SHA refutes news regarding denial of PMJAY benefits to patients needing thrombolysis at SMHS

JAMMU, DECEMBER 23: Refuting the news report appeared in Daily Excelsior on 23-12-2023, titled “Patients needing thrombolysis denied PMJAY benefits at SMHS”, State Health Agency, J&K, has termed the claim as half-researched and inaccurate.

SHA clarified that a package namely Systemic Thrombolysis with the code MC020A is available for thrombolysis in patients with myocardial infarction (MI) under Health Benefit Package (HBP) 2.2 of AB PM-JAY and AB PM-JAY SEHAT according to the existing guidelines. 

However, the package has some prerequisites which are mandatory for booking the same under the scheme. As per HBP 2.2 issued by National Health Authority (NHA), this package is categorized as a regular package and not a day-care procedure, with an average length of stay of 3 days necessary for processing the same.

Therefore, adhering to the Standard Treatment Guidelines (STGs) of NHA, if the package is blocked for patients who require thrombolysis, the patient must be admitted for a minimum duration of 24 hours in the hospital. Contrary to the article’s claim, the hospital authorities have never stopped AB-PMJAY-SEHAT benefits for patients in need of thrombolysis and who were admitted for at least 24 hours.

Till date 625 cases worth Rs. 1 Cr pertaining to System Thrombolysis package have been processed under AB PM-JAY & AB PM JAY SEHAT in the UT of J&K out of which 587 cases have been processed in SMHS hospital alone. This clearly negates the statement that there is denial of the said treatment under scheme provided all the STGs are followed by the hospitals.

To address any potential confusion, State Health Agency (SHA) Jammu & Kashmir has proactively sought clarification from the National Health Authority regarding the inclusion of thrombolysis package as a day-care procedure.

In conclusion, the assertion that AB-PMJAY-SEHAT benefits are denied to patients requiring thrombolysis at SMHS Hospital is inaccurate. The hospital continues to provide necessary care within the framework of established guidelines. Any further updates or clarifications from the NHA will be promptly communicated to ensure seamless patient care under the scheme.