The state health department “urgently” issued an order barring two hospitals in Rajkot and one in the state capital Ahmedabad from providing services to beneficiaries of both the Pradhan Mantri Jan Arogya Yojana (PMJAY) – Ayushman Bharat – and the state’s own Mukhyamantri Amrutam Vatsalya Yojana (MA), which also offers cashless assistance to impoverished families to help with their healthcare costs. This was down to irregularities flagged by state auditors.
“There was evidence of money being accepted from patients under subsidy, patients not being found on hospital beds by insurance companies,” said Dr H. K. Bhavsar, the additional director of medical services. As such, he said, it was recommended that the hospitals in question be “debarred.”
The three hospitals joined six others in the state to have been de-empanelled from the schemes, whilst eight hospitals have been served notices for similar irregularities – some for the second time. Far from being an isolated problem in Gujarat, many hospitals nationwide have been implicated in unsavoury practises during the implementation of Ayushman Bharat and other healthcare schemes.
In Uttarakhand in June, at least 697 possible cases of irregularities within hospitals administering services under Ayushman Bharat services were reported. Of these, eleven were fined more than Rs 1.17 crore. In Maharashtra last month, the state government de-empanelled 27 hospitals from providing services under the state’s Mahatma Jyotiba Phule Jan Arogya Yojana, on grounds of fraudulent practises.
The National Health Authority (NHA), the nodal agency tasked with overseeing Ayushman Bharat, de-empanelled approximately 250 hospitals from the scheme within ten months of its launch. The fraudulent practises identified included “a single doctor conducting surgeries in four districts on the same day, patients charged for expensive procedures not conducted on them, multiple surgeries conducted on a single day late in the night, hysterectomies on men and fake beneficiaries issued cards” according to The Economic Times.
Indeed, for Ayushman Bharat and other initiatives to be successful in improving healthcare, vigilance against mismanagement is a must from both state and central government authorities. More than ten crore individuals have benefited from Ayushman Bharat thus far. Ensuring that their wellbeing and not unscrupulous profiteering is at the forefront of the initiative will require such attention.