Assam: Fraudulent Claims Abound in Ayushman Bharat Scheme

Staff Reporter

Guwahati: The Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) has been introduced for the weaker section of society to avail free healthcare, but a section of unscrupulous people are conniving with private hospitals to turn it into a money-making racket.

According to data from the Union Health Ministry, there have been fake claims for reimbursement of medical expenses worth Rs 562 crore across the country. Of this, there were claims amounting to Rs 359 lakh in the Northeast-Meghalaya Rs 237 lakh, Assam Rs 48 lakh, Manipur Rs 21 lakh, Mizoram Rs 10 lakh, Nagaland Rs 16 lakh, and Tripura Rs 60 lakh.

Punjab, Haryana, and Himachal Pradesh are the top states listed for fraud in the Ayushman Bharat scheme.

Sources revealed that there are 174 lakh Ayushman Bharat cardholders in Assam as of August 24. Under this scheme, a family can get free medical treatment for up to Rs 5 lakh per year. However, there is a circle of frauds who are filing fake claims in league with certain private hospitals and getting the money for medical treatment without actually going for any such treatment.

The Union Health Ministry has responded to these fake claims by blacklisting several empaneled private hospitals and imposing penalties or initiating legal action against the hospitals indulging in fraud.

Sources said that various measures have been implemented to prevent, detect, and deter fraudulent activities at different stages of the scheme's implementation. To verify the claims, state health agencies carry out regular desk and field measures. Also, the ministry has set up a national anti-fraud unit to check such malpractices, and recently, the unit found 2.7 lakh claims from private hospitals with anomalies.

State health department sources said that the fraudulent claims in Assam are being strictly monitored and that they have been contained to a certain degree. Regular contact is also kept with private hospitals in this regard. Warnings have also been issued to certain hospitals to contain the menace, they said.

Also Read: New Delhi: 6.5 Lakh Senior Citizens Join Ayushman Bharat Scheme

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