ECHS fraud: CBI books Hisar hospital over alleged fake claims, inflated bills

Hisar: In a major crackdown on alleged corruption in government healthcare schemes, the Central Bureau of Investigation (CBI) has registered an FIR in a case involving suspected fraud under the Ex Servicemen Contributory Health Scheme (ECHS) in Haryana, naming a private hospital in Hisar, its management, several representatives, and unidentified officials of ECHS institutions for their alleged role in inflated medical claims and misuse of public funds.

According to the FIR, beneficiaries under the scheme were allegedly pressured into hospital admission with threats that treatment would be denied or that they would face financial burden if they refused. A preliminary inquiry found that between 2023 and 2025, ECHS beneficiaries were issued outpatient (OPD) referrals from the Hisar polyclinic that did not require hospital admission. 

Also Read:CBI Registers FIR Against Doctors, Hospitals in ECHS Fraud Over Fake Bills

However, the hospital, in alleged connivance with officials at the ECHS Polyclinic, is accused of admitting patients without mandatory inpatient (IPD) referrals or emergency approvals. The probe further alleges that patients were kept admitted longer than necessary to inflate hospital bills.

The inquiry has also highlighted suspected tampering of medical documentation. In several cases, patients who had already been discharged were allegedly shown as admitted for extended periods to justify higher reimbursement claims.

Referral documents are also said to have been altered, including changes in remarks from “NO” to “YES” to falsely validate admissions.

The CBI enquiry additionally found that fake and inflated bills were allegedly generated and submitted by the Hisar hospital and were then processed, validated, recommended, and approved by concerned officials of the ECHS Regional Centre in Hisar, despite what the agency described as glaring deficiencies and violations of prescribed norms. The enquiry also refers to forgery and fabrication of medical records, as well as backdating of documents, to support fraudulent medical claims, reports 420.

The FIR further alleges that officials of the ECHS Regional Centre and Polyclinic in Hisar acted in connivance with private hospitals by failing to enforce mandatory checks and guidelines. It is alleged that they processed and approved fake or inflated bills despite clear violations of procedure. 

According to Tribune India, further, personnel associated with the Bill Procession Agency (BPA) portal neglected mandatory checks and facilitated processing of fake claims without due diligence, added the enquiry.

The CBI has indicated that the role of four other hospitals in Rohtak, Hisar, and Fatehabad will also be examined for similar alleged irregularities. Preliminary findings suggest possible involvement in record manipulation, fake diagnostic testing, and irregular empanelment practices, though these claims are yet to be verified.

Based on the enquiry, the FIR has been registered under charges of cheating, forgery, and criminal conspiracy, according to 420.

Also Read:CBI arrests medical officer, Noida hospital executive in Rs 3 lakh bribery case