Jahangeer Ganaie
Srinagar, Feb 6: The Jammu and Kashmir Private Hospitals and Dialysis Centre Association has raised serious concerns over the future of the Ayushman Bharat SEHAT scheme, warning that they may stop providing free treatment under the programme unless urgent reforms are introduced.
In a letter addressed to the CEO of the State Health Agency (SHA), J&K, the association said that following extensive deliberations, they have concluded that the current contract—set to expire on March 15, 2025—is no longer viable under existing terms.
The letter highlighted several key grievances arising from the 9th Governing Council Meeting held on January 19, 2025, where certain decisions were made that the association considers detrimental to private healthcare providers.
“The reservation of four surgical procedures for public hospitals, a 10% reduction in UT-specific incentives, and the implementation of HBP 2.2 instead of HBP 2022 are not in our interests. These measures are anti-private sector and will push many hospitals to the verge of bankruptcy, given that we have already been suffering for the past ten months,” the letter stated.
The association also expressed concern that the meeting failed to address long-pending payments, interest on delayed reimbursements, or the review of unjustified deductions and claim rejections dating back to 2022.
A member of the association said that the government’s plan to exclude key surgeries such as gall bladder surgeries, hemorrhoids, appendectomies and fissure surgeries from the scheme and restrict them to government hospitals is a concern.
“These surgeries constitute around 50-60% of total surgical cases. Excluding them from private hospitals will not only defeat the purpose of providing free healthcare but also increase patient suffering, as government hospitals already have long waiting lists,” he said.
He warned that financially stable patients may opt for private hospitals and pay for their treatment, while economically weaker patients would be forced to wait for months for their turn at public hospitals.
Furthermore, he cautioned that staff layoffs would become inevitable as private hospitals experience a 50-60% drop in surgical procedures, worsening the unemployment crisis in the region.
The association has urged the SHA and government authorities to implement the reforms to ensure the sustainability of the SEHAT scheme. These reforms include implementation of HBP 2022 (approved by the National Health Authority in 2022), special rate revision for dialysis patients to reflect rising operational costs, no reservation of surgical procedures for government hospitals so that patients retain the right to choose between public and private healthcare under PMJAY, adherence to National Health Authority guidelines to ensure fair reimbursement practices.
It demanded 1% interest on delayed payments and resolution of past claim deductions and rejections, finalisation of deduction rates before implementation to prevent financial uncertainty, immediate release of pending payments, including Bajaj reimbursements, with 1% interest and continuation of the 10% UT-specific incentive for private hospitals.
The association warned that if their concerns are not addressed, they will be forced to withdraw from the scheme by March 15, 2025, which could severely impact thousands of patients relying on private healthcare facilities under Ayushman Bharat SEHAT. (KNO)
