Ayushman Scam: Show Cause Notices Issued to 10 Hospitals

Raipur: The Ayushman Bharat Health Scheme, aimed at providing free treatment to the underprivileged sections of society, is currently embroiled in a controversy after investigations revealed widespread fraudulent practices. As a result, show cause notices have been issued to ten government hospitals, nine hospitals have been blacklisted, and three private hospitals have been suspended.

Also Read: UP Govt Seeks PG Doctors to audit Ayushman Bharat Reimbursement Claims

The Ayushman Bharat scheme offers financial incentives to hospitals for providing treatment for various diseases, including eye surgeries, dental treatments, uterine operations, and piles. These funds are distributed to hospitals and then allocated as incentives to doctors and staff for their efforts in delivering treatment.

However, recent investigations have uncovered fraudulent activities where some government hospital staff have been enrolling fake patients to claim these incentives. This practice, similar to the malpractice seen in private hospitals, involves creating false records of non-existent patients to receive reimbursement for services that were never provided.

According to the Free Press Journal, the Health Department’s inquiry confirmed multiple complaints, including excessive billing, unnecessary hospital admissions, and treatments conducted without specialists. As a result, nine hospitals have been permanently removed from the scheme, while three hospitals have been suspended for six months.

Also Read: Rs 562.4 crore fake claims under AB-PMJAY: 1,114 Hospitals de-empanelled, 549 suspended

Medical Dialogues had earlier reported that according to the National Anti-Fraud Unit (NAFU) investigation, out of Rs 6.66 crore claims processed under the Ayushman Bharat-PM Jan Arogya Yojana (AB-PMJAY), nearly 2.7 lakh claims from private hospitals were found to be fraudulent. These claims, worth Rs 562.4 crore, involved alleged misuse, abuse, or incorrect entries. As a result, the government has de-empanelled 1,114 hospitals and suspended 549 hospitals under the scheme so far in this regard, Union Minister of State for Health Prataprao Jadhav informed the Rajya Sabha.