The response of the Union Health Ministry has come to the fore on the claim of the media on the treatment of dead people under PMJAY. The Health Ministry has said that the media reports which claimed that those who have already passed away, such beneficiaries of the Ayushman Bharat PMJAY scheme, are shown to be still receiving treatment in the system. The ministry also said that mobile numbers have no role in deciding the eligibility of the beneficiary.
The ministry’s comment came in response to media reports which claimed that the Comptroller and Auditor General of India (CAG) has pointed out that treatment is still being shown for beneficiaries who are declared dead in the system. Already happened. The report also claimed that the same beneficiary was found undergoing treatment in two hospitals at the same time. On behalf of the ministry, it was said that these news reports in the media are completely misleading and misinformed.
What did the ministry say on the report of the Comptroller and Auditor General
The ministry said in a statement that the report of the Comptroller and Auditor General of India, which contains the results of the performance audit on Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PMJAY) covering the period September 2018 to March 2021, is expected to be released before the monsoon of 2023. was laid in Parliament in session. The statement said that under AB PMJAY, hospitals are allowed to initiate requests for pre-authorisation up to a date of three days after hospitalization. This facility is provided to avoid denial of treatment in case of limited connectivity, emergency situations etc.
It said that in some cases, patients were admitted and died during treatment even before their pre-authorisation was submitted. In such cases, the date of death is the same as or earlier than the date of recruitment, the statement said. Additionally, the death has also been reported by the same hospital that submitted the pre-authorization request. Thus, if the intention of the hospital was to cheat the system, it would not have shown any interest in declaring the patient dead on the IT system.
Request to register under the scheme for free treatment
It said it is pertinent to note that more than 50 per cent of the cases highlighted in the report are reported by public hospitals, which have no additional incentive to commit fraud, as the money is reimbursed to the hospital’s account. . It said that apart from this, in case of death during treatment, the hospital would mandatorily have to submit the death report. The statement said that there are also instances where the patient is admitted to the hospital as a private patient (self-pay), but later on knowing about the scheme and his/her eligibility under the scheme. , the patient requests the hospital to register under the scheme for free treatment.
This facility of requesting for backdated ex-authorization helps in saving the out of pocket expenditure of the beneficiaries. With regard to the same patient availing treatment in two hospitals at the same time, it may be noted that under AB PMJAY children up to the age of five years can avail treatment on the Ayushman card of their parents. According to this, the Ayushman card can be used for children and either of the parents, simultaneously in two different hospitals.