Crores of claims taken from Ayushman Yojana without patient recruitment, secret revealed in investigation. Crores of claims taken from Ayushman scheme without recruiting patients, uncovered secret in investigation Pi News

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  • Crores Of Claims Taken From Ayushman Scheme Without Recruiting Patients, Uncovered Secret In Investigation

BhopalOne hour ago

The Health Department has canceled the registration of Vaishno Multi Specialty Hospital, which took claim from Ayushman Yojana by showing fake patient recruitment. In this hospital, the claim of treatment of such patients was also taken from the Ayushman scheme, who were never admitted to the hospital. In this case, GM Operation Dr. Padmakar Tripathi of Ayushman Bharat Niramayam Yojana had lodged a complaint with Bhopal Crime Branch. On his complaint, the crime branch registered a case against the owner of this hospital, Vivek Parihar and investigated. In the investigation, it was revealed that fraudulently receiving crores of rupees from the government by putting bills in the name of fake patients. After this the police acted on Vivek Parihar, while after investigation, it was recommended to cancel the license of the hospital. Based on the report, the license of the hospital was canceled by the CMHO office on Thursday. This hospital will no longer be able to treat patients.

18 hospitals and targets

After the action on Vaishno Hospital, the Ayushman Society along with the State Health Agency also raided more than 50 hospitals in the city. Out of this, all the disturbances were revealed in 18 hospitals. A big action can be started on them too soon.

Action will be taken after report

Here Ayushman Niramay Society has made preparations to take action on other 18 hospitals. According to the information, at present, the investigation report of all the hospitals is being prepared. As soon as the report is ready, action will be taken by issuing notices to these hospitals.

Attempts were made to mislead the investigation team as well.
Vaishno Multispecialty Hospital at Khajurikalan is empaneled in Ayushman Bharat Niramayam Yojana. This hospital was empaneled to provide cashless treatment to the eligible beneficiaries of Ayushman Yojana. On receipt of information about fraud under the scheme by the hospital, it was found in the investigation of the State Health Agency that false claims were submitted by the hospital through the scheme. On May 27, the State Health Agency inspected the hospital. During the inspection, the hospital management entered the Transaction Management Software (TMS) of those beneficiaries, patients’ claims with the aim of misleading the officials of the State Health Agency, even though these patients were not admitted to the hospital.

Fatum was billing the hospital

Phantom billing was done fraudulently by the hospital. In Fatum Billing, the hospital submitted claims for packages that were never provided to any patient. For this, the hospital used to make fake clinical notes of the beneficiaries. The claim was sent by the hospital by uploading the recruitment and discharge report on the transaction management software in a fraudulent manner.

Hospital closed under Nursing Home Act

Preliminary investigation by the State Health Agency found that Vivek Parihar, the operator of Vaishno Multispecialty Hospital, received the claim amount under the Ayushman scheme by fraud and forgery. In this regard, Bhopal Collector Avinash Lavania had directed the CMHO to take necessary action in the matter. CMHO has now revoked Dr. Prabhakar Tiwari’s permission for fraud committed by the hospital.

they say

The license has been canceled on the basis of the investigation report of the irregularities done by Vaishnav Hospital. There has already been a ban on admitting patients here. Orders have been given to shift the patients here to other hospitals.

Dr. Prabhakar Tiwari, CMHO

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