CBI names 2 Kanpur hospitals over CGHS fraud

New Delhi: The Central Bureau of Investigation (CBI) has registered an FIR against two hospitals in Kanpur over alleged irregularities in billing and payments under the Central Government Health Scheme (CGHS), officials said on Wednesday.

According to news reports, the central agency has booked Rajni Hospital and Taurus Hospital in Kanpur after an enquiry report by the CGHS Directorate showed gross irregularities, lack of proper infrastructure and violation of empanelment criteria.

The Central Government Health Scheme provides for subsidised treatment for serving and retired employees of the Central government and some autonomous organisations, for which hospitals, including empanelled private ones, are compensated by the government.

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The CGHS directorate had constituted enquiry committee, which cited grossly inadequate infrastructure, lack of basic medical facilities and critical equipment in Rajni Hospital, which was running without meeting basic health care standards, violating empanelment criteria, yet continued to submit high-value claims, which were processed and paid without sufficient scrutiny, news agency PTI reported.

"The investigating committee examined the National Health Authority records, which reveal that Rajni Hospital, Kanpur, has raised a claim of a total of ₹39.34 crore, of which ₹27 crore has already been paid since June 2021 from CGHS, Kanpur," the report, which became the basis for the FIR, alleged.

The sample bill review by a hospital monitoring committee detected fake claims submitted on behalf of 25 CGHS beneficiaries who denied ever getting treated in Rajni Hospital, whereas they were shown admitted 66 times with fake treatment bills of over ₹79.42 lakh that were paid to the hospital by CGHS, Kanpur, it alleged.

In the case of Taurus Hospital, the report raised concerns over "questionable billing practices with a sudden and dramatic increase in medical claims" after a change in its ownership.

"As per the enquiry report, Tarus Hospital has been paid over ₹1.24 crore during 2024-25 in respect of the medical claims of different CGHS Beneficiaries," the FIR said.

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