MoS: Govt has zero tolerance for fraud in Ayushman scheme

He said the hospital and the implicated doctors have been suspended from the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY).

The minister said that as of November 25, a total of 18,184 grievances have been registered on the Central Grievance Redressal and Monitoring System (CGRMS) pertaining to issues such as denial of treatment, charges for admission, discharge or medicines and the unavailability of Pradhan Mantri Arogya Mitra (PMAM), etc.

“The AB-PMJAY ensures quality healthcare services to the scheme beneficiaries. The scheme is governed on a zero-tolerance approach to any kind of fraud and abuse and various steps are taken for prevention, detection and deterrence of different kinds of fraud that could occur in the scheme at different stages of its implementation,” Jadhav said.

The National Anti-Fraud Unit has been established at National Health Authority and works in close coordination with State Anti-Fraud Units to investigate and take joint action against issues related to fraud and abuse. Appropriate actions, including suspension, show-cause notice, warning letter de-empanelment of hospitals, de-activation of e-cards, levying penalty on errant hospitals and lodging of FIRs are taken against fraudulent entities, he said.

Under AB-PMJAY, a three-tier grievance redressal system at district, state and national-level has been created to resolve the issues faced by beneficiaries in utilising healthcare, he said.

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