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Various hospitals de-empanelled under SEHAT scheme, reports about suffering of dialysis patients’ half-truth: SHA

SRINAGAR: Jammu and Kashmir State Health Agency today stated that 43 hospitals and dialysis centres have been empanelled till now under the SEHAT scheme in the Kashmir division.

On average, these centres cater to over 452 dialysis patients on a daily basis.

Reacting to a report, carried in a section of a press, regarding sufferings caused to some dialysis patients, the SHA has said that Khyber Hospital, through emails on August 10, 2021 and November 20, 2021 had requested the Agency for empanelment. The State Health Agency held several meetings with the administration of the Khyber Hospital, requesting it to continue the services as an empanelled hospital under the Scheme.

The hospital gave various reasons and expressed unwillingness for the renewal of the contract, including financial crunch faced by the hospital, payments pending with the Insurance Company, backlog of cases and poor response of SHA J&K and Insurance Company on non-payment of cases.

All the concerns raised by the hospital were examined by SHA J&K while the concerns regarding non-payment of claims were nullified by the Insurance Company as per the data.

SHA J&K organized several meetings from time to time addressing various issues of the Khyber hospital and review of the rejected cases. The genuine issues of the hospital were addressed from time to time and supported the hospital by relaxing (Turn Around Time) TAT guidelines when and wherever it was necessary.

It was also reported by the Insurance Company that the hospital did not adhere to TAT guidelines issued by the National Health Authority which led to the rejection of claims of the hospital by the Insurance Company.

“Furthermore, any empanelled hospital under the scheme is supposed to extend all the available services to the beneficiaries under the schemes and cannot cherry pick the procedures/specialities as per their choices and convenience. However in this case, the hospital has not shown its willingness to extent the entire gamut of available services”, the SHA stated.

For smooth relocation of patients being served by Khyber Hospital, SHA J&K telephonically contacted all such dialysis patients. All the patients who were receiving dialysis services at Khyber Hospital are adjusted in other centres, and still spare dialysis capacities exist, it added.

SHA reiterated commitment to provide cashless services to the empanelled hospitals and dialysis centres. The agency has paid Rs. 792.5 crore to the empanelled hospitals till now and there is no backlog of payment under the ongoing policy.


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