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J&K Suspends Cardiologist Over Alleged Mis‑coding of 103 Pacemaker Procedures

The suspension follows an expert audit that found nearly half of sampled Left Bundle Branch Area Pacing cases lacked clear clinical indication, suggesting gaps in claims controls and procurement.

Overview

  • Health officials suspended Dr. Syed Maqbool and issued a departmental charge sheet after a probe alleged he recorded 103 cases on the PM-JAY Transaction Management System as dual‑chamber pacemaker implantations while physical records showed Left Bundle Branch Area Pacing (LBBAP).
  • An expert review of a 55‑case sample found 27 patients had normal left ventricular function and no clear medical need for LBBAP, a finding the State Health Agency used to reject multiple insurance claims.
  • The State Anti‑Fraud Unit first flagged an unusual spike in LBBAP claims and conducted an unannounced inspection of GMC Anantnag in December 2025 before referring cases for specialist review.
  • The inquiry also alleges procurement irregularities and direct patient payments, citing a beneficiary who said he paid ₹70,000 to a private firm despite entitlement to cashless PM-JAY care.
  • Dr. Maqbool denies the allegations and some cardiologists defend LBBAP as clinically appropriate, leaving a technical dispute over indications, coding and coverage that could prompt wider audits and policy clarity for new pacing techniques.