3 weeks ago

Patients Treated for One Ailment, Hospitals Bill Another in Bhopal

Patients Treated for One Ailment, Hospitals Bill Another in Bhopal
Patients Treated For One Ailment, Hospitals Bill For Another For Higher Payouts Across Bhopal · freepressjournal.in

The government of India runs a special health program called Ayushman Bharat that pays hospitals to treat sick people who cannot afford it.

But some private hospitals in the state of Madhya Pradesh are accused of cheating this program.

They are accused of treating a patient for one illness but writing on the paperwork that they treated a different, more expensive illness, so they could get more money.

Some hospitals are also accused of collecting people's fingerprints and ID numbers without explaining why, and then using that information to file claims.

A man named Shyam went to a hospital in Bhopal for treatment of piles, but his papers said he had surgery for kidney stones, and money was taken from his insurance account.

A woman named Rekha went to a hospital in Narmadapuram for a fracture, but was reportedly billed for two surgeries that were not connected to her condition.

A government doctor in Narmadapuram said an inquiry found the hospital guilty of fraud and recommended stopping it from taking part in the program.

Another patient in Jabalpur said his insurance account still showed he was in hospital even after he went home, and big claims were raised without his knowledge.

When asked, one hospital denied any wrongdoing, while another did not answer.

Cheating a health program is not fair because it takes money away from helping people who really need medical care.

Key facts

Scheme
Ayushman Bharat (government-funded health insurance)
State
Madhya Pradesh, India
Accused hospitals
RA Stone and Surgical Care (Bhopal), Meena Fracture Hospital (Narmadapuram), Swastik Multispeciality Hospital (Jabalpur)
Amount deducted in Bhopal case
₹84,260 from Shyam Kumar's Ayushman account
Inquiry finding (Narmadapuram)
Meena Fracture Hospital guilty of negligence, financial irregularities and fraud
Recommended action
Immediate cancellation of Meena Fracture Hospital's empanelment under Ayushman Bharat
Complaints filed
CM Helpline, Jansunwai, and the chief medical and health officer (CMHO)

Sources

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