Major irregularities have come to light under Ayushman Bharat ‘Niramayam’ scheme in Madhya Pradesh. During investigation, fake claims and fraud were found in Life Medicity of Jabalpur and Brahmani Hospital of Gwalior. The state health agency has suspended both hospitals from the scheme with immediate effect.
Bhopal. Major irregularities have come to light under Ayushman Bharat ‘Niramayam’ scheme in Madhya Pradesh. After complaints and investigation, the state health agency has taken strict action against two hospitals in Jabalpur and Gwalior. The agency has suspended both the hospitals from the scheme with immediate effect.
This action has been taken on the basis of the investigation report of the Third Party Audit Agency (TPAA) and complaints already received. The state health agency is continuously reviewing the claims of the hospitals empaneled in the scheme, so that eligible patients can get transparent and quality health services.
Serious irregularities found in Life Medicity Hospital, Jabalpur
During the investigation, several serious financial and procedural irregularities came to light in the claims of Life Medicity Hospital, Jabalpur. During investigation, it was found that the hospital admitted some patients in the wrong category and submitted claims by applying wrong packages for treatment. Apart from this, cases of taking financial benefits by cheating have also come to light. According to the state health agency, action has already been taken against this hospital for similar irregularities.
A fine of around Rs 47 lakh has already been imposed.
A financial penalty of Rs 46 lakh 99 thousand 990 was imposed on Life Medicity Hospital after irregularities were found in the earlier investigation. However, despite several warnings, the irregularities continued to be repeated by the hospital. For this reason, keeping in mind the public interest, the state health agency has decided to suspend the hospital from the Ayushman Bharat ‘Niramayam’ scheme.
Fraud found in Gwalior’s Brahmani Hospital also
Similarly, serious irregularities have also come to light in the investigation of claims of Gwalior-based Brahmani Hospital. The investigation found that the hospital tried to take unnecessary financial benefits by describing the condition of some patients as serious. Apart from this, many claims were wrongly submitted and cases of fraud have also come to light in the investigation.
Action already taken, fine of more than Rs 21 lakh imposed
The state health agency had earlier also taken action against Brahmani Hospital and imposed a fine of Rs 21 lakh 8 thousand 300. But despite repeated warnings, irregularities continued in the hospital. Due to this, the agency has also suspended this hospital from the Ayushman Bharat ‘Niramayam’ scheme with immediate effect.
State Health Agency’s warning: Strict action will be taken against irregularities
The state health agency has clarified that it is the government’s priority to provide quality and transparent health services to eligible patients under the Ayushman Bharat ‘Niramayam’ scheme. The agency has said that irregularities or fraud by any hospital will not be tolerated under any circumstances. Further strict action will be taken against both the hospitals and the process of completely dislinking them from the scheme will also be started.
Questions raised even after not getting NABH certification
During investigation it also came to light that both the hospitals did not have NABH accreditation certificate. This is also considered a serious irregularity. The state health agency has said that to maintain transparency in the scheme, monitoring of all the hospitals listed will continue and strict action will be taken if found guilty.