Rajasthan govt cracks down on RGHS fraud; seven doctors suspended, FIRs against hospital and diagnostic centre
Jaipur, Feb 13 (IANS) The Rajasthan government, on Friday, intensified its crackdown on irregularities under the Rajasthan Government Health Scheme (RGHS), suspending seven doctors and initiating criminal proceedings against one hospital and one diagnostic centre.
The action has been taken under the direction of Chief Minister Bhajan Lal Sharma and Health Minister Gajendra Singh Khinvsar to ensure transparency and accountability in the public health insurance scheme.
Principal Secretary of the State Medical and Health Department, Gayatri Rathore, said that continuous monitoring and audits are being conducted to strengthen the scheme.
Following an audit, seven doctors in Sikar district have been suspended for alleged irregularities.
Those suspended include Kamal Kumar Agarwal and Sunil Kumar Dhaka (Associate Professors of Orthopedics department from Sikar Medical College), Mukesh Verma (Associate Professor of General Medicine Department), Rakesh Kumar (Community Health Centre Kirwa), and Gajraj Singh, S.S. Rathore and Sunil Sharma from S.K. Hospital.
FIRs are being registered against Bharatpur Nursing Home in Bharatpur and Bothra Diagnostic and Imaging Centre in Bikaner for fraudulent claims and misuse of the RGHS system.
The concerned district health authorities have been informed.
Rajasthan State Health Assurance Agency CEO Harjilal Atal said investigations revealed collusion between Kashish Pharmacy and Bharatpur Nursing Home to generate fake claims using beneficiary cards.
The hospital allegedly treated patients without RGHS approval, obtained Single Sign-On IDs and passwords to generate transaction IDs, and raised fraudulent claims through the pharmacy, causing losses to the taxpayers.
The hospital has been de-empanelled from the scheme.
In the case of Bothra Diagnostic Centre, the investigation found that patients were subjected to unnecessary tests such as HbA1c, RA Factor and Procalcitonin without proper medical justification.
In several cases, test reports and OPD consultations were missing or inconsistent.
Verification at PBM Government Hospital revealed that several prescriptions carried forged signatures and seals of doctors, who were either on leave or not posted in the OPD during the relevant period.
Some prescriptions were issued in the names of doctors, who were not posted at the hospital at that time.
As of now, 19 FIRs have been filed and 64 personnel suspended for irregularities.
Around 500 beneficiary cards have been blocked, with Rs 2 crore recovered for misuse.
Payments of 39 hospitals and officials of 33 hospitals have been blocked, with more than Rs 32 crore recovered from eight de-empanelled hospitals.
The officials of 212 pharmacies have been blocked, with more than Rs 5 crore recovered.
The state government said strict action will continue to protect public funds and ensure the integrity of the RGHS scheme.
–IANS
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