Worli Police File FIR in ₹1.79 Crore Health Scheme Scam

The Worli Police have registered a First Information Report (FIR) in connection with an alleged fraud involving ₹1.79 crore siphoned off from the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) and the Mahatma Jyotirao Phule Jan Arogya Yojana (MJPJAY) health schemes.

The complaint was lodged by Chandrakant Vibhute, Chief Executive Officer of the State Health Assurance Society, against the managements of three private hospitals in Nashik.

The accused hospitals, namely Shiv Multispeciality and Critical Care Hospital, Satpur, Nashik Grace Hospital, CIDCO, and Rishikesh Hospital, Gangapur Road, have been booked for allegedly cheating the government and misappropriating public funds.

According to the complaint, a verification of insurance claims by the State Health Assurance Society revealed that records of treatment provided to 361 patients were fabricated.

The accused allegedly misused beneficiaries' documents, created forged medical records, and uploaded false information on the Jeevandayee portal to obtain approval for online insurance claims.

The investigation found that Shiv Multispeciality and Critical Care Hospital allegedly received ₹71.83 lakh through 163 fake claims, while Nashik Grace Hospital allegedly obtained ₹62.13 lakh through 126 fraudulent claims. Rishikesh Hospital allegedly received ₹45.45 lakh through 72 fake claims.

An FIR has been registered against the founders, authorised signatories, and the concerned account holders of the three hospitals.

The Worli Police are also investigating whether a larger racket or other individuals were involved in the fraud.

The alleged scam has raised serious concerns over the misuse of government-funded healthcare schemes and has sent shockwaves through the health department.

The Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) and the Mahatma Jyotirao Phule Jan Arogya Yojana (MJPJAY) are government-funded health schemes aimed at providing affordable healthcare to economically vulnerable families.

The schemes have been successful in providing healthcare services to millions of people across the country. However, instances of fraud and misappropriation of funds have raised concerns about the implementation and monitoring of these schemes.

The Maharashtra government has taken steps to prevent such instances of fraud and has strengthened the monitoring and verification process for insurance claims.

The police investigation into the alleged scam is ongoing, and the accused hospitals and individuals are likely to face severe penalties if found guilty.

The case highlights the need for stricter monitoring and implementation of government-funded healthcare schemes to prevent the misuse of public funds.

It also underscores the importance of ensuring that beneficiaries receive genuine healthcare services and that the schemes are not exploited for personal gain.

The Maharashtra government and the health department will be closely watching the investigation and will take necessary steps to prevent such instances of fraud in the future.

The alleged scam has also raised questions about the accountability of private hospitals and the need for stricter regulations to prevent the misuse of government-funded healthcare schemes.

The Worli Police and the State Health Assurance Society will continue to investigate the case and will take necessary action against those found guilty of fraud and misappropriation of public funds.