Chd/Shimla, April 20,
A alleged healthcare fraud, initially estimated at Rs 400 crore, involving the Ayushman Bharat and Himcare schemes, now threatens to exceed Rs 500 crore as investigations by the Enforcement Directorate (ED) reveal a far-reaching network of deceit spanning Himachal Pradesh, Punjab, Haryana, and Chandigarh. The scandal, which first surfaced with fraudulent activities centered at PGI Chandigarh, has now implicated private hospitals and clinics in Himachal Pradesh, exposing a systemic misuse of government-funded health initiatives.
The ED’s recent raids in Una and Solan districts have brought to light the alarming practice of private medical establishments submitting inflated claims for even the most basic treatments. Instances of billing thousands of rupees for common ailments like colds and mild fevers under the Ayushman and Himcare schemes have surfaced, indicating a deliberate and organized effort to siphon off public funds intended for genuine medical needs of the underprivileged.
This revelation comes on the heels of the arrest of Durlabh Kumar Jatav, the operator of Brothoers Chemist Shop within PGI Chandigarh, who is alleged to be the mastermind behind an elaborate scheme involving stolen patient data, forged prescriptions, and the use of duplicate health cards to illicitly obtain and resell expensive medicines. The rejection of Jatav’s bail plea underscores the gravity with which investigative agencies are now treating the case.
The state vigilance department has joined forces with the ED to conduct a comprehensive audit of all Himcare treatments provided by private hospitals.
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Scrutiny of hospital records is underway to identify patterns of inflated billing, duplicate entries, and fraudulent diagnostic procedures. Sources suggest that potential collusion between hospital administrators and data entry operators is a key area of investigation.
A senior official involved in the probe indicated that a thorough investigation could easily push the total value of the scam beyond Rs 500 crore, encompassing the fraudulent activities within PGI and the widespread misuse by private entities across the four states. Allegations of political interference have also emerged, with claims that an individual with Rightist links exerted pressure on the former DGP of UT Police to protect one of the accused.
Meanwhile, government hospitals like PGI Chandigarh, IGMC Shimla, and Dr. Rajendra Prasad GMC Tanda are grappling with pending dues under the Himcare scheme, with PGI alone awaiting over Rs 14.30 crore. The Union Health Ministry has directed these institutions to issue formal reminders and even legal notices to the Himachal Pradesh government for these overdue payments. The fact that the MoUs for cashless treatment were signed without the necessary approval from the Standing Finance Committee (SFC) has further complicated the financial and administrative aspects of the case.
As the scale of the Ayushman-Himcare scam widens, the focus is intensifying on systemic loopholes within the healthcare schemes, including lax verification processes and insufficient monitoring mechanisms.
Experts are calling for stringent measures, such as biometric verification of patients and digital tracking of prescriptions, to prevent further abuse and restore public trust in these vital healthcare programs.
