3 weeks ago

Maharashtra Forms SIT to Probe 15,407 Suspicious Health Insurance Claims

Maharashtra Forms SIT to Probe 15,407 Suspicious Health Insurance Claims
Maharashtra Forms SIT To Probe 15,407 Suspicious Ayushman Bharat And MJPJAY Health Claims · freepressjournal.in

Some people in Maharashtra may have cheated the government's health insurance programs by making claims for medical treatment that was not real or not needed.

The government checked health insurance claims and found 15,407 that looked suspicious.

These claims were made under two schemes that help poor families pay for hospital care of up to Rs 5 lakh a year.

To figure out what happened, the government created a special team called the SIT.

The SIT is led by an important government officer named Pravin Gedam.

The team will look at hospitals that may have made fake claims or charged too much money.

It will also check if people used the same phone number or identity proof to register many patients.

The SIT has to finish its investigation and give a report within 30 days.

The goal is to stop cheating and make the insurance plans work fairly for the people who really need them.

Key facts

Suspicious claims detected
15,407
Schemes involved
Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) and Mahatma Jyotirao Phule Jan Arogya Yojana (MJPJAY)
Claims period
2024-2026
Government Resolution date
August 5
SIT head
Nashik Divisional Commissioner Dr Pravin Gedam
Report deadline
Within 30 days of SIT formation
Coverage
Up to Rs 5 lakh per family per year under both schemes
Review meeting
July 10, chaired by Chief Minister Devendra Fadnavis

Sources

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