CHANDIGARH: Punjab Vigilance Bureau has unearthed a scam running into crores under the Pradhan Mantri Jan Arogya Yojana-Aushmaan Bharat scheme, in which private hospitals have obtained health insurance claims from insurance company on the basis of fake bills for treatment of patients possessing smart health cards.
DGP-cum-Chief Director of Vigilance Bureau, BK Uppal, said it has come to light that several well known private hospitals in Jalandhar, Hoshiarpur and Kapurthala have prepared hefty fake bills in the names of smart card holders for treatment under Ayushman Bharat scheme and received insurance claims from IFFCO Tokio.
The company had rejected hundreds of claims pertaining to government hospitals causing a huge loss to the state exchequer. “A regular vigilance inquiry has been registered to investigate this scam worth crores,” Uppal said.
Giving details of preliminary findings, he said several fake bills of private hospitals had been cleared by the insurance company, but reimbursement bills forwarded by government hospitals were rejected.
“The Punjab government has incurred financial losses during the last one year from these three districts.”
Revealing the modus operandi, he said that a patient named Paramjeet Kaur was admitted to hospital gall bladder stone but did not undergo surgery.
In this regard, the hospital prepared a fake bill of `22,000 for this patient and claimed reimbursement form IFFCO TOKIO under the Ayushman Bharat health insurance scheme.