PMJAY Fraud: Crime branch seeks Patient Records from 145 hospitals

Ahmedabad: The Ahmedabad Crime Branch, investigating alleged irregularities at Khyati Hospital, has expanded its probe by summoning six private hospitals in the city daily for interrogation and instructing 145 hospitals to submit patient medical records.

The investigation agency has been summoning these hospitals for questioning about their treatment of patients under the Pradhan Mantri Jan Arogya Yojana (PMJAY) scheme.

Aiming to carry out a detailed and thorough investigation to expose the full extent of the scam, the crime branch has also asked officials of 145 hospitals in the city to provide medical records of patients treated under the PMJAY scheme. 

Also read- PMJAY Fraud: 5 Gujarat Hospitals debarred over alleged irregularities

This comes in the backdrop of Ahmedabad-based Khyati Multispecialty Hospital being caught performing unnecessary angioplasty procedures on several PMJAY cardholders just to siphon off government money.

The scam, in which the private hospital's management and doctors were involved, came to light after two healthy people died following angioplasty, a procedure used to open blocked coronary arteries in heart patients.

Medical Dialogues recently reported that the Gujarat Health Department debarred five private hospitals and two doctors from participating in the PMJAY due to alleged irregularities. On this, the Gujarat health ministry said it has debarred five private hospitals from providing services under the Pradhan Mantri Jan Arogya Yojana (PMJAY) due to irregularities in the last week, taking the count of medical facilities de-panelled so far in 2024 to 12.

Crime branch investigators told Ahmedabad Mirror, “We are now carrying out a comprehensive investigation to uncover the whole scam, which requires verification of hospitals other than Khyati."

The Khyati Hospital Chairman Kartik Patel who is currently at large and was reported to be hiding abroad is supposedly in Dubai at present as confirmed by the investigators. 

“Patel had a US visa and if one wants to fly to Dubai from Australia, they do not need a visa from the visiting country. We have informed the MEA through legal channels to get Patel deported from Dubai," said a crime branch official. 

Meanwhile, the state health department has proposed to increase the staff from 60 to 180 personnel to handle the approval of medical reimbursement bills from hospitals. They will also demand detailed medical documents, such as angiography and angioplasty reports for heart-related procedures.

Speaking to The Daily, a source from the health department said, "We have about 60 employees and officers who used to approve the medical bills. In some bills and consent letters, there are emergency ticks that are approved online, as the report sent by the hospital suggests an emergency treatment of the patient. However, we have now moved a proposal to increase the PMJAY approval desk staff to 180. We will now demand the medical reports, and for heart-related surgeries, we will seek angiography and angioplasty reports. This is why we have moved to increase staff so that no time is lost on actual emergency treatments in government medical schemes.”

Medical dialogues had earlier reported that according to the Ahmedabad crime branch, as many as 112 deaths have occurred in the past three years, either during or after treatment under government healthcare schemes. The revelation came during investigations days after the Ahmedabad crime branch arrested Dr Sanjay Patolia, a bariatric surgeon and one of the directors of city-based Khyati Multispeciality Hospital.

Between September 2021 and October 2024, nearly 8,500 patients received treatment or underwent different surgeries at the private hospital.

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