Rs 26 lakh scam hits Rajasthan Health Scheme; 5 doctors among 9 suspended

Jaipur: A shocking fraud and alleged irregularities in the Rajasthan Government Health Scheme (RGHS), the state’s flagship programme, has led to the suspension of nine individuals, two Ayurveda doctors, three allopathy doctors and four government employees for allegedly misusing a beneficiary’s health card to claim fake medical treatments and benefits worth around Rs 26 lakh.

In connection with the case, an FIR has also been registered against Mittal Hospital, Rajasthan Pensioners Association Medical Store in Alwar, three doctors, and the scheme cardholder.

The fraud involved fabricating treatment records and prescriptions to siphon off funds from the government health scheme. The accused allegedly colluded to create false prescriptions and used a single beneficiary card to generate fake OPD slips, claiming the amount within a single year.

Instead of dispensing only the prescribed medicines, the pharmacy sold other materials, inflating the bills. This allowed them to illegally claim health scheme benefits for treatments that never actually took place.

Also read- Rajasthan Releases Partial RGHS dues amid threat from private hospitals

The RGHS scheme covers a wide range of healthcare services, including consultations, diagnostics, surgeries, and medicines. Specialist treatments such as cardiology, neurology, and oncology may also be covered. Beneficiaries usually need to present their health card.

The matter was revealed after a thorough investigation into long-pending complaints of irregularities from stakeholders at various levels under the RGHS. The investigation conducted by the health department allegedly found collusion between the beneficiary, doctors, and the pharmacy store in the fraud, reports TOI.

Principal Secretary of the Medical and Health Department, Gayatri Rathore, told PTI, "These complaints were thoroughly investigated, and after confirmation, strict action has been initiated. Nine personnel have been suspended."

According to Harji Lal Atal, CEO of the Rajasthan State Health Assurance Agency, those suspended include, Dr Kavita Dhankhar and Dr Pawan Jangid (Ayurveda, Government Ayurveda DB General Hospital, Churu), Dr Manisha (CHC Bibrani, Khairthal-Tijara), Dr Narsilal Pachauri (District Hospital, Alwar), Dr Kapil Bhardwaj (TBC, Alwar), compounders Madan Mohan Pandey (Ayurveda dispensary, Nahari ka Naka, Jaipur) and Chandrashekhar Jatav (Ayurveda dispensary, Baleta, Alwar), attendant Mohsin Khan (Deputy Director's office, Ayurveda, Jaipur), and Assistant Administrative Officer Mahesh Kumar Mahawar (Water Resources Department).

Medical Dialogues had previously reported about a massive scam worth over Rs 100 crore under the Rajasthan Government Health Scheme (RGHS), involving several doctors posted at health centres across the district. These doctors allegedly misdiagnosed patients and prescribed costly medications for ailments the patients never had, directing them to buy the drugs from specific medical stores.

Also read- Over Rs 100 crore fraud in Rajasthan Health Scheme; Audit flags Doctors-Medical store Collusion