Ayushman Bharat golden card fraud busted, 49 hospitals de-empanelled

LUCKNOW Over 1,400 fraudulently-made golden cards of the Ayushman Bharat scheme have been cancelled and 49 hospitals de-empanelled across the state after it was

LUCKNOW Over 1,400 fraudulently-made golden cards of the Ayushman Bharat scheme have been cancelled and 49 hospitals de-empanelled across the state after it was discovered that a feature ‘Add Member Facility (AMF)’, meant to add new members in the family, was misused to make these cards.

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Agra had maximum 704 such fraudulently-made cards, while Jhansi followed with 204 cases and Hapur with 177 cases. Lucknow reported seven such cases and all these cards were cancelled. What types of treatment was availed of with these fraudulently-made cards is under investigation, said an official.

“All 1,445 cards identified as bogus have been cancelled and measures are being taken to enhance screening of Ayushman Bharat scheme beneficiaries in the state,” said Sangeeta Singh, CEO of State Agency for Comprehensive Health Insurance and Integrated Services (SACHIS) that is monitoring the scheme in Uttar Pradesh.

As per the investigations findings, the golden cards were made with the help of fake documents, by adding bogus names in the original ration cards of the real beneficiaries.

The involvement of some hospitals is suspected and 49 hospitals have already been de-empanelled.

According to officials, doctored ration cards were used at Ayushman Bharat counters at hospitals, though Ayushman Mitras (volunteers) to get new bogus names added in the scheme.

This addition of names was done by misusing the AMF that actually existed to add names of new members of the family, like when a child is born or someone got married, to get Ayushman Bharat facility. AMF was misused in 1,445 cases, Singh said.

Sample this. If ‘A Kumar’ is the head of a family with four other members and is a beneficiary under Ayushman Bharat scheme, the ₹5 lakh per year benefit of cashless treatment will be divided in the family of five members, who individually have one golden card made in their names. Now after his ration card is used to add two more names of those who are actually not eligible to be Ayushman Bharat beneficiaries, the benefit of A Kumar’s family will be shared by seven-people and that, too, without the knowledge of Kumar.

There are 11.8 million families covered under the scheme, which means close to six crore people. As checking the documents of all these individuals is not possible a formula has been devised for verification -- if in one family there have been more than 10 AMF applications all will be cancelled.

“If this goes wrong and names of genuine members get deleted, the same shall be added when requested by the head of the family but this way we shall be able to filter majority incorrect/bogus names from the lists,” said Singh.

Two separate FIRs have been lodged in this connection in Jhansi and Azamgarh.

UNDER SCANNER

The monitoring agency is scanning those centres from where maximum names have been added. There is one ID that has added 196 names to various families and there are similar centres that have added multiple names. All such centres and Ayushman Mitras are under scanner. The official says that before action “we want to be sure about the offence and since all data is there on the server, scanning might take time but would be done.”