Published 08:34 IST, January 4th 2020
171 hospitals de-empanelled, Rs 4.6 Cr penalty levied for committing fraud in PMJAY
National Health Authority has revoked the empanelment of nearly 171 hospitals and imposed a penalty of Rs 4.6 crore on many hospitals under PMJAY in nine states
The National Health Authority (NHA) has revoked the empanelment of nearly 171 hospitals and imposed a penalty of Rs 4.6 crore on many hospitals in nine states for indulging in activities of fraud in Prime Minister Narendra Modi's flagship health insurance scheme: Ayushman Bharat- Pradhan Mantri Jan Arogya Yojana (AB-PMJAY).
Besides, over 390 hospitals in different states have been issued a show-cause notice and were suspended. The National Anti-Fraud Unit (NAFU) at NHA found that there are several cases of malpractices among empanelled hospitals. These misbehaviours have largely taken place in hospitals located in northern states of Gujarat, Chhattisgarh, Madhya Pradesh and Punjab.
"Soon after getting the tipoff, the State Health Agency was alerted which disabled cards, FIR was also lodged and show cause notice was issued to the hospitals. The penalty has also been levied on TPA," said a senior official at NHA.
Penalties of more than Rs 4.5 crores have also been imposed on hospitals indulging in malpractices, the NHA official added. The department is also checking for any false enrolment of beneficiaries under the scheme.
"About 3,785 village-level entrepreneurs who are positioned at common service centres and Pradhan Mantri Arogya Mitras positioned at PMJAY empanelled hospital have been deactivated so far," stated the official.
The State authorities reserve certain beneficiary packages for government hospitals. It was discovered that private hospitals were performing and blocking these government reserved procedures and were submitting the same under a different or unspecified package name.
About PMJAY
Ayushman Bharat- PMJAY is the world's greatest healthcare scheme, which aims to reach out to over 10 crore poor and vulnerable families (nearly 50 crore beneficiaries). Under this scheme, up to 5 lakh rupees is provided to each family every year for secondary and tertiary care hospitalization.
READ | NHRC Seeks Report Over Ayushman Bharat Beneficiaries Not Able To Avail High-cost Treatment Under RAN
(With inputs from ANI)
Updated 08:34 IST, January 4th 2020