49% of Cardiac Procedures at GMC Anantnag Found Unwarranted; Senior Doctor Faces Fraud Charges
OnlyKashmir.in News Desk
A major anti-fraud investigation has uncovered alleged large-scale irregularities in the Cardiology Department of Government Medical College (GMC) Anantnag, with authorities claiming that nearly half of the audited advanced cardiac procedures carried out under the Ayushman Bharat PM-JAY SEHAT scheme were performed on patients who did not medically require them.
The inquiry has placed senior cardiologist Dr. Syed Maqbool under scrutiny, with the Jammu and Kashmir Health and Medical Education (H&ME) Department initiating formal disciplinary proceedings that could potentially result in his dismissal from service.
According to an official memorandum issued by the department, Dr. Maqbool has been asked to submit a written explanation within seven days. Failure to respond could lead to ex-parte proceedings under the Jammu and Kashmir Civil Services (Classification, Control and Appeal) Rules, 1956.
Audit Uncovers Suspected Fraud
The investigation began after the State Anti-Fraud Unit (SAFU) received complaints regarding alleged out-of-pocket expenses incurred by beneficiaries who were entitled to free treatment under the PM-JAY SEHAT scheme.
A review of the Transaction Management System (TMS) reportedly identified irregularities in claims submitted by the Cardiology Department. Authorities allege that 103 cases were booked under the “Dual Chamber Pacemaker Implantation” package, while hospital records showed that a different procedure, known as Left Bundle Branch Area Pacing (LBBAP), had actually been performed.
Investigators contend that the discrepancy amounted to deliberate misrepresentation aimed at securing higher reimbursements from the government-funded healthcare scheme.
Independent Medical Review Raises Concerns
Following an unusual rise in LBBAP procedures at GMC Anantnag, the State Health Agency referred the matter to experts from SKIMS, Srinagar, for an independent assessment.
The review found that LBBAP is generally recommended only for specific categories of cardiac patients. However, of 55 cases examined, experts concluded that 27 patients, nearly 49 percent, had normal heart function and did not meet the accepted clinical criteria for the procedure.
The panel reportedly found no medical justification for performing LBBAP in these cases, prompting the State Health Agency to reject related claims on grounds of suspected medical fraud.
Allegations of Illegal Payments
The probe has also revealed allegations that patients were made to incur expenses despite the PM-JAY SEHAT scheme being designed to provide cashless treatment in government hospitals.
Investigators cited a case in which a patient allegedly paid ₹70,000 to a private vendor for a cardiac procedure. During verification, the beneficiary reportedly confirmed the payment and stated that the transaction was carried out outside the hospital’s official procurement system.
Authorities claim this violated the scheme’s guidelines and constituted financial exploitation of beneficiaries.
Procurement Irregularities Alleged
The investigation further alleges that standard procurement procedures were bypassed. Under established protocols, medical devices used in such procedures are required to pass through approved hospital channels and receive multiple levels of administrative approval.
However, investigators reportedly found implant barcodes that did not match authorised hospital inventories and noted the absence of mandatory approvals from designated officials.
Officials have also alleged that certain procurement records were withheld during the course of the investigation, raising concerns about possible institutional collusion.
Evidence and Witnesses
The H&ME Department has compiled extensive evidence, including digital claim records, operation theatre documents, Cath Lab registers, procurement records and invoices linked to the disputed procedures.
The government is also expected to rely on testimony from cardiology experts at SKIMS, GMC Anantnag officials, Cath Lab personnel, beneficiaries and their family members.
Department Initiates Disciplinary Action
In its findings, the department has described the alleged conduct as serious misconduct, abuse of official position, violation of professional ethics and failure to adhere to public service obligations.
Dr. Syed Maqbool has been granted seven days to submit his defence. Following his response, the government will determine further action, which could include major disciplinary measures and other proceedings as deemed appropriate.
