Nashik: Three Hospitals Booked For ₹1.79 Crore Health Scheme Fraud; Fake Treatment Claims Under Scanner
· Free Press Journal
Nashik: A major alleged financial fraud has surfaced in government-funded healthcare schemes meant to provide free and quality medical treatment to poor and needy patients. Three private hospitals in Nashik have been accused of fraudulently claiming around ₹17.943 million (₹1.79 crore) by submitting fake treatment claims in the names of patients who allegedly never received the services. Following a complaint by the Public Health Department, the Worli Police in Mumbai have registered a case against five office-bearers associated with the three hospitals.
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According to the police, action has been initiated against Shiv Multispeciality and Critical Care Hospital, Nashik Grace Hospital, and Rishikesh Hospital. The complaint was filed by the Deputy Secretary of the Public Health Department. Alleged misuse of government health schemes
Bills under the Ayushman Bharat–Pradhan Mantri Jan Arogya Yojana (PM-JAY), the Mahatma Jyotirao Phule Jan Arogya Yojana (MJPJAY), and other government health schemes are processed through Jeevandayee Bhavan in Worli, Mumbai. After suspicion arose over certain claims, the state government ordered a detailed audit of claims submitted through the Jeevandayee portal.
The investigation identified 361 suspicious claims from Nashik. Further scrutiny allegedly revealed that several bills had been approved by falsely showing that treatments had been provided, even though no actual treatment had taken place.
Forged documents and false information
According to the Public Health Department, fake patient records were created using beneficiaries' documents. Forged documents and misleading information were allegedly uploaded to the portal to obtain reimbursement from the government for treatments that were never provided.
The alleged fraud uncovered during the inquiry includes:
Shiv Multispeciality and Critical Care Hospital: 163 cases, ₹71.83 lakh
Nashik Grace Hospital: 126 cases, ₹62.14 lakh
Rishikesh Hospital: 72 cases, ₹45.46 lakh
Together, the three hospitals are accused of fraudulently claiming approximately ₹1.79 crore from government healthcare schemes.
Verification reveals shocking findings.
Officials conducted field verification of beneficiaries from Deola, Kalwan, and Dindori talukas. The inquiry reportedly found that several beneficiaries had never received treatment at the hospitals concerned. Some had actually been treated at other hospitals, while in certain cases, beneficiaries had died before the dates on which treatment was allegedly provided. Despite this, treatment claims were reportedly submitted, and government funds were sanctioned in their names.
Investigation underway
The case has raised serious concerns about transparency in the implementation of government healthcare schemes and the alleged misuse of beneficiaries' identities to siphon off public funds. The Worli Police have registered a criminal case and are continuing their investigation to determine whether more individuals were involved in the alleged fraud.