Rajkot: The health department of Rajkot has unearthed a major scam, wherein a pediatric hospital has been fined Rs.6.54 crores for submitting manipulated medical records of 116 children’s in the Pradhan Mantri Jan Arogya Yojana (PMJAY) portal. As per the health department the paediatric hospital tampered with the medical records of children’s and submitted inflated bills to the health department under the PMJAY scheme for approval. The probe by the health department took 45 days to uncover the scam.
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Under the standard procedures in PMJAY scheme the doctors has to send lab reports and other investigations done by them to justify the diagnosis of the patient and can claim a maximum of Rs.10 Lakhs per patient. The health department investigated the records of 524 children’s treated by the hospital in the last 8 months. During investigation the health department compared the lab reports submitted by the hospital with the lab reports actually given by the laboratories. It was discovered that 116 children’s lab report mismatched with the original. The original reports were manipulated by the hospital and the bills were inflated. Also, it is being alleged that the hospital was having alliance with certain laboratories so as to fabricate reports and misrepresent healthy children as sick.
The Gandhinagar Health Department had sent a penalty notice to the hospital detailing violations under the PMJAY scheme. The hospital improperly modified reports for 116 cases seeking pre-authorization, resulting in rejected claims totalling Rs 65,47,950. As a consequence, the government plans to levy a penalty ten times this amount i.e. Rs. 6.54 crores from the hospital.