The recent report by the Comptroller and Auditor General (CAG) regarding the Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana, presented in Parliament this week, highlights some astonishing and significant figures.
As per a report by FIT Quint, the report reveals that around 750,000 beneficiaries were associated with an invalid mobile number, specifically 9999999999.
Moreover, the CAG identified 4,761 registrations that were linked to only seven Aadhar numbers, indicating potential irregularities.
Additionally, the audit found instances of hospitals that were absent from the list of facilities registered under the public health insurance scheme.
In an interview with FIT Quint, Srinivas Kodali, a researcher specializing in data, governance, and the internet, as well as Shweta Mohandas, a policy officer at the Centre for Internet and Society. They also consulted with a public health expert in order to gain a deeper understanding of the matter.
Verifying one Unique ID for multiple beneficiaries: What’s the process?
When an individual visits a hospital to access the advantages offered by the Ayushman Bharat scheme, they are required to present their Aadhar card, which is then utilized to verify the patient’s eligibility.
“AB-PMJAY identifies the beneficiary through Aadhaar identification wherein the beneficiary undergoes the process of mandatory Aadhaar based e-KYC. The details fetched from the Aadhaar database are matched with the source database and accordingly, the request for Ayushman card is approved or rejected based on the beneficiary details,” an unnamed official told news agency PTI.
As per the CAG audit findings, approximately 4,761 enrollments were recorded using only seven Aadhaar numbers in Tamil Nadu.
Mint could not independently confirm the development.
In the 2019 report, concerns were raised regarding the absence of publicly accessible data related to the “most conducted surgeries.” This raised suspicions that hospitals might engage in fraudulent activities by conducting surgeries that are financially advantageous for them.
Were dummy numbers employed by hospitals for monetary claims?
Srinivas Kodali suggests that there might be indications of a potential ‘fraudulent activity’ by private hospitals within the nationwide public health insurance scheme. The report highlights instances where ₹1.1 crore was disbursed for 403 patients who were supposedly deceased, FIT Quint reported.
“It’s possible that many of the 7.5 lakh people who registered 9999999999 as their number don’t exist and the hospitals used these dummy numbers to claim money from the government. There are so many missing hospitals enrolled in the Ayushman Bharat scheme.”
The report from 2019 also raised concerns about the absence of publicly accessible information concerning the surgeries that are most frequently conducted. This observation implied the potential for hospitals to engage in fraudulent practices by prioritizing surgeries that yield financial gains for them.