RGHS Irregularities: 51 hospitals suspended, Rs 3 crore penalty on 24 facilities

Jaipur: Fifty-one empanelled hospitals have been suspended from the Rajasthan Government Health Scheme (RGHS) in the past three months over allegations of corruption, fraudulent billing and financial irregularities, while penalties amounting to nearly Rs 3 crore have been imposed on 24 hospitals.

The action, carried out over the past three months, was disclosed in a government report released on Friday. According to the news reports, several major hospitals are among those facing action, including nine facilities in Jaipur such as Manipal Hospital, Soni Hospital, Narayana Multispeciality Hospital, Mahavir Jaipuria Hospital, and Indus Hospital. Other hospitals facing recovery and penalty proceedings include Paras JK Hospital in Udaipur, District Hospital in Dungarpur, and Marble City Hospital in Ajmer.

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Speaking to Bhaskar English, Medical and Health Minister Gajendra Singh Khinvsar said the government has adopted a zero-tolerance policy at RGHS. Action is ongoing against financial irregularities, fraudulent claims, and corruption.

Medical Dialogues had previously reported that a multi-crore fraud has been uncovered in the Rajasthan Government Health Scheme (RGHS), in which a doctor and a private lab operator allegedly colluded to create fake prescriptions and diagnostic reports to claim reimbursements from the state government. Two accused have been arrested in connection with the case.

Principal Secretary of the Medical and Health Department Gayatri Rathore said audits of hospitals under RGHS revealed several serious violations. These included submission of claims using fake or duplicate documents, unnecessary testing, claiming additional payments by showing multiple services under a single package, submitting bills without required supporting documents, and falsely showing OPD patients as admitted to the IPD to claim higher reimbursements.

Dr Nidhi Patel, Additional Chief Executive Officer of RGHS, conducted detailed hearings in the cases and ordered action after reviewing documents and available evidence.

Harjilal Atal, Chief Executive Officer of the Rajasthan State Health Insurance Agency, said, "The government's objective is to ensure the proper use of every rupee of the treasury. To this end, the audit system is being further strengthened," reports Bhaskar English.

He said similar strict measures will continue in the future against hospitals found involved in fake billing, fraudulent claims, procedural violations, or financial misconduct.

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