FIR against 4 over alleged Rs 45 lakh Ayushman claim fraud at IGIMS Patna

Patna: Indira Gandhi Institute of Medical Sciences (IGIMS), Patna, has launched an inquiry into an alleged fake Ayushman Bharat claim worth Rs 45 lakh after a patient reported that a claim was filed in their name despite not receiving treatment at the institute.  

The complaint was reportedly lodged around five months ago after the patient found that their name and Ayushman card had allegedly been used to process a treatment claim at IGIMS. The patient had not visited the institute for the said treatment.

Following the complaint, IGIMS examined the claim and related records. The inquiry brought employees associated with an outsourcing agency under scrutiny over the alleged use of patient records and documents in the hospital management system to process claims.

An FIR has since been registered against four people in connection with the alleged irregularities. Reports have also stated that the institute removed its chief nodal officer for the Ayushman scheme.

The latest case is separate from an earlier issue flagged by the Comptroller and Auditor General of India (CAG) concerning Ayushman claims at IGIMS.

A CAG communication dated November 28, 2025, reportedly pointed to a Rs 13.89 crore revenue loss involving cases where treatment had been provided but corresponding Ayushman claims were not submitted within the prescribed period. The institute was asked to respond to the issue.

Following the latest allegations, IGIMS has introduced additional monitoring of Ayushman Bharat claims. A committee headed by the institute's director will review claims and corresponding patient records every Friday at 4 pm.

The monitoring system will cover six levels of verification, including checking records from admission to discharge, verifying whether claims were submitted within the prescribed period and comparing hospital-management-system records with data on the Ayushman portal, reports Patna Press. 

The monitoring will also cover verification of treatment provided, the role of outsourcing personnel and financial audits of pending claims and government funds.

Describing the mechanism as an administrative measure, the IGIMS deputy director said the objective was to ensure that eligible patients receive treatment without difficulty and that the Ayushman scheme functions in an organised manner.

The FIR and internal inquiry are expected to establish how the alleged claims were processed and fix responsibility based on the findings. The allegations remain subject to the ongoing investigation.