After-effects of abrogation of Article 370 are being felt on flagship health insurance scheme, Pradhan Mantri Jan Arogya Yojana (PM-JAY), which has shown a declining trend in Jammu and Kashmir in August.

Sources in the Ministry of Health said that this drop in reporting of data on the Ayushman scheme follows the clampdown on internet, mobile phones and restrictions placed on travelling in Kashmir.

In June, there were 6,144 hospitalisations with pre-authorised amount of up to ₹2.67 crore, which increased by 16 per cent in July to 7,391 hospitalisations with pre-authorised amount of up to ₹3.18 crore.

Declining trend

In August, official estimates show a declining trend. At least 2,424 cases were processed under the scheme, with Jammu accounting for 897, Kashmir 1,500 and Ladakh 27. This includes both updated online and offline data gathered by the establishment.

“We have received these numbers for the entire State of J&K over text messages from officials based out of Jammu as on September 5 and data is still pouring in bits and parts. We will know the whole picture only when communications entirely resume,” said a senior official in the Ministry.

Three weeks ago, doctors in J&K had met the State Health Authority seeking clarifications on carrying out the scheme. Following this, the State Authority had written to the National Health Authority seeking directions. “We have advised the hospitals to work ‘offline’ for now which means that hospitals will treat patients first, raise bills later and upload data after internet is resumed,” said Indu Bhushan, CEO, PM-JAY.

August 5 onwards there had been a steep drop in the cases being recorded online, following the internet blackout.

Sharp fall

For example, between July 15 and 29, 1,743 patients were recorded, while only 163 patients were recorded online between August 5 and 12-- the first week after Article 370 was abrogated .

“Patients are still coming to hospitals for treatment though there is a drop in numbers due to curfew-like situation. Patients from remote areas may not be able to reach the hospitals,” said the Ministry official.

“We were not prepared for this unprecedented situation. Offline mode is used in remote areas of the North-East where there is poor connectivity, or at the most for half a day or a few days in case there is a breakdown of infrastructure. Also, the risk of fraud due to untimely data collection may arise in offline mode,” the official said.

Bajaj Allianz is the insurance service provider in J&K. Its office has a dedicated BSNL leased line, which provides internet connectivity. However, hospitals do not have a leased line.

“The approval for setting up dedicated leased lines in district hospitals of J&K is pending. Right now, our hospitals are working on broadband which is currently down,” said a senior J&K state official.

In the absence of internet, the company has asked hospitals to come to the insurance company’s Srinagar office and physically upload insurance related documents.

BusinessLine tried multiple times to contact some empanelled hospitals under the scheme – Florence Hospital, Khyber Medical Institute, Sher-i-Kashmir Institute of Medical Sciences, GB Pant Children’s Hospital and Government Hospital for Chest Diseases-- on landline phones, but the calls did not go through. Other private or public empanelled hospitals operate over mobile phones, of which there is anyway no connectivity.

Last month, a surgeon from a Srinagar-based government hospital in a video had said that internet is crucial to doctors for research. He had said that closing down of mobile and landline networks meant that doctors were unable to co-ordinate for patient treatment.

Many patients avail of benefits of Ayushman Bharat for dialysis, gall bladder removal, breathing disorders, kidney failure, cancer care, cardiac stenting, and total hip replacement. Since the scheme was launched in J&K in December last year, 30,439 patients have registered themselves for an estimate treatment amount of ₹20.2 crore.

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