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NHA for blacklisting hospitals caught in PMJAY fraud

So far, 97 hospitals across the country have already been de-empanelled by the authority which administers PMJAY.

Written by Abantika Ghosh | New Delhi | Updated: September 18, 2019 6:52:53 am
Harsh Vardhan

The National Health Authority (NHA) is in talks with the Insurance Regulatory and Development Authority (IRDA) for universal blacklisting of hospitals that have been caught making fraudulent transactions under Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana (PMJAY).

So far, 97 hospitals across the country have already been de-empanelled by the authority which administers PMJAY.

“We are talking to IRDA so that not only are names of de-empanelled hospitals displayed on our website but also for wider dissemination of the information so that they are not only kept away from all other government schemes such as CGHS, ESI etc but other insurers too are told to stay away from such hospitals,” NHA CEO Dr Indu Bhushan said on Tuesday.

A strong fraud prevention, detection and control system is critical for PMJAY, under which an annual health cover of Rs 5 lakh will be provided to 10.74 crore families. Penalties worth more than Rs 1.5 crore have been levied on errant hospitals.

As PMJAY completes one year — it was inaugurated by PM Narendra Modi on September 23 last year — the government is planning Ayushman Bharat Pakhwara. “As we complete a year of launch of AB-PMJAY, we are celebrating Ayushman Bharat Pakhwara, a national campaign to enhance awareness around preventive, promotive and curative aspects of healthcare, nutrition, yoga and healthy lifestyle through Ayushman Bharat and other related initiatives,” said Health Minister Dr Harsh Vardhan.

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