Ahmedabad: In a significant crackdown on fraudulent activities, the Gujarat Health Department has debarred five private hospitals and two doctors from participating in the Pradhan Mantri Jan Arogya Yojana (PMJAY) following a series of inspections revealing various irregularities. These actions come amid an ongoing investigation into Ahmedabad’s Khyati Multispecialty Hospital, which was involved in performing unnecessary angioplasty procedures on PMJAY beneficiaries to siphon off government funds.
Between December 2 and December 8, five hospitals from Patan, Dahod, Ahmedabad, and Aravalli districts were suspended from the scheme, taking the total number of de-panelled hospitals in 2024 to 12. These hospitals were found to be involved in fraudulent practices, including altered medical reports, insufficient infrastructure, and violations of PMJAY guidelines.
Key findings include:
- Heer Children Hospital (Patan): Authorities altered 91 lab reports to gain benefits under PMJAY. The hospital also applied for higher insurance packages unjustifiably. A fine of Rs 50 lakh was imposed, and both the hospital and its doctor, Hiren Patel, were suspended from the scheme.
- Niskha Children Hospital (Patan): 60 medical reports were altered to claim undue benefits. The hospital and its doctor, Divyesh Shah, were also suspended, with a recovery notice of Rs 15 lakh issued.
- Sonal Hospital (Dahod): The hospital was de-empanelled for failing to meet the required staffing and infrastructure standards and for inadequate infection control measures.
- Sentora Hospital (Ahmedabad): The hospital lacked proper authorization for its fourth and fifth floors, had insufficient staff, and was found with expired medicines on its premises.
- Shree Jalaram Hospital (Aravalli): The hospital lacked a fire certificate and failed to meet the ICU norms, leading to its suspension.
This crackdown is part of the state’s effort to ensure that PMJAY, which provides free medical treatment to the poor and middle class, is not misused. Since January 2024, the health department has debarred 12 hospitals for irregularities. The department emphasized that any malpractice would not be tolerated in the scheme designed to provide essential healthcare to underserved communities.
In addition to these actions, the ongoing investigation into Khyati Multispecialty Hospital has led to the arrest of seven individuals, including the CEO and director, after the deaths of two PMJAY beneficiaries due to unnecessary angioplasty procedures. The hospital allegedly organized free check-up camps to persuade PMJAY cardholders to undergo the procedure, despite it being medically unnecessary, and falsely registered patients under the “emergency” category to expedite government approval.
