x

Like our Facebook Page

   
Early Times Newspaper Jammu, Leading Newspaper Jammu
 
Breaking News :   Vishwa Yog Sansthaan organises plantation drive at Har Ki Pauri | Sadhotra calls for collective effort to support rain-flood-hit families | SKK's initiative for rnvironmental stewardship among Divyang | DPS Jammu bids farewell to three stalwart teachers | Reasi police cracks scooty theft case - two arrested, stolen vehicle recovered | AJKTWA urges expedited implementation of E-Bus routes, CEO Smart City promises swift action | On the eve of PM's birthday, Sat Sharma releases poem titled "Modi Era" written by Balbir | Absconder arrested after 33 years | Textile and apparel parks to be set up in UP in the name of Sant Kabir: CM Yogi | Commissioner JMC visits flood-hit areas of ward no. 56, Gangyal-Babliana | LG Kavinder Gupta participates in India Youth Parliament at Jaipur | MLA Ch Vikram Randhawa Visits Belicharana & Bank of Nikki Tawi to Assess Damage | Director Health Services, Jammu Visits Sub District Hospital Jagti | Unique International Public School organises Bocce Ball Sports event | Rana reviews measures to address water woes in Habbakadal constituency | Repeat drug offender can't escape preventive detention:DB | Distance-Mode Engineering Degree Can't Add Weightage: DB | Humanity Public School organises English and Hindi calligraphy competition | Resonance 2025: A fusion of memories and milestones at DAV College, Amritsar | Shiv Public Hr Sec School & Shiv Kidz Planet Host Painting Competition | KC College of Education observed World Ozone Day | SMVDU cadets selected for prestigious All India Vayu Sainik Camp (AIVSC) | GDC Ramnagar organises Poster Making Competition on World Ozone Day | GDC RS Pura organizes sympsium on local youth actions for the sustainable development goals and beyond | GDC Ramgarh Initiates Tribute to Mahatma Gandhi | Infighting emerges in AAP amid stir against PSA on Mehraj Malik | BJP eyes comeback in Leh, starts preparations for prestigious LAHDC Leh polls | Terrorism supporter Shahid Afridi hails Rahul Gandhi as a “voice of peace” | Robust mobile, internet services essential for effective governance: CM Omar | Gadkari, CM review Srinagar-Jammu Highway traffic restoration | Over 3,000 forced to leave homes in Jammu | Proclaimed offender in terror case brought back To Jammu from Bengaluru | Conviction in terror and narcotics cases must improve: IGP Kashmir directs officers | Threat of Dengue, Malaria looms; fogging intensified | Mata Vaishno Devi pilgrimage to resume today | Terrorist hideout busted | Modi’s words that moved a nation | Information Overloaded Minds | Amit Shah’s Clarion Call | Back Issues  
 
news details
Private hospitals under scanner for Rs 11.82 cr fraud
J&K Ayushman Bharat Scheme
2/11/2025 10:39:24 PM

Early Times Report

Jammu, Feb 11: Private hospitals across the country are involved in making money through fraudulent means by presenting fake bills under the Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) which was launched for the economically weaker sections of society.
Private hospitals in Jammu and Kashmir too have followed the footsteps of their counterparts in other parts of the country and have committed alleged fraud worth Rs 11.82 crore by presenting fake and fraudulent bills under this scheme.
Replying to a question in Rajya Sabha, Minister of State for Health and Family Welfare Pratap Rao Jadhav said that as many as 2. 7 lakh fake claims worth Rs 562. 4 crores made by private hospitals, were detected by the authorities. Out of these frauds, Rs 11.82 crore fraud detected in Jammu and Kashmir.
After detecting these frauds, a total of 1,114 hospitals have been de-empanelled, and 549 hospitals have been suspended under AB-PMJAY.
“AB-PMJAY is governed by a zero-tolerance approach towards any kind of fraud and abuse and various steps are taken for the prevention, detection, and deterrence of different kinds of fraud that could occur in the scheme at different stages of its implementation”, the Minister said, adding, “National Anti-Fraud Unit (NAFU) has been established at National Health Authority (NHA) and works in close coordination with State Anti-Fraud Units (SAFU) to investigate and take joint action against issues related to fraud and abuse”
“Out of 6.66 crore claims processed by NAFU, 2.7 lakh claims of private hospitals worth Rs. 562.4 crore were found to be
Private hospitals in J&K have allegedly committed a fraud worth Rs 11.82 crore by presenting fake and fraudulent bills.
AB-PMJAY is governed by a zero-tolerance approach towards any kind of fraud and abuse.
National Anti-Fraud Unit (NAFU) has been established at National Health Authority (NHA) and works in close coordination with State Anti-Fraud Units (SAFU).
NHA has issued guidelines to undertake several punitive actions to curb cases involving misuse or abuse under AB-PMJAY.
on-admissible on account of abuse, misuse or incorrect entries”, the minister informed the House, adding, “Further, any claims by empanelled hospitals found to be suspicious by NAFU are withheld until proper scrutiny by SAFU teams including field verification where necessary”.
NHA has issued guidelines to undertake several punitive actions to curb cases involving misuse or abuse under AB-PMJAY.
“These include the suspension or blacklisting or de empanelment of hospitals concerned from the AB-PMJAY network”, the Minister said, adding, “Additionally, misuse/abuse claims are rejected, and penalties or legal actions are imposed on such hospitals”.
To enhance the detection of misuse or abuse, near real-time monitoring and AI-based systems are used to check hospital claims. Furthermore, hospitals undergo random audits and surprise inspections to ensure the authenticity of claims. State Health Agencies (SHAs) also conduct regular desk medical audits as well as field audits.
“As a result of the stringent measures, a total of 1,114 hospitals have been de-empanelled, and 549 hospitals have been suspended under AB-PMJAY”, the Minister said, adding, “NAFU deployed 57 different technologies including rule-based triggers and Machine Learning algorithms, fuzzy logic, image classification, and de-duplication, etc. to identify misuse/abuse cases”.
Other technologies and interventions such as enhanced access controls to the NHAIT system, near real-time dashboards to highlight suspicious cases, regular monitoring and cleansing of databases, and other data analytic techniques are also deployed to make AB-PMJAY.
  Share This News with Your Friends on Social Network  
  Comment on this Story  
 
 
 
Early Times Android App
STOCK UPDATE
  
BSE Sensex
NSE Nifty
 
CRICKET UPDATE
 
 
 
 
 
 
 
 
   
Home About Us Top Stories Local News National News Sports News Opinion Editorial ET Cetra Advertise with Us ET E-paper
 
 
J&K RELATED WEBSITES
J&K Govt. Official website
Jammu Kashmir Tourism
JKTDC
Mata Vaishnodevi Shrine Board
Shri Amarnath Ji Shrine Board
Shri Shiv Khori Shrine Board
UTILITY
Train Enquiry
IRCTC
Matavaishnodevi
BSNL
Jammu Kashmir Bank
State Bank of India
PUBLIC INTEREST
Passport Department
Income Tax Department
JK CAMPA
JK GAD
IT Education
Web Site Design Services
EDUCATION
Jammu University
Jammu University Results
JKBOSE
Kashmir University
IGNOU Jammu Center
SMVDU