The Jammu and Kashmir government has issued show-cause notices to 11 government hospitals for alleged misuse of the Golden Card scheme under Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) and SEHAT.
The State Health Agency (SHA) took action after a tele-calling survey by Paramount Health Services & Insurance TPA Pvt. Ltd. revealed that these hospitals denied eligible patients cashless treatment, forcing them to pay out-of-pocket expenses.The hospitals served with notices include SKIMS Soura, Super Specialty Hospital Srinagar, SMHS Hospital Srinagar, JLNM Hospital Srinagar, SMGS Hospital Jammu, Government Medical College Jammu, GMC Udhampur, GMC Rajouri, Government Children’s Hospital Bemina, Government Hospital Gandhi Nagar, and SKIMS Medical College Bemina.
The State Health Agency has directed these hospitals to submit their written explanations within seven days. Failure to comply may result in penalties, suspension from the scheme, or legal action. Officials stressed that such violations undermine the core purpose of the Golden Card scheme, which aims to provide accessible, cashless healthcare to economically vulnerable sections of society.
Pertinently, it was in March this year Private hospitals across Jammu and Kashmir suspended free medical services and initiated mass layoffs after the government removed four key surgical procedures from the Ayushman Bharat health insurance scheme. The decision, which reserves surgeries like cholecystectomy, appendectomy, and haemorrhoidectomy for government hospitals, has triggered a crisis, with private healthcare providers warning of unsustainable operations and financial distress.
The government also removed four surgeries from the list for private hospitals and restricted them to government-run healthcare facilities.The procedures include cholecystectomy (removal of the gallbladder), haemorrhoidectomy (haemorrhoid), sphincterotomy (fissure), and appendectomy (appendix). “In pursuance of the decisions taken in the 8th & 9th Governing Council meeting of the State Health Agency, it has been decided to implement significant changes in the Health Benefits Packages (HBP) 2.2 across all empanelled public and private hospitals in the UT of J&K"-this was stated in the official order in March.
“The 10% additional package price that was previously applied to private hospitals under HBP 2.2 shall no longer be applicable. All packages for private hospitals will be standardized as per the base rates under HBP 2.2.” It read further.
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