In this year’s interim and union budget, the government introduced a scheme for providing health protection cover to around 10 crore vulnerable families. The scheme was introduced for the welfare of the underprivileged Indians, who cannot take the burden of expenditure against severe medical problems.
The doctors in the tiny Himalayan state of Uttarakhand have been caught scamming the ambitious plan for a quick buck. Many private hospitals are involved in the scam, where they have been accused of siphoning almost Rs.1.2 crore of public funds in a span of a few months. And not just like any other scam. The doctors have found out bizarre ways to execute the scam.
You will be surprised to know that doctors in the hospitals have used these kinds of ways to claim money under the scheme of Ayushman Bharat for these false reasons:
1. Patients have been afflicted with deadly diseases, while they were just suffering from a common cold.
2. Dialysis has been shown to be performed in a facility where there is no kidney specialist.
3. Hospitals have shown surgeries performed on patients whose surgeries had already been completed elsewhere
4. A hospital claimed to perform 38 cataract surgeries in 45 days, which were classified as ‘emergency’. But according to the medical rules, cataract is not considered as an emergency.
5. A hospital forged patients’ medical history in 152 cases, and also showed itself to be a medical college to get impanelled in the scheme.
6. A hospital siphoned Rs.10 lakhs showing that 12 surgeries have been done in 14 hours, attributing all of them to the same doctor.
Over 150 hospitals are empanelled under the scheme, which runs in the name of Atal Ayushman Yojana in Uttarakhand. The scheme was announced to cover around 18 lakh more beneficiaries, besides the ones identified earlier. The blanket extension of the scope of the scheme, which was done in good faith, has led to it being open to fraud.
Investigations were conducted in Uttarakhand and seven hospitals were de-impaneled from the scheme for forgery, FIRs were filed against four, and show-cause notices were issued against 12 other hospitals on the grounds of gross irregularities.
When the hospitals are asked for a response, the majority of them refuse to answer or were just blank. Some doctors alleged that they haven’t done anything wrong, and will be moving to the court to challenge the action taken by the Atal Ayushman authorities. One of the hospitals responded that the scheme signed, prohibits any of the parties to speak to media unless the process of de-empanelment is done.