CBI registers alleged Rs 1.5 crore medical reimbursement fraud case against private hospital, railway officials

Jodhpur: The Central Bureau of Investigation (CBI) has registered a case against the directors and officials of a private hospital in Jodhpur, along with unidentified Railway officials, for allegedly causing a loss of around Rs 1.5 crore to the Indian Railways by submitting inflated and fabricated medical reimbursement claims.

The case pertains to alleged irregularities in reimbursement claims submitted between 2022 and 2024 under a cashless treatment scheme for railway employees. According to the CBI, the alleged fraud involved manipulated medical records, inflated bills and false claims for treatments and medicines that were never provided. 

The FIR was registered following a preliminary inquiry into complaints received from the Divisional Railway Hospital, Jodhpur. Under a Memorandum of Understanding (MoU), the private hospital was authorised to provide cashless treatment to railway beneficiaries for services unavailable at the railway hospital.  

The CBI further alleged that patients admitted to general wards were shown as having received treatment in intensive care units (ICUs), enabling higher reimbursement claims. In some cases, expensive ICU medicines were reportedly billed despite not being administered, while discrepancies were also found in discharge summaries and doctors' signatures. 

“Under this agreement, the private hospital was required to provide cashless medical treatment to railway beneficiaries in accordance with the stipulated terms and conditions,” they said. “Claims for patient treatment were submitted for payment, but a preliminary CBI investigation revealed serious irregularities. The medical records submitted for payment were inflated, differing significantly from the original bills issued to the patients or their relatives”, reports ETV Bharat.

The investigation has been assigned to a Deputy Superintendent of Police of the CBI.  

“This has been deemed a criminal conspiracy. Consequently, a case has been registered against the director of the private hospital, unknown public servants from the Divisional Railway Hospital, Jodhpur, and other unknown private individuals,” they said. 

This is not the first time the CBI has investigated alleged irregularities involving railway officials in Jodhpur. In 2017, the agency arrested a Senior Divisional Medical Officer of the Jodhpur Railway Hospital in an alleged bribery case linked to the issuance of favourable medical certificates. In another case, the CBI registered an FIR against a Railway Office Superintendent and local contractors over an alleged parking and licence fee scam at Raika Bagh Railway Station, which reportedly caused a loss of around ₹42 lakh to the Railways. 

The agency is continuing its investigation to identify all those involved and examine the suspected criminal conspiracy.