Jaipur: In a major crackdown on fraud under the Rajasthan Government Health Scheme (RGHS), the state Health Department has suspended 34 private hospitals and 431 approved pharma stores over the past three months for alleged large-scale irregularities. Additionally, 28 government employees have been suspended and 17 FIRs registered for misuse of the scheme.
Special Audit Uncovers Widespread Fraud
The action followed a special audit and intensive investigation triggered by complaints of false billing, misuse of beneficiary cards, and fraudulent coordination between hospitals, medical stores, doctors, and beneficiaries.
Principal Secretary (Health) Gayatri Rathore said that several hospitals were found raising double claims for single surgeries, conducting unnecessary diagnostic tests, and charging higher-rate packages despite the availability of cheaper alternatives. Penalties totaling ₹36 crore have already been recovered from these hospitals.
Pharma Stores Caught Issuing Fake Bills
The suspended 431 pharmacy outlets were allegedly involved in issuing fake bills and misusing RGHS benefits through collusion with beneficiaries and medical practitioners. The Health Department has recovered ₹4.6 crore in penalties from these stores.
1,000+ Beneficiary Cards Blocked
The investigation also identified over 1,000 RGHS beneficiary cards used for fraudulent claims. All such cards have been blocked, and 28 government employees involved in the misuse have been suspended, according to a Times of India report.
Anti-Fraud Cell Established
To prevent such irregularities in the future, the Rajasthan government has created a dedicated Anti-Fraud Cell and is preparing a new Standard Operating Procedure (SOP) aimed at strengthening monitoring and accountability.
Increased Surveillance to Protect State Funds
Officials said the RGHS office significantly ramped up surveillance over recent months after repeated reports of hospitals, pharmacies, and beneficiaries exploiting loopholes in the system. The fraudulent practices were causing major financial losses and compromising the scheme’s smooth functioning.
With the crackdown underway, authorities are working to ensure stricter enforcement and restore trust in the state’s flagship healthcare scheme.
