The Comptroller and Auditor General of India (CAG) has flagged The Centre’s ambitious Ayushman Yojana in Madhya Pradesh for serious irregularities just before the MP election 2023. The Pradhan Mantri Jan Arogya Yojana (PM-JAY), also known as Ayushman Bharat, was launched to provide a defined benefit cover of Rs 5 lakh per family to 50 crore people, Including 10.74 crore poor families from both rural and urban areas.
In addition to increasing access to quality and affordable healthcare and medication, the Union Government states that it will address the unmet needs of the population such as timely treatments, improved health outcomes, patient satisfaction, and increased productivity and efficiency through this scheme.
In August this year, Shivraj Singh Chauhan decided to expand eligibility for this scheme from 1.08 crore Madhya Pradesh families to 40 lakh additional families. Following this decision, the total number of beneficiaries under the Ayushman Bharat Scheme will reach 1.48 crore. Concurrently, officials have verified and issued Ayushman cards for over 23 crore beneficiaries to receive free treatment under the scheme in the country.
MP’s Ayushman Yojana Scam
In the CAG’s pan-India audit report, Madhya Pradesh has the highest number of cases of irregularities. The audit discovered that over 1.1 crore was paid to approximately 403 patients who had been declared “dead” in the database. “8,000 patients were shown to be hospitalised at multiple hospitals across the state during the same period”, according to the report.
The audit names 24 state hospitals, including a government hospital, where occupancy was much higher than actual bed strength. The audit stated, “The Madhya Pradesh health authority paid the full amount for both claims as against the prescribed rate of 50% payment on the second claim.”
Many suspicious cards and information about the registration of dead people as beneficiaries have also been noticed in Madhya Pradesh.
According to the CAG report, approximately 25 hospitals in Madhya Pradesh have more beds than capacity. This means that these hospitals made claims by admitting more patients. Jawaharlal Nehru Cancer Hospital and Research Centre had 100 beds until March 20, 2023, but it was shown to have 233 patients.
The CAG report states that Madhya Pradesh has the lowest recovery rates from defaulting hospitals. In Madhya Pradesh, authorities have yet to recover up to 96 percent of fraudsters.
MP holds most Ayushman Yojana cards
Under the Pradhan Mantri Ayushman Yojana, Madhya Pradesh has the highest number of Ayushman card holders. This is where the most carelessness can be found.
According to the CAG report, complaint redressal committees for Ayushman were not formed at the district level in Madhya Pradesh. The Ayushman Yojana had an information, education, and communication plan, but it was never implemented. The Ayushman Bharat scheme identifies the beneficiary using Aadhaar, and the person is verified using mandatory Aadhaar-based e-KYC.
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