CAG audit flags multiple frauds in PMJAY, patients shown dead are still beneficiaries

𝐎𝐩𝐩𝐨𝐬𝐢𝐭𝐢𝐨𝐧 𝐝𝐞𝐦𝐚𝐧𝐝𝐬 𝐩𝐫𝐨𝐛𝐞, 𝐇𝐞𝐚𝐥𝐭𝐡 𝐌𝐢𝐧𝐢𝐬𝐭𝐫𝐲 𝐝𝐞𝐧𝐢𝐞𝐬 𝐟𝐫𝐚𝐮𝐝𝐬

SHAKEELA ANDRABI

SRINAGAR: PM-JAY was launched by the PM Narendra Modi on September 23, 2018, with aim to provide Rs 5 lakh per family as per the strict criteria defined in the scheme.
The funding of the scheme is shared between Centre and State in the 60:40 and NHA is responsible for scheme implementation.
During the recent Monsoon Session of Parliament the Comptroller and Auditor General (CAG) tabled audit report in Lok Sabha noted multiple cases of the Ayushmaan Bharat-Pradhan Mantri Jan ArogyaYojna PMJAY providing treatment for patients who had already been declared dead ,as well as for thousands of people using same Aadhaar number or invalid mobile phone number.
CAG report says, almost 7.5 lakh people in the scheme’s beneficiary database were linked with a single cell phone number 9999999999. Almost 1.4 lakh were linked to the number 8888888888, while another 96,000 were linked another obviously bogus number. There were some similar cases of multiple beneficiaries being linked to a single Aadhaar number as well.
Other key issue exposed by the CAG included private hospital performing procedures reserved for public hospital, hospitals with pending penalties amounting to multiple crores of rupees fraudulent database errors and spending on ineligible beneficiaries, and more systemic issues such as shortage of infrastructure, equipment and doctors at empanelled hospitals, as well as cases of medical malpractice .
According to the NHA database,27,649 hospitals have been empanelled across India for providing services under this scheme. An Empanelled Healthcare Provider has to fulfill criteria like the presence of round the clock support system required for services like pharmacy, blood bank, laboratory, dialysis unit, post-operative services ICU care etc. However in Bihar, Andaman Nicobar Islands, Assam, Chandigarh, Gujrat, Himachal Pradesh, Jammu and Kashmir, Manipur, Nagaland, Puducherry, Tripura, and Utter Pradesh figured in this list of States where hospitals got empanelled and failed to serve the purpose.
The CAG report also said ,that patients earlier shown as “dead” continued to avail treatment under the scheme. The maximum number of such cases were in Chhattisgarh, Haryana, Jharkhand, Kerala, and Madhya Pradesh. While as the minimum number of such cases were observed in the Andaman and Nicobar Islands, Assam, Chandigarh, Manipur and Sikkim.
The CAG also noted that penalties amounting to Rs 12.32 crore from 100 hospitals were pending in nine states, and that in Andhra Pradesh and Punjab private hospitals were performing procedures reserved for public hospitals.
Meanwhile Health Ministry defended the scheme and saying that mobile number did not play any role in the verification of scheme beneficiaries.
In a statement, the Health Ministry said that the scheme only used numbers to reach out to the beneficiaries in case of any need.”AB-PMJAY identifies the beneficiary through Aadhaar Identification where the beneficiary undergoes the process of mandatory Aadhaar based e-KYC. The details fetched from the Aadhaar database are matched with the source database and accordingly ,the request for Ayushmaan card is approved or rejected based on the beneficiary details”, the Ministry said.
On the other side, opposition parties like Congress and AAP questioning the Centre over discrepancies in the database of the Ayushman Bharat Scheme, which were highlighted in an audit report prepared by the CAG. Will there be any investigation into these discrepancies, asked opposition leader to government.