Jaipur: The health department Friday reported major action against irregularities in the Rajasthan Govt Health Scheme (RGHS), suspending 34 hospitals and 431 pharma stores over the past three months. The department also suspended 28 govt employees and registered 17 FIRs for misuse of the scheme.
Officials said multiple complaints were received about hospitals, medical stores and govt employees engaging in fraudulent practices that harmed the scheme’s functioning. A special audit and intensive investigation were conducted, following which strict action was taken against all entities found prima facie guilty.
An Anti-Fraud Cell has now been set up to curb future violations, and a new SOP will soon be issued to strengthen monitoring, health minister Gajendra Singh Khimsar said.
According to the report, the RGHS office increased surveillance in recent months to protect the treasury and ensure smooth functioning of the scheme. During this period, cases surfaced of private hospitals, approved pharma stores and even beneficiaries availing benefits through improper and rule-violating methods, causing substantial financial losses.
Principal secretary (health) Gayatri Rathore said 34 hospitals were suspended after being found involved in practices such as raising double claims for a single surgery, conducting unnecessary tests and billing higher-rate test packages instead of lower-rate available options. Penalties amounting to Rs 36 crore have been recovered from these hospitals so far.
Similarly, 431 pharma stores were suspended for issuing fake bills and misusing RGHS benefits through collusion between pharmacists, doctors and beneficiaries. The department recovered Rs 4.6 crore in penalties in these cases. More than 1,000 RGHS beneficiary cards used in fraudulent claims have also been blocked, while 28 employees involved in misuse have been suspended.
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