Rajasthan Health Scheme Fraud: Diagnostic firm accused of siphoning Rs 5-7 crore in fake claims

Bikaner: A major alleged fraud under the Rajasthan Government Health Scheme (RGHS) has come to light, with a private diagnostic company operating CT and MRI services at a government medical college accused of siphoning off Rs 5–7 crore through fake patient records, forged signatures, and the misuse of doctors’ seals.

The case involves a Diagnostic and Imaging Centre, which was assigned CT and MRI services at PBM Hospital, Bikaner. According to officials of the Medical Department, the firm allegedly generated false medical records and uploaded fabricated documents under RGHS to claim reimbursements for diagnostic services that were either not performed or were falsely recorded. 

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According to the FIR, between 2024 and 2025, the company allegedly fabricated multiple diagnostic reports, including HIV tests, Procalcitonin tests, HbA1c tests, and other screening tests.

Officials also noted inconsistencies in medical records, including cases where a patient diagnosed with Type 2 Diabetes Mellitus (T2DM) had completely normal HbA1c reports.

Several doctors whose names and signatures appeared on the disputed documents have denied any involvement in the alleged fraud.

Assistant Professor, Department of Cardiology, PBM Hospital, stated that none of the signatures on documents generated through the Transaction ID (TID) system was his. He alleged that employees of the diagnostic centre may have been involved in the forgery.

Similarly, a Medical Officer said that OPD slips attributed to her were sent via email by the diagnostic centre, but neither the slips nor the signatures and seals belonged to her.

Another doctor said that his RMC registration number had been misused despite the fact that he completed his internship only in 2025 and was not in a position to issue such prescriptions.

The case has also raised serious questions over administrative oversight, as the same company allegedly continued receiving government contracts despite facing action.

Officials had de-panelled the company in December 2025 and registered a case against it. However, in January 2026, it was reportedly awarded a Rs 12 crore contract for ECG investigations with manpower services at the Bikaner Medical College. Later, in April 2026, another MRI tender at MDM Hospital in Jodhpur was also granted to the same firm, prompting scrutiny of departmental decision-making.

Officials confirmed that FIRs have also been registered against a nursing home and a pharmacy in related cases, while the Special Operations Group (SOG) is conducting a wider investigation into irregularities under RGHS. Several arrests have already been made in connected cases, including individuals linked to private hospitals and diagnostic centres.

“A fraud case has been registered against the Diagnostic and Imaging Centre. Our doctors have given written statements that the signatures and seals are not theirs. An investigation is also underway in another tender involving the centre. We cannot take action in that matter until we receive orders from the department,” said Dr. B.C. Ghiya, Superintendent, PBM Hospital, Bikaner, reports Bhaskar English.

Police said the case is currently being investigated by SHO Vikram Tiwari. Officials added that further scrutiny of billing records, digital submissions, and patient data is underway to determine the full extent of the alleged fraud. 

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