In order to provide better treatment to economically weak people, irregularities have come to the fore in several states of the country including Jharkhand in the Ayushman Bharat Yojana launched by the central government in April 2018. This has been revealed in the report of the Comptroller and Auditor General of India (CAG). In its audit report released by the CAG, it has been told that under this scheme, such patients are also taking benefits, who were earlier shown dead. This was done to grab the amount of the scheme. 250 such dead bodies were treated in different hospitals of Jharkhand.
323 claims, payment of more than 30 lakhs :
It has come to the fore in the audit that under the scheme, such patients are getting treatment or have got it done, who have died. Studying the data of death cases in the Transaction Management System ie TMS revealed that 88,760 patients have died in the country during treatment under the Ayushman Bharat scheme. A total of 2,14,923 claims related to new treatment in respect of these patients have been shown as paid in the system.
In about 3,903 cases involved in these claims, the claim amount was paid to the hospitals. Of these, the payment related to 3446 patients was Rs 6.97 crore. Claims were paid in 323 cases in Jharkhand. In these, the death of 250 patients was shown and later those patients were also treated. Rs 30,37,440 was paid to hospitals in Jharkhand.
Investigation of three hospitals of Bokaro:
Seven hospitals in Bokaro have been investigated in the CAG report. More than total beds were treated in these hospitals in a day. In one hospital, patients twice the capacity were treated. Scanning has been done at Advance Diagnostic Centre, Mahalakshmi Nursing Home and RNB Hospital and Pal Eye Research Center in Bokaro district.
In the report, the details related to the capacity of beds and treatment of total patients have been presented in these hospitals on different dates. On March 22, 2021, 24 patients were treated in lieu of 16 beds in Advance Diagnostic Center, 18 patients in lieu of 15 beds in Mahalaxmi Nursing Home on March 19, 2021, and 38 patients were treated in lieu of 20 beds in RNB Hospital and Pal Eye Research Center on March 06, 2021. Happened.
Godda’s Lifeline Nursing Home did 72 operations without feco machine:
Further, the insurance company informed (26 December 2019) SHA that Lifeline Nursing Home Godda had performed 92 operations without feco machine. The SHA had asked the insurance company in March 2020 to submit beneficiary audit reports of all the procedures done by the hospital and details of claim payments made to the hospital.
However, the insurance company did not provide details of beneficiary audit and claim amount. The great thing is that the SHA did not take action against the insurance company or the hospital. The audit found that as per TMS data, the hospital had performed 72 phaco procedures till December 26, 2019, and received a payment of Rs 5.98 lakh.
With reference to Jharkhand
Payment of claim in 323 case
Death of 250 patients was shown, later they were also treated
Rs 30 lakh 37 thousand 440 paid to hospitals
1325 patients admitted in many hospitals at the same time
In the report of the CAG, not only the matter of treating the dead person has come to the fore, but also the matter of treating the same person in two hospitals at the same time has also come to the fore. 1942 such cases have come to the fore in Jharkhand. Of these, 1325 patients were treated in several hospitals at the same time. 652 men and 673 women were treated in this manner. In these cases, 148 hospitals of the state are involved. It has been told in the report that such claims were paid without getting the investigation done by the State Health Agencies ie SHA. These cases have also come to the fore in cases where a child is born in one hospital but is transferred to another hospital for neonatal care using the mother’s PMJAY ID.