Srinagar: The High Court has directed the J&K government to consider the extension of National Health Package mentioned in the Office Memorandum dated 6th April, 2022/AB-PMJAY Health Benefit Package Master 2022 and also deliberate upon 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.
Justice M Y Wani while hearing a petition by the proprietors, administrators of different empanelled private hospitals, diagnostic centres and dialysis centres, directed the UT authorities “to consider the extension of National Health Package mentioned in the Office Memorandum dated 6th April, 2022/AB-PMJAY Health Benefit Package Master 2022 in the Union Territory of Jammu and Kashmir”.
The bench asked the authorities to accordingly, “consider the amendment to the request for, “proposal for selection of Insurance Company” for implementation of Araichman Bharat Pradhan Mantri Jan Arogya Yojna andAyushman 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 respondents were also directed “to consider the inclusion of the surgical procedures, namely, (i) Appendectomy (ii) Cholecystectomy (iii) Hemorrhoidectomy (iv) Fissure in ANO, as per the Office Memorandum dated April, 2022, in the request for proposal for selection of Insurance Company for implementation of AB-PMJAY and AB-PMJAY-SEHAT in the Union Territory of Kashmir through empanelled petitioners”.
The same, bench observed, “constitute the most common surgical procedures needed by common citizens living below poverty line who are not in a position to avail said services properly in the public hospitals”.
The bench expected that the respondents may have the consideration strictly as per the governing Yojana/Scheme before the award of contract to the selected insurance companies.
The counsel for the petitioners pleaded that the Government of India has launched Ayushman Bharat Pradhan Mantri Jan Arogya Yojna Scheme in September 2018, which is a flagship programme of the government and provides insurance cover up to Rs five lakhs per family per year for secondary and tertiary care hospitalization to over 10.74 crore entitled beneficiary families.
He submitted that the government of Jammu and Kashmir has also launched Ayushman Bharat Pradhan Mantri Jan Arogya Yojna-SEHAT (AB-PMJAY-SEHAT) to provide free of cost universal health coverage to all its residents including the serving and retired employees and their families.
The scheme is intended to provide same benefits as those available under Aushman Bharat Pradhan Mantri Jan Arogya Yojna Scheme, a Government of India scheme, which provides annual heath insurance cover of Rs. 5.00 lakhs per family on a floater and cashless basis through an established network of healthcare providers, the lawyer said.
The counsel for the petitioners further submitted that the official respondents have decided to implement the schedule of HBP 2022 issued by NHA in the UT of Jammu and Kashmir. However, the Ministry of Health and Family Welfare (National Health Authority) has issued an Office Memorandum dated 6th April, 2022 and the said HBP has been named as HBP 2022.
The counsel submitted that on the bare perusal of the Office Memorandum dated 6th April, 2022, the revised package master of AB-PMJAY HBP 2022 also known as National Package, has to be included by all the States in order to provide healthcare facilities to the citizens through empanelled healthcare providers.
The government of Jammu Kashmir through its State Health Agency has issued a “Request for Proposal” for selection of insurance company for implementation of Ayushman Bharat Pradhan Mantri Jan Arogya Yojna and Ayushman Bharat Pradhan Mantri Jan Arogya Yojna-SEHAT in the UT of Jammu and Kashmir based on HBP 2.2. (November, 2021) scheme/schedule.
The scheme has become redundant as on date due to the issuance of AB-PMJAY Health Benefit Package Master 2022 and this scheme of 2022 has to be implemented in the UT of Jammu and Kashmir, as per Clause 5 of Office Memorandum dated 6th April, 2022/AB-PMJAY Health Benefit Package Master 2022.
The scheme of 2021 will affect healthcare benefits to the domiciles of UT of Jammu and Kashmir and will also cause huge financial losses to the empanelled hospitals which include the petitioners, reads the petition.
