GMC Anantnag cardiologist suspended over alleged PMJAY claim irregularities

Srinagar: A senior cardiologist at Government Medical College (GMC), Anantnag, has been suspended by the Jammu and Kashmir government following allegations of irregularities in the reporting of cardiac procedures under the Pradhan Mantri Jan Arogya Yojana (PMJAY). The doctor has denied the allegations, calling the procedures clinically justified, while the case has triggered debate within the medical community.  

According to a suspension order issued by the Health Department, the Associate Professor of Cardiology at Government Medical College (GMC), Anantnag, has been accused of intentional misrepresentation, data falsification, and financial fraud. The government has further alleged that he caused patients to incur out-of-pocket expenses, bypassed official procurement channels, and performed advanced cardiac procedures without proper clinical justification.

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The controversy centres on Left Bundle Branch Area Pacing (LBBAP), an advanced form of pacemaker implantation designed to stimulate the heart’s natural electrical conduction system for more physiological rhythm control.

While standard dual-chamber pacemaker implantation is covered under PMJAY, LBBAP is not explicitly included under the same reimbursement category. The government has alleged that the accused doctor booked 103 cases under the “dual chamber pacemaker implantation” package on the PMJAY Transaction Management System (TMS), despite performing LBBAP procedures.

According to the Indian Express report, “Physical records prove you have actually performed LBBAP. This intentional misrepresentation was designed to siphon public welfare funds from the PMJAY/SEHAT scheme under a false clinical pretext,” reads the probe order. “You directly violated the absolute cashless and free mandate of the PMJAY/SEHAT scheme and forced vulnerable patients to pay out-of-pocket expenses for procedures done within a government facility.”

The allegations also cite a case in which a patient was reportedly asked to pay Rs 70,000 to a private vendor. The probe further claims that the doctor bypassed the hospital’s supply chain system by sourcing equipment from external suppliers, raising concerns over procurement transparency and accountability.

The government also claimed that an expert review of selected cases found that several patients had normal cardiac function, questioning the medical necessity of certain procedures performed under LBBAP.

The accused doctor has denied all allegations, stating that he has submitted a detailed response with supporting documentation. Speaking to The Indian Express, he said that with a dual-chamber pacemaker, there’s a 20 per cent chance of failure within six months to three years. “And to overcome it, the LBBAP is the advanced procedure that is being implemented worldwide,” he said. “In both cases, two wires are put. In a dual chamber, we put it in the heart muscle, while in LBBAP, we put it in the heart’s conduction system.”

He also maintained that all procedures were conducted within government systems and under the PMJAY cashless framework, with purchases routed through authorised channels such as the Amrit supply network.

The cardiologist acknowledged that some patients may have incurred partial expenses in exceptional cases but denied any wrongdoing or systemic bypass of procurement rules. He further argued that clinical decisions cannot be assessed solely on laboratory reports and must consider broader medical indications.

The suspension has sparked differing reactions among doctors. Some in the fraternity have described the action as being influenced by internal institutional politics and have credited the doctor with developing advanced cardiac care services at GMC Anantnag.

Others, however, have stressed that the issue is less about medical innovation and more about compliance with PMJAY protocols. Speaking to the Indian Express, a doctor said the cardiologist went against PMJAY guidelines. “Irrespective of whether advanced procedures were needed or not, he has violated the guidelines issued in PMJAY,” said the doctor. “We need to wait for the decision of the probe committee.”

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