- CAG report has highlighted issues including beneficiary validation errors, shortcomings in claim handling, lapses by State Health Authorities, and more.
- The CAG in its pan-India audit has found serious irregularities in the Ayushman Bharat scheme in Madhya Pradesh.
- Over ₹1.1 crore was paid to about 403 patients who were declared ‘dead’ in the database.
- Around 8,000 patients were shown to be hospitalized at multiple hospitals.
- The audit stated that 25 hospitals had submitted claims for 81 patients twice for various surgical treatments.
- The audit names 24 state hospitals, including a government hospital, which showed much higher occupancy than the actual bed strength.
In a startling disclosure, the Comptroller and Auditor General of India (CAG) has revealed significant discrepancies in the registration and validation of beneficiaries under the Ayushman Bharat – Pradhan Mantri Jan Aarogya Yojana (PMJAY). This central government health initiative offers free and cashless medical treatments to qualified beneficiaries. Spanning from September 2018 to March 2021, the CAG report has highlighted issues including beneficiary validation errors, shortcomings in claim handling, lapses by state health authorities, and more. The scheme operates under the auspices of the National Health Authority, affiliated with the union health ministry.
The Comptroller and Auditor General of India (CAG) in its pan-India audit has found serious irregularities in the Ayushman Bharat scheme in Madhya Pradesh. According to the report, over ₹1.1 crore was paid to about 403 patients who were declared ‘dead’ in the database, the report added.
Apart from it, the CAG audit report even mentioned that across the state during the same period, around 8,000 patients were shown to be hospitalized at multiple hospitals. In the report, CAG named 24 state hospitals, including a government hospital, that surprisingly showed much higher occupancy than the actual bed strength.
The audit stated that 25 hospitals had submitted claims for 81 patients twice for various surgical treatments. “The Madhya Pradesh health authority paid the full amount for both claims as against the prescribed rate of 50% payment on the second claim,” NDTV quoted the audit report as saying.
Implemented by the National Health Authority (NHA), the flagship scheme provides a health cover of ₹5 lakhs per family per year to beneficiaries. Over 23 crore beneficiaries have been verified and issued Ayushman cards to date so that they can avail of free treatment under the scheme. As per details, the person is verified through mandatory Aadhaar-based e-KYC for the scheme.
The scheme has achieved a milestone of 5 crore hospital admissions, amounting to ₹ 61,501 crore for free treatment of people.
(With inputs from agencies)
