the meeting did not address the release of their long-pending payments from Bajaj-the insurer-nor did it discuss 1% interest on delayed payments, review and reimbursement of unjustified deductions, or rejections since 2022.
Private hospitals and dialysis centers, which play a crucial role in implementing the scheme in J&K, have stated in the letter-termed as an “exit notice”-that they have concluded that their contract with the State Health Agency, upon completion of the three-year term on March 15, 2025, “is no longer tenable.”
The Association stated that it will not be possible for them to cover expenses at “these diminishing rates,” especially with “delayed payments.”
“Neither have the package rates been revised, even after the Union Government enhanced the budget for the Ayushman Bharat scheme by 24% to Rs 9,406 crores,” the letter added.
“HBP 2022, approved by the National Health Authority of India in 2022, should be implemented with a special rate revision for dialysis patients,” it stated.
The Association demanded that no procedure should be reserved exclusively for public hospitals, asserting that the Right to Health is guaranteed under Article 21 of the Constitution of India.
It further stressed that patients should not be restricted to receiving treatment only from public hospitals under PMJAY and that guidelines issued by the National Health Authority of India should be implemented, “including the reimbursement of 1% interest on delayed payments.”
As more conditions for continuing with the scheme, the association demanded that no unjustified deductions or rejections should be made and that a standardized rate for deductions should be finalized in advance.
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