Srinagar 22 May (KNB): Private sector hospitals and dialysis centres empanelled of Kashmir are likely to close their services to beneficiaries of the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) due to payment delays amid insufficient fund allocations from government towards the health insurance scheme.
The Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY), launched in 2018, is a health insurance scheme jointly funded by the Centre and states. The funding ratio stands at 60:40, with the union government allocating ₹7,500 crore to PMJAY this year.
Due to the lack of reimbursement since March, the owners of the empanelled hospitals, dialysis centres in Jammu and Kashmir have written to Chief Secretary Atal Dullo, expressing their inability to continue providing services to patients beyond May. A total of 239 government and private hospitals are part of the scheme.
The letter from the private hospitals and dialysis centers empanelled under the SEHAT scheme states that they have not received any payment since March 15, 2024. They express their inability to continue with the scheme beyond June 1, 2024.
The owners of the empanelled hospitals wrote a letter on May 17 to the Chief Secretary through the office of the Chief Executive Officer of the State Health Agency, Sanjiv M Gadkar. In the letter, they expressed that the empanelled hospitals have depleted their funds to operate their health centers under the scheme.
“We are struggling to pay salaries to employees, and distributors are not receiving payments for medicine and equipment. The financial strain is affecting our ability to continue providing services under the scheme, told hospital owner to news agency Kashmir News Bureau-KNB.
The Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY)was initially implemented through private insurer Bajaj Allianz General Insurance Company, whose contract ended in 2022. Subsequently, IFFCO-TOKIO took over the scheme. However, citing financial losses, IFFCO-TOKIO attempted to exit the scheme in November 2023, a year ahead of its three-year term contract. Despite the State Health Agency (SHA) urging the company to continue the contract for patient care, the request was refused.
The SHA then approached the High Court seeking a stay on the exit. In its plea, the SHA emphasized the importance of “patient care” and public well-being, urging the court to order the insurance company to fulfill the contract until its expiry on March 14, 2025. Unfortunately, the petition was dismissed on February 2, leading to further complications for the SHA and beneficiaries across the Union Territory.
Currently, private hospitals are experiencing exhaustion due to the PM-JAY scheme. Initially, we expected to fill vacant beds at subsidized rates, but now it’s impacting our profits, said another hospital owner.(KNB)