New Delhi: The hospitals found involved in any fraud under government’s health scheme Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) would be named and shamed, union health minister Harsh Vardhan said on Tuesday. The minister said that the government has already de-empanelled 97 errant hospitals and penalties worth more than Rs.1.5 crore have been levied.
Nearly 1,200 cases of fraud have been confirmed and action has been taken against 338 hospitals. The names of the hospitals involved in any corruption would be put up on the official website of PMJAY and made public. The idea is to name and shame them," said Harsh Vardhan.
“And all these figures show the government’s zero tolerance towards corruption and we have been able to detect all these frauds because of a proactive robust strong IT anti-fraud detection system," he said.
The government said that the decision to publicly name the health insurance fraudsters under Ayushman Bharat was taken in collaboration with the Insurance Regulatory and Development Authority (IRDAI) to deter them from indulging in malpractices.
“We are taking stern action against such fraudsters and have filed criminal cases and FIRs in some cases. We have also suggested such hospitals should not only be de-empanelled from the PMJAY scheme but also from other scheme including that of CGHS and ECHA," said Indu Bhushan, CEO of the National Health Authority, the implementing body of the scheme.
Health minister also said that around 376 hospitals currently are under investigation while the NHA has taken action in terms of issuing show cause notice, suspending, levying penalty and de-empanelling against 338 hospitals.
PMJAY covers 50 crore poor and vulnerable people in the country. It provides a health assurance cover of Rs. 5 lakh per family per year for secondary and tertiary care for serious and catastrophic illnesses, he elaborated. PM-JAY provides cashless and paperless access to services for the beneficiary at the point of service.
As on date, 32 States and Union Territories are implementing the PMJAY. Under the scheme, around 18,073 hospitals and health care providers have been empanelled across the country. Of this, 53% of the hospitals empanelled are private, especially multi-speciality, and 62% of the treatments have been in these private hospitals.
According to the government, since the launch of PMJAY on 23rd Sept in 2018, more than 47 lakh hospital treatments worth over ₹7,500 crore have been carried out. Of the total amount utilised, 55% has been on tertiary procedures. In addition, more than 10 crore beneficiary cards have been issued.
“More than 39 lakh people have availed cashless treatment worth over Rs. 6,100 crore for serious illnesses since the launch of AB-PMJAY. This has resulted in savings of ₹12,000 crore to the beneficiary families," said Harsh Vardhan.
The union health ministry on Tuesday also announced setting up of 40,000 Health and Wellness Centers by March 2020. “With a target of 1,50,000 centers till 31 December, 2022, more than 21,000 Health and Wellness Centers have already been created till now; will reach 40,000 by March 31st," said Harsh Vardhan.