Even as the accused doctor has been placed under suspension for allegedly conducting unnecessary cardiac procedures among healthy patients to mint money, the Jammu and Kashmir government has ordered a fresh inquiry into cardiology procedures carried out under the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY) and AB PM-JAY SEHAT scheme.
The newly constituted committee was directed to re-examine earlier findings and conduct a comprehensive audit of medical and financial records.
On June 20, the Jammu and Kashmir government had suspended a senior cardiologist posted at Government Medical College (GMC), Anantnag, pending the completion of a departmental inquiry into allegations of fraudulent insurance claims, unnecessary cardiac procedures, patient exploitation, and manipulation of medical records under the PMJAY-SEHAT health insurance scheme.
The fresh move comes amid allegations of large-scale procedural irregularities, fraudulent insurance claims, and misuse of government-funded health schemes to siphon off public money.
The fresh inquiry follows the suspension of prominent Kashmir-based cardiologist Dr Syed Maqbool Ahmad Shah on June 20, pending a departmental inquiry into the alleged malpractices.
After placing Dr Shah under suspension, the Health and Medical Education Department constituted a four-member inquiry committee headed by Prof (Dr) Khalid Mohi-ud-Din of Government Medical College (GMC), Srinagar. The committee comprises Prof (Dr) Dharminder Kumar and Prof (Dr) Sanjeev Bhat of GMC Jammu, along with Dr Misbah Samad, State Nodal Officer, State Health Agency (SHA), J&K.
According to the latest government order, the newly constituted panel has been tasked with reviewing the findings and recommendations of the earlier expert committee while also examining the written statement of defence and supplementary submissions filed by Dr Shah, an Associate Professor in the Department of Cardiology.
The committee has been directed to scrutinise all relevant medical records, including package selection under the AB PM-JAY and SEHAT schemes, procedural appropriateness, pacemaker implantation records, procurement documents, billing records, and all supporting evidence.
It has also been asked to assess the financial implications of the procedures and insurance claims raised under the two government health schemes and determine whether the treatments adhered to national clinical guidelines and prescribed package norms.
The new panel has been directed to submit a comprehensive report, along with specific findings and recommendations, to the Administrative Department within 15 days.
Departmental inquiry already ordered against the accused doctor
As reported earlier, the Health and Medical Education Department has already initiated a departmental inquiry against Dr Shah over allegations of large-scale procedural irregularities, fraudulent insurance claims, patient exploitation, manipulation of official records, and violations of established medical protocols.
The doctor is also facing charges of performing invasive cardiac procedures, including pacemaker implantations, on patients who allegedly did not require them.
Official documents reveal that multiple Articles of Charge have been framed against the doctor under the Jammu and Kashmir Civil Services (Classification, Control and Appeal) Rules, 1956. The charges include falsification of records, submission of misleading claims under the PMJAY-SEHAT scheme, unauthorised medical interventions, violation of procurement norms, and conduct unbecoming of a government servant.
A departmental inquiry has reportedly found that nearly 50 per cent of the evaluated patients who underwent advanced cardiac procedures at GMC Anantnag did not require such interventions.
The case pertains to an alleged pacemaker implantation scam involving 103 cardiac patients. According to the inquiry findings, 27 of the 55 patients who underwent the procedure were found to have normal heart function, indicating that there was no medical justification for the intervention.
