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Hospitals charging money from patients under PM-JAY to face stern action

It has been witnessed that the hospitals empanelled under Ayushman Bharat, have been collecting money from the beneficiaries of the scheme.

Dr Indu Bhushan, CEO, National Health Authority, has issued the circular, suggesting possible action against the hospitals.

With an aim to provide healthcare to all the poor and needy people, the Union government led by PM Narendra Modi led Union rolled out the world’s largest cashless insurance scheme called Ayushman Bharat.

But, during the past few months, the National Health Authority has received a number of complaints regarding money being collected by the hospitals who are empanelled under the PM-JYA. To curb this fraud, Dr Indu Bhushan has sent a circular to all the states.

The circular states,

‘It has been brought to the notice of the National Health Authority that certain hospitals have collected money from the beneficiaries of PM-JYA, despite the fact that these costs are already incorporated under PM-JYA packages and rates.

Such activities of errant hospitals needed to be curbed and disciplinary action needs to be taken. The National Anti-Fraud cell has recommended that in such cases the State Health Authorities take action against the errant hospital’

Dr Dinesh Arora, Deputy CEO, Ayushman Bharat, tweeted saying, “Fraud has no place in Ayushman Bharat. Ayushman NHA clamps down on fraudulent entities through extremely vigilant monitoring. With State teams, NHA is conducting surprise visits in empanelled hospitals. Also, a circular is issued to tackle every form of fraud and abuse.

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The National Health Authority has asked the state to take the following action against the errant hospitals:

  • Issuance of a show-cause notice to hospitals.
  • Ensure that the money collected by the hospital is returned to the beneficiaries.
  • Temporary suspension of the hospital.
  • Withholding the payment to the hospital until the detailed investigation.

A few hospitals and the beneficiaries are still unaware of the packages and the benefits under PM-JYA. So, the NHA has recommended that awareness should be spread among the hospitals and the beneficiaries.

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