Srinagar: The Jammu and Kashmir Government has ordered a fresh high-level inquiry into the cardiology procedures performed under the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY)/SEHAT scheme at Government Medical College (GMC), Anantnag, constituting a four-member expert committee to re-examine the case and submit its findings within 15 days.
According to the order issued by secretary health and medical education, the inquiry committee will be headed by Prof. (Dr.) Khalid Mohi-ud-Din, Professor at GMC Srinagar while the other members include Prof. (Dr.) Dharminder Kumar and Prof. (Dr.) Sanjeev Bhat, both Professors at GMC Jammu, and Dr. Misbah Samad, State Nodal Officer, State Health Agency (SHA), J&K.
The committee has been tasked with examining the findings and recommendations of the earlier expert committee that investigated the cardiology cases, scrutinising the written statement of defence and supplementary submissions submitted by Dr. Syed Maqbool Ahmad Shah, Associate Professor of Cardiology, GMC Jammu, and reviewing all relevant medical records.
It will also verify package selection details, assess the appropriateness of procedures performed, examine pacemaker implantation records, procurement and billing documents, and evaluate the financial implications arising from claims raised under the AB PM-JAY/SEHAT scheme.
The panel has further been asked to determine whether the procedures complied with national clinical guidelines and package norms before submitting a comprehensive report with specific findings and recommendations to the Health and Medical Education Department within 15 days.
The Government has directed the State Health Agency, J&K, and GMC Anantnag to extend full cooperation to the committee by providing all required records, technical inputs, documents and logistical support.
The latest inquiry comes after the Government initiated major penalty proceedings and suspended Dr. Shah following allegations of irregularities in cardiac procedures carried out under the PM-JAY SEHAT scheme at GMC Anantnag.
The matter first came to light after the State Anti-Fraud Unit received complaints alleging that some beneficiaries were made to incur out-of-pocket expenses despite the scheme providing cashless treatment. An audit later identified unusual trends in claims related to advanced cardiac procedures.
Subsequently, the State Health Agency referred the matter to an expert committee from Sher-i-Kashmir Institute of Medical Sciences (SKIMS), Soura, for technical evaluation. The committee examined a sample of Left Bundle Branch Area Pacing (LBBAP) procedures and reportedly concluded that several cases lacked adequate clinical justification, leading to the rejection of multiple claims under the scheme.
Based on those findings, the Government issued a charge memorandum against Dr. Shah alleging serious data falsification and financial irregularities. The charges included alleged submission of claims under incorrect package codes, performance of invasive procedures without sufficient clinical indication, violation of procurement procedures and alleged out-of-pocket expenditure by beneficiaries despite the cashless nature of the PM-JAY SEHAT scheme.
Dr. Shah, however, has denied all allegations, maintaining that the procedures performed were medically justified and in accordance with accepted cardiology practices.
He has also questioned the audit findings, asserting that his clinical decisions were based solely on the individual medical needs of patients.
