J&K Govt suspends cardiologist over alleged PMJAY-SEHAT fraud, unnecessary cardiac procedures

Amid allegations of large-scale procedural irregularities and fraudulent insurance claims aimed at syphoning public funds, the Jammu and Kashmir government on Saturday placed a prominent Kashmir-based cardiologist, Dr. Syed Maqbool Ahmad Shah, under suspension pending an inquiry into the alleged malpractices.

According to Order No. 504-JK (HME) of 2025, dated June 20, 2026, issued by the Health and Medical Education (HME) Department, Dr. Shah has been suspended until the completion of the inquiry.

“Pending inquiry into his conduct, Dr Syed Maqbool Ahmad Shah, Associate Professor, Cardiology, presently deputed to Government Medical College (GMC), Anantnag, is hereby placed under suspension with immediate effect in terms of Rule 31 of the Jammu and Kashmir Civil Services (Classification, Control and Appeal) Rules, 1956. During the period of suspension, he shall remain attached to the office of Government Medical College, Jammu,” the order stated.

Department Frames Multiple Charges

The HME 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. Dr. Shah is also facing allegations of conducting cardiac surgeries on healthy patients.

A view of the Government Medical College Anantnagsocial media

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, unauthorized medical interventions, violation of procurement norms, and conduct unbecoming of a government servant.

Inquiry Flags Unnecessary Cardiac Procedures

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.

The inquiry further alleged that unnecessary procedures were performed on patients and that fraudulent insurance claims were generated under government-funded health schemes.

Alleged Fraudulent PMJAY-SEHAT Claims

Among the most serious allegations is the misuse of the PMJAY-SEHAT scheme through the submission of false claims.

According to the chargesheet, Dr. Shah allegedly booked and claimed reimbursement for 103 cases on the Transaction Management System (TMS) under the “Dual Chamber Pacemaker Implantation” package (Code: MC016A), whereas physical records reportedly showed that the patients had actually undergone Left Bundle Branch Area Pacing (LBBAP).

IANS

“You booked and claimed 103 cases on the Transaction Management System (TMS) under the ‘Dual Chamber Pacemaker Implantation’ package (Code: MC016A). However, physical records prove that you actually performed Left Bundle Branch Area Pacing (LBBAP). This intentional misrepresentation was designed to siphon public welfare funds from the PMJAY-SEHAT scheme under a false clinical pretext,” the chargesheet alleged.

The inquiry noted that among the 55 suspected LBBAP cases, 27 patients, accounting for approximately 49 per cent, had completely normal left ventricular function despite undergoing the procedure.

IANS

Patient Exploitation and Procurement Violations

The inquiry also uncovered allegations of financial exploitation of PMJAY-SEHAT beneficiaries.

In one case cited in the chargesheet, a patient identified as Peer Rafiq Ahmad was allegedly compelled to pay ₹70,000 to a private vendor for a cardiac procedure despite being entitled to cashless treatment under the government-sponsored health insurance scheme.

Investigators 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 incident as a gross violation of PMJAY-SEHAT guidelines and a serious infringement of patient rights.

The chargesheet further accuses Dr. Shah of bypassing established procurement and supply-chain procedures by allegedly sourcing medical implants and related equipment directly from private vendors instead of using approved institutional channels involving the PMJAY Section, Casualty Medical Officer, and AMRIT Store.

Doctor Rejects Allegations

Meanwhile, Dr. Syed Maqbool has strongly denied the allegations, describing them as “fabricated” and emphasizing that the matter remains under inquiry.

He said reports appearing in sections of the media were presenting the allegations as established facts despite the absence of any final findings.

“What is being circulated in the media is totally different from the actual report. People are treating a memorandum of allegations as a final verdict, which is not correct,” he said.

Dr. Maqbool maintained that GMC Anantnag had submitted a detailed response to all allegations and that the inquiry committee was currently examining the evidence.

“We have replied to every allegation with documentary evidence. The matter is under consideration and we have full faith in the system. Justice will ultimately prevail,” he said.

Appealing against what he described as premature conclusions, the cardiologist urged people to allow the inquiry process to proceed and await the outcome of the investigation.