Pradhan Mantri Jan-Arogya Yojana: The government has come down heavily on errant hospitals and common service centres that have been found violating the guidelines Prime Minister Narendra Modi’s mega health insurance scheme that covers nearly 50 crore poor Indians. Action has been initiated against more than 300 hospitals by the state governments and the penalty of over Rs 3 crore has been levied on these hospitals, said the government.
The government has received several complaints of the use of fake admission cards and forged documents to claim benefits under the scheme that provides the coverage of up to Rs 5 lakh year per family per annum for the treatment of serious ailments.
"Some instances of creation of fake cards and submission of manipulated or forged claims under Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) have come to the notice," said Ashwini Kumar Choubey, minister of state for health and family welfare.
He said more than 338 hospitals have been served the show cause notice or suspended in different states and penalties of over Rs 3 crore have been slapped on the errant builders.
To curb the use of fake admission cards and manipulated documents to claim the benefits under the scheme, the government has issued comprehensive anti-fraud guidelines. It has also decided that all admissions under Ayushman Bharat scheme will require pre-authorization from respective State Health Agencies (SHAs).
"A close watch is maintained on wrongful enrollments of the beneficiary," Ashwini Choubey informed the Rajya Sabha.
The government has also created the National Anti-Fraud Unit (NAFU) for the overall monitoring and implementation of the anti-fraud framework. This central anti-fraud monitoring unit is supported by state anti-fraud units at the state level.
The government has also cracked down against errant common service centres (CSCs) that have been found involved in issuing bogus ID cards and manipulated documents.
It has already deactivated 3,785 Common Service Centres and Pradhan Mantri Arogya in 21 States.