Srinagar- The High Court of J&K and Ladakh has directed government to consider amendment to selection of insurance company for implementation of Ayushman Bharat Pradhan Mantri Jan Arogya Yojna and Ayushman Bharat Pradhan Mantri Jan Arogya Yojna-SEHAT in Jammu and Kashmir.
A Bench of Justice Mohammad Yousuf Wani passed the direction “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 instant petition is disposed of at this threshold stage with the direction to the respondents (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 and, accordingly, consider the amendment to the request for, “proposal for selection of Insurance Company” for implementation of Ayushman 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 court said.
The authorities have been 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 2022, in the request for proposal for selection of Insurance Company for implementation of AB-PMJAY and AB-PMJAY-SEHAT in the J&K “as the same 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 court said that it was expected that authorities may have the “consideration strictly as per the governing Yojana/Scheme before the award of contract to the selected Insurance Company(s).”
According to the counsel for petitioner, St Josepgh Hospital, 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 Jammu and Kashmir based on HBP 2.2. (November, 2021) Scheme/Schedule, which 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 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, the petitioner said, will affect health care benefits to the domiciles of Jammu and Kashmir and will also cause huge financial loses to the empanelled hospitals.
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