Ex-Servicemen Contributory Health Scheme ‘fraud’ | Fake bills and forged records used to siphon off govt funds: CBI books doctors, hospitals

Modus operandi

According to the CBI FIR, a reliable source indicated large-scale irregularities in the processing of ECHS medical reimbursement claims. It is alleged that the accused, in collusion with empanelled hospitals and unidentified ECHS officials, devised a systematic mechanism to fraudulently generate claims by misusing emergency admission provisions, manipulating referral systems, fabricating medical and diagnostic records, and inflating treatment and pharmacy bills.

The CBI conducted a Joint Surprise Check (JSC) on February 24, 2026, on the premises of Manthan Health Care in Sector 38 and Dharam Hospital in Sector 15, Chandigarh, in the presence of ECHS vigilance officials. During the operation, the agency reportedly seized patients’ files, referral papers, WhatsApp chats, blank letterheads, hospital stamps, digital signature materials, and storage devices covering the period from 2018 to 2026.

Non-empanelled entity under scanner

The FIR alleges that Manthan Health Care, which is not empanelled under ECHS, was operating in active collusion with Dharam Hospital, an empanelled facility.

According to the FIR, CBI sleuths found the ECHS desk at Dharam Hospital was “effectively being run from the premises of Manthan Health Care, using its credentials, indicating possible unauthorised diversion of a regulated hospital interface”. Further, official stamps, blank letterheads, and digital signature credentials of Dharam Hospital were allegedly found in possession of Manthan Health Care.

The CBI stated in the FIR that claims were being processed and submitted on the ECHS portal in the name of Dharam Hospital from the premises of Manthan Health Care, indicating “unauthorised diversion of a regulated hospital interface to a non-empanelled intermediary”.

The FIR alleges a pattern of “abnormal patient admissions” existed, wherein ECHS beneficiaries were being systematically identified and “routed through intermediaries to selected private hospitals”. The admissions were “frequently shown as emergency cases without adequate clinical justification, enabling higher reimbursement claims”.

The CBI FIR alleges large-scale fabrication and forgery of medical documents, including emergency admission letters, prescriptions, pathology reports, and discharge summaries, purportedly issued by Dharam Hospital, which were recovered from Manthan Health Care. Some documents bore signatures allegedly of doctors, which, upon preliminary scrutiny, appeared to be forged. Also, certain diagnostic reports were found to be fake, with laboratories denying issuance.

According to the CBI, WhatsApp chats recovered during the JSC are stated to indicate prior coordination regarding patient admissions, discharge timing and preparation of medical records, suggesting post-facto documentation to support fraudulent claims, mentioned CBI FIR.

The FIR notes a pattern of repeated and clustered hospital admissions of ECHS beneficiaries, often shown as emergency cases without adequate clinical justification. It has also emerged that patients were routed through a network involving intermediaries and were admitted to hospitals based on billing considerations rather than medical need, and that commission was shared among the involved parties, the CBI stated in the FIR.

The CBI alleged that the accused persons, in criminal conspiracy with each other and with unidentified public servants, indulged in systematic cheating of the government by fraudulently claiming reimbursements under ECHS.

The role of unidentified ECHS officials is also under scrutiny, with the agency examining whether there was active collusion or negligence in processing suspicious claims, as mentioned in the CBI’s FIR.