Fake bills, forged documents: CBI registers FIR against doctors, hospitals in ECHS fraud

Chandigarh: In a major crackdown, the Central Bureau of Investigation (CBI) has unearthed a multi-crore fraud involving fraudulent medical reimbursement claims under the Ex-Servicemen Contributory Health Scheme (ECHS).

As per a HT report, the agency has registered an FIR against the two directors of Manthan Health Care, along with Dharam Hospital, Kare Partner Heart Centre, and several other individuals. The role of unknown ECHS officials is also under the scrutiny.

The FIR has been registered under Sections 120-B (criminal conspiracy), 420 (cheating) and 471 (using forged documents) of the IPC, with relevant provisions of the Bharatiya Nyaya Sanhita, along with Sections 13(2) read with 13(1)(d) of the Prevention of Corruption Act, 1988.

According to the agency, the case is described as a “well-organised racket” involving private hospitals, middlemen, and suspected involvement of officials.

Also read- CBI arrests medical officer, Noida hospital executive in Rs 3 lakh bribery case

According to the CBI, the accused allegedly exploited loopholes in the ECHS system to generate fake or inflated reimbursement claims. The modus operandi allegedly involved misusing “emergency admission” provisions to bypass standard referral protocols, manipulating referral systems to channel patients into select hospitals, fabricating medical records, prescriptions, and diagnostic reports, and inflating treatment costs and pharmacy bills to claim higher reimbursements.

The agency told HT, "ECHS beneficiaries were systematically identified and routed through intermediaries to empanelled hospitals, where admissions were frequently projected as emergency cases without adequate medical justification, thereby enabling higher reimbursement claims."

Acting on the tip-off, a joint surprise check was carried out on February 24, 2026, at Manthan Health Care in Sector 38 and Dharam Hospital in Sector 15, Chandigarh, in the presence of ECHS vigilance officials.

During the searches, the CBI recovered several incriminating materials and seized them, which include patient files and emergency/referral documents, blank letterheads, hospital stamps, digital signature credentials, WhatsApp chats indicating coordination and storage devices containing records from 2018 to 2026. The agency also found documents linked to other hospitals, suggesting the racket may be wider.

The investigation revealed that Manthan Health Care, which is not empanelled under ECHS, was allegedly working closely with Dharam Hospital, an empanelled facility.

Shocking, the ECHS desk of Dharam Hospital was effectively being run from the premises of Manthan Health Care. The accused reportedly processed the claims and submitted them on the ECHS portal in the name of Dharam Hospital from the premises of Manthan Health Care.

This, according to the agency, indicated unauthorised diversion of a regulated hospital interface to a non-empanelled intermediary. The agency officials also found official stamps, blank letterheads, and digital signature credentials of Dharam Hospital.

The CBI found repeated admissions of the same patients within short periods for similar illnesses across multiple hospitals. Several patients were admitted multiple times at Dharam Hospital, Kare Partner Heart Centre, and others.

According to the Daily, CBI officials noted that such patterns "strongly indicate that hospitalisations were orchestrated for claim generation rather than genuine medical necessity."

The investigation also uncovered large-scale fabrication of medical documents, including emergency admission papers, prescriptions, pathology reports, and discharge summaries.

"Signatures attributed to Dr Aggarwal appeared to be forged upon preliminary comparison, while several diagnostic reports were found to be fake, with laboratories and doctors denying having issued them. The recovery of blank letterheads of multiple hospitals and labs further points to a structured document fabrication mechanism," officials said.

Evidence suggests that the racket involved financial deals between hospitals and intermediaries. The CBI found referral-based commission agreements, where middlemen were paid per patient or given a share of the billed amount. An unsigned agreement between Manthan Health Care and Dharam Hospital reportedly mentioned a 50:50 revenue-sharing model.

CBI said, “This reflects a commercially organised operation aimed at wrongful gain through fraudulent reimbursements.”

The CBI said, "Crucially, WhatsApp chats retrieved during the search provide direct insight into the alleged conspiracy. Messages indicate prior coordination regarding admission and discharge timing, preparation and alteration of medical records and post facto fabrication of documents to support claims. These chats clearly show that records were tailored to fit reimbursement requirements."

The agency is also looking into the role of ECHS officials, and an investigation is underway to understand the full extent of the conspiracy.

Also read- Rs 4 crore fraud: 36 loans allegedly using Jaipur doctor's identity