India News | Payment of Rs 113 Cr Withheld over Suspicious Claims Under Ayushman Bharat: Govt Tells RS
Get latest articles and stories on India at LatestLY. Claims worth approximately Rs 113 crore under the Ayushman Bharat health insurance scheme that were allegedly found to be suspicious have been withheld from payment till a probe on it is completed, the Rajya Sabha was told on Tuesday.
New Delhi, Dec 5 (PTI) Claims worth approximately Rs 113 crore under the Ayushman Bharat health insurance scheme that were allegedly found to be suspicious have been withheld from payment till a probe on it is completed, the Rajya Sabha was told on Tuesday.
In a written reply, Minister of State for Health SP Singh Baghel said that over 900 hospitals have been de-empanelled under the scheme.
The minister was responding to a question on anomalies in the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) cited in the Comptroller and Auditor General of India (CAG) report and if the government has taken any corrective steps to resolve the issue.
The CAG has highlighted discrepancies, including invalid names, unrealistic dates of birth, duplicate health IDs and unrealistic family sizes in the database of PMJAY.
Ineligible households were found registered as PMJAY beneficiaries and had availed the benefits ranging between Rs 0.12 lakh to Rs 22.44 crore under the scheme, said the audit report tabled in Parliament on August 8.
It stated that 7.49 lakh people are registered against the mobile number 9999999999 as beneficiaries.
The National Health Authority (NHA), which implements the PMJAY has submitted its action taken note to the CAG observations.
"With respect to anti-fraud initiatives, the NHA has moved from a 'recovery' approach to 'prevention' approach. This would mean payment of such claims which have been found to be suspicious are withheld till the investigation is completed,” Baghel told the Rajya Sabha.
“As on date, over 900 hospitals have been de-empanelled under the scheme. Claims worth approximately Rs. 113 crore have been withheld from payment under the scheme," he said in his written reply.
Baghel said that the audit report on PMJAY suggested certain improvisations in the scheme implementation with regards to beneficiary verification, hospital empanelment, claims settlement, fund release to states, and monitoring and evaluation.
Regarding beneficiary verification, a new Beneficiary Identification System (BIS) with improved workflow and validations has been launched, he said.
Further, the Government of India's decision to use alternative digitised Aadhaar-seeded databases to identify beneficiaries has brought ease and certainty in the beneficiary verification process, the minister said.
Baghel said efforts have been made to achieve Ayushman card saturation at the earliest through activities such as the ‘Ayushman Bhava' campaign.
He said that, as of November 30 this year, 99 per cent of the total registered grievances (4.76 lakh) under the scheme have been resolved.
The minister said that constant monitoring is done to ensure timely redressal of the grievances received under the scheme.
Concerted efforts are also taken to ensure effective implementation of the scheme at the state and district level, he added.
(The above story is verified and authored by Press Trust of India (PTI) staff. PTI, India’s premier news agency, employs more than 400 journalists and 500 stringers to cover almost every district and small town in India.. The views appearing in the above post do not reflect the opinions of LatestLY)