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EditorialPM-JAY fraud in hospitals

PM-JAY fraud in hospitals



Healthcare in and has dramatically improved since the launch of the Pradhan Mantri Jan Arogya Yojana, or PM-JAY Yojana, which covers medical costs up to five lakhs and authorises hundreds of hospitals, including private hospitals, to provide specialised medical services to patients. In contrast to the rest of , where the programme is only available to those who are poor, Jammu and Kashmir residents are all eligible to sign up for the programme, receive an Ayushman Bharat card, and benefit from its provisions. The days of agonising months-long wait times in government hospitals for even basic surgery are long gone with just one stroke.

The website contains details about each hospital that has been appointed, making it simple to select a facility for receiving medical care. There is also a feedback mechanism offered by the GoI, as patients do get calls after being hospitalised and using the services to verify the legitimacy and calibre of the services and to make sure no payment is required of the patient. For middle-class and disadvantaged families, the PM-JAY programme has been a blessing in disguise because they are no longer taxed or financially stretched to receive medical care. Nurses make sure Ayushman Bharat cardholders receive their free medicine supplies promptly even in government facilities.

With the exception of chronic conditions, when it is always preferable to seek treatment at GMC Jammu or another type of specialised government hospital, the strain on government hospitals has significantly decreased. For patients who are hospitalised, all diagnostic procedures, including lab tests, ultrasounds, CT scans, and MRIs, are free of charge. However, the PM-JAY programme does not cover the expenses of these procedures for outpatients. When everything is said and done, the Ayushman Bharat Yojana is a win-win situation for everyone: patients receive appropriate care at no cost, private hospitals receive , and government hospitals experience a small reduction in their typical volume of patients. Yet con artists participate in every government scheme, and the PM-JAY scheme is no exception.

Many private hospitals in Jammu and Kashmir have repeatedly received fines for filing false claims under PM-JAY. The fact that some white-coated men are engaging in such misconduct despite swearing an oath to serve humanity is a significant concern. This is not the first time thirteen hospitals have been suspended and fines totaling Rs. 1.77 crore have been levied; some of these institutions have committed violations in the past. There appears to be a cluster of hospitals engaging in these deplorable practises.
The LG Administration must impose stiffer punishments on repeat offenders; the suspension is not a sufficient punishment for taking advantage of patients and filing false medical claims.

Such instances shouldn't reflect poorly on the administration's good efforts. The Medical Council of India must also take a collegial stand against these terrible actions. More watchfulness is required; sincere hospitals must be recognised with recommendations on official websites, and defaulting hospitals must also be named so that potential patients can determine their reliability.


The Northlines is an independent source on the Web for news, facts and figures relating to Jammu, Kashmir and Ladakh and its neighbourhood.


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