Ayushman Bharat insurance frauds on Health Dept's radar

Tribune News Service

Amritsar, August 9

With reports of some private hospitals trying to mint money from Ayushman Bharat-Sarbat Sehat Bima Yojana (AB-SSBY) by using fake and inflated bills, the district Health Department has started looking into the details of such cases and is keeping a vigil.

With over 3.20 lakh beneficiary card holders in the district, the AB-SSBY has promised to provide cashless treatment of up to Rs 5 lakh in the government and private hospitals. Of the total 105 empanelled hospitals in the district under the scheme, 95 are private hospitals and 10 are government hospitals.

Officials of the district Health Department stated that while some hospitals were trying to make money by showing inflated bills, others were using fake bills for the same. It has also been alleged that while these hospitals are making money, actual beneficiaries are forced to pay for their treatment even though they are eligible for the cashless treatment facility.

A flagship programme of the government to help people get cashless treatment at government and private hospitals is being exploited by some unscrupulous hospitals to make money. Earlier too, the Health Department had detected such anomalies and taken action against the guilty hospitals.

Civil Surgeon Dr Charanjit Singh said, “If any empanelled hospital is found indulging in any fraudulent activity, action is taken against it as per the law.” He said the audit of these hospitals was being conducted regularly by the department as well as the insurer.

Action as per law

If any empanelled hospital is found indulging in any fraudulent activity, action is taken against it as per the law. — Dr Charanjit Singh, civil surgeon

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