SRINAGAR: The Health and Medical Education (HME) Department has initiated major departmental proceedings against a cardiologist posted at Government Medical College (GMC) Anantnag over allegations of fraudulent PMJAY-SEHAT claims, manipulation of medical records, unauthorised cardiac procedures, patient exploitation and violations of procurement norms, official documents reveal.
The departmental action against Dr Syed Maqbool, a cardiologist at GMC Anantnag, follows an inquiry that allegedly uncovered serious procedural irregularities involving cardiac interventions, public healthcare funds and the implementation of the Ayushman Bharat PMJAY-SEHAT scheme.
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 insurance claims, violation of procurement procedures, unauthorised medical interventions and conduct unbecoming of a government servant.
The department has directed the doctor to submit a written defence within seven days, warning that ex parte proceedings may be initiated in the event of non-compliance.
At the centre of the controversy is an alleged pacemaker implantation scam involving 103 cardiac cases booked under the “Dual Chamber Pacemaker Implantation” package on the Transaction Management System (TMS). Investigators have alleged that the procedures actually performed were Left Bundle Branch Area Pacing (LBBAP), while claims and records reflected a different procedural category under the PMJAY-SEHAT scheme.
The inquiry report further alleges that procedural data uploaded on official platforms did not correspond with Cath Lab records, raising concerns of deliberate misrepresentation and fraudulent utilisation of public healthcare funds.
In another significant finding, an expert audit reportedly found that 27 of the 55 patients reviewed who underwent the LBBAP procedure had normal heart function and lacked established clinical indications for the intervention. The audit was initiated after the State Health Agency observed an unusual increase in LBBAP-related claims from the institution.
According to the inquiry findings, nearly 49 per cent of the reviewed cases did not conform to accepted medical guidelines governing the procedure. Several claims linked to the questioned interventions were subsequently rejected.
The inquiry has also alleged financial exploitation of PMJAY-SEHAT beneficiaries. In one instance cited in the chargesheet, a patient identified as Peer Rafiq Ahmad allegedly paid Rs 70,000 to a private vendor for a cardiac procedure despite being entitled to cashless treatment under the government health scheme.
Investigators have claimed that beneficiary audits and field verification established that the payment was made outside the official hospital mechanism and that the patient attributed the transaction to directions allegedly issued by the treating doctor. Officials described the alleged incident as a serious violation of PMJAY-SEHAT guidelines and patient rights.
The chargesheet further accuses the cardiologist of bypassing approved procurement and supply-chain mechanisms by allegedly sourcing implants and medical hardware directly from private vendors instead of authorised institutional channels. Investigators have alleged that mandatory approvals, procurement safeguards and quality-control procedures were ignored, while certain records were reportedly not produced during the anti-fraud investigation.
The HME Department has termed the allegations grave in nature and stated that, if established, they would amount to serious professional misconduct, abuse of official position, lack of integrity, dereliction of duty and breach of public trust.
A comprehensive list of documentary evidence, including TMS logs, Cath Lab registers, patient records, invoices, procurement documents, audit reports and findings of the State Anti-Fraud Unit, has been included in the proceedings. Several senior medical experts, administrators and officials associated with the investigation have also been listed as witnesses.
The department has warned that the charges, if substantiated, may attract stringent penalties, including removal from government service.
Meanwhile, the case has triggered widespread public outrage, with citizens and civil society members demanding a criminal investigation into the allegations. Many have called for the registration of an FIR and cancellation of the doctor’s medical registration if the charges are proved during the inquiry.
Members of the public expressed concern that allegations relating to patient exploitation, record manipulation and misuse of the PMJAY-SEHAT scheme, if established, would constitute a grave breach of public trust and raise serious questions about patient safety and institutional accountability.
Several residents also demanded a wider probe to determine whether additional individuals were involved and whether public funds or patient welfare were adversely affected. They urged the government to ensure a fair, transparent and time-bound investigation and take action against all those found responsible.
Officials said the departmental inquiry is underway and that any determination of guilt would depend on the outcome of the proceedings. Further action is expected to be taken based on the findings of the investigation. (KNC)
