Consider inclusion of 4 surgical procedures in private hospitals: JnK HC directs State

Srinagar: In a bid to provide equal healthcare access for below poverty line citizens, the Jammu and Kashmir High Court has recently directed the state government to consider the inclusion of four surgical procedures—Appendectomy, Cholecystectomy, Hemorrhoidectomy, and Fissure in ANO—under the Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) scheme for empanelled private hospitals in the Union Territory.

The directive came from Justice Mohammad Yousuf Wani while disposing of a petition filed by private empanelled hospitals seeking the extension of Ayushman Bharat Pradhan Mantri Jan Arogya Yojna (AB-PMJAY) and Ayushman Bharat Pradhan Mantri Jan Arogya Yojna-SEHAT in J&K in keeping with the National Health Benefit Package 2022. The court emphasized that these surgical procedures are essential for Below Poverty Line (BPL) citizens who often struggle to access proper treatment in public hospitals.

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The petitioners, comprising proprietors and administrators of various empanelled private hospitals, diagnostic centers, and dialysis centers, had approached the court to demand the implementation of the updated Ayushman Bharat Health Benefit Package Master 2022 in Jammu and Kashmir and include the four surgical procedures in the scheme so that private empanelled hospitals could perform it as it is only restricted to public hospitals. This will help the domiciles of J&K to equally avail the benefits of the flagship scheme at par with the other citizens of the country.

They also sought amendments to the "Request for Proposal" for selecting an insurance company responsible for implementing the Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana and Ayushman Bharat PMJAY-SEHAT in the Union Territory.

During the hearing, the court noted as reported by Daily Excelsior, "Consider the amendment to the request for, “proposal for selection of Insurance Company” for implementation of Araichman Bharat Pradhan Mantri Jan Arogya Yojna and Ayushman Bharat Pradhan Mantri Jan Arogya Yojna-SEHAT in the UT of Jammu and Kashmir, so that the domiciles of the UT of J&K are in a position to equally avail the benefits of the flagship scheme at par with the other citizens of the country."

The petitioner's counsel highlighted that the Ayushman Bharat Pradhan Mantri Jan Arogya Yojna scheme, launched in September 2018, which is a flagship programme of the Government, provides insurance cover up to Rs. 5 lakhs per family per year for secondary and tertiary care hospitalization to over 10.74 crore entitled beneficiary families.

Further, the counsel submitted that the Hospitals/Nursing Homes/Clinics empanelled under Ayushman Bharat Pradhan Mantri Jan Arogya Yojana and the “request for proposal” further mentioned that the four surgical procedures will be the reservation packages for Public Hospitals only. Therefore, they argued that the four surgical procedures in question had been reserved exclusively for public hospitals, thereby limiting treatment options for BPL patients in private facilities.

The court acknowledged this concern and instructed the authorities to ensure that the domiciles of Jammu and Kashmir receive healthcare benefits on par with citizens in the rest of the country. Additionally, it directed the government to consider updating the health scheme to align with the latest national policies before awarding the contract to an insurance company, Greater Kashmir reports.

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