Corruption in Ayushman Bharat: 97 hospitals de-empanelled, Rs 1.5 crore penality levied, informs Health Minister

New Delhi: Reiterating the government's zero-tolerance policy towards corruption by hospitals in its flagship healthcare scheme Ayushman Bharat- PMJAY, the Union Health Minister, Shri Harsh Vardhan informed that about action against errant hospitals. He informed that Due to the policy of zero tolerance towards corruption, 97 errant hospitals have been de-empanelled and penalties worth more than Rs.1.5 crore have been levied. He further informed that FIR have also been lodged against 6 errant hospitals

Nearly 1,200 cases of fraud have been confirmed and action has been taken against 338 hospitals, he said, asserting that the government has zero-tolerance towards corruption.

That names of hospitals found involved in any kind of fraudulent practices in the Ayushman Bharat health insurance scheme will be put up on its official website to "name and shame" them, the Minister further added

"Not only would such hospitals found involved in any kind of fraudulent activity and practices would be de-empanelled, but their names would also be put up on the official website of Pradhan Mantri Jan Arogya Yojna (Ayushman Bharat) and made public. The idea is to name and shame them," the Health minister said at a press conference.

Indu Bhushan, CEO of the National Health Authority, the apex body responsible for the implementation of the centrally-sponsored scheme, said that the decision to publicly name the health insurance fraudsters under Ayushman Bharat was taken in collaboration with the IRDAI to deter them from indulging in malpractices.

"We are taking stern action against such fraudsters and have filed criminal cases and FIRs in some cases. In fact, we have suggested such hospitals should not only be de-empanelled from the PMJAY scheme but also from other scheme including that of CGHS and ECHA," Bhushan said.

Union Minister, providing an update about the scheme further stated that under AB-PMJAY, 18,073 hospitals and health care providers have been empanelled across the country. Of this, 53% of the hospitals empanelled are private, especially multi-speciality, and 62% of the treatments have been in these private hospitals. Since the launch of PMJAY on 23rd Sept last year by the Hon. Prime Minister, more than 47 lakh hospital treatments worth over Rs 7,500 crore have been carried out. Of the total amount utilised, 55% has been on tertiary procedures. In addition, more than 10 crore beneficiary cards have been issued, he added.

Giving out figures, Vardhan said 376 hospitals currently are under investigation while the NHA has taken action in terms of issuing showcause notice, suspending, levying penalty and de-empanelling against 338 hospitals.

He said 97 hospitals have been de-empanelled from the scheme while FIRs have been lodged against six hospitals. A total amount of Rs 1.5 crore in penalty has been levied and nearly 1,200 cases of fraud have been confirmed.

"And all these figures show the government's zero-tolerance towards corruption and we have been able to detect all these frauds because of a proactive robust strong IT anti-fraud detection system. Our message is loud and clear that no fraud, even of minute nature, will be tolerated in the whole scheme," he said.

Vardhan said the government's ambitious Ayushman Bharat scheme will complete first year of its launch on September 23 and the fortnight of September 15-30 is being marked as the 'Ayushman Bharat Pakhwara' where several activities will be carried out in the states to generate awareness around the scheme.

A mega national event 'Gyan Sangam' will be organised from September 29-30 during which the Prime Minister will take stock of the progress of the insurance scheme and its achievements will be highlighted.

Adopting the true spirit of cooperative federalism, 32 states and Union Territories have already implemented the scheme so far, Vardhan said and appealed to the remaining states including Delhi and West Bengal to join the scheme so that people there are not deprived of its benefits.

He said that 10 crore e-cards have been given out to beneficiaries and the government so far has spent Rs 7,500 crore on treatment. 18,073 hospitals have been empanelled and around 53 per cent the hospitals are from the private sector.

More than 39 lakh people have availed cashless treatment worth over Rs. 6,100 crore for serious illnesses since the launch of AB-PMJAY. This has resulted in savings of Rs 12,000 crore to the beneficiary families.

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