PMJAY Scheme for Patient Assistance Becomes a Profit-Making Tool for Hospitals in Gujarat
The PMJAY scheme, intended to provide free treatment to poor and middle-class patients, seems to have turned into a money-making tool for hospitals. The 2023 audit report by the Comptroller and Auditor General (CAG) on the PMJAY scheme revealed widespread irregularities in Gujarat hospitals.
Despite these extensive irregularities, the state health department took no significant action. The CAG report highlights a shocking finding: hospitals provided treatment to more patients than their bed capacity allowed. In the name of treatment, hospital administrators siphoned off millions of rupees from the government.
CAG Report of 2023 Reveals Irregularities: Treatment on Paper Only
The PMJAY scheme, which provides free treatment to poor patients, has been exploited by hospital administrators, who take advantage of the scheme as patients rarely question the treatment provided. The 2023 CAG report clearly mentions that auditors visited 50 different hospitals in Gujarat between January and March 2021.
During this period, significant irregularities were observed, with hospitals providing treatment to more patients than their bed capacity.
These 50 hospitals had a total of 2,552 beds, yet treated 5,217 patients on various dates. For instance, on March 8, 2021, Surendranagar’s Medico Multi-Speciality Hospital, with only 34 beds, treated 97 patients “on paper” for that day. Essentially, all treatments were recorded only on paper.
In Gujarat, there have been cases under the PMJAY scheme where patients were simultaneously admitted to multiple hospitals. It was found that 21,514 patients were receiving treatment at different hospitals at the same time. This clearly indicates that the scheme was being exploited.
According to the CAG report, by November 2022, Gujarat had disbursed a total of ₹3,507.72 crore, covering 1,412,311 cases. Despite these irregularities, the state health department paid millions to the hospitals. This further proves that the PMJAY scheme has become a profit-making tool for hospitals.
Hospitals Claim ₹3.66 Crore in Just Six Months under PMJAY Scheme
It has come to light that renowned hospitals have been making claims to the government under the PMJAY scheme, particularly for heart-related treatments.
One such hospital, Khyati Hospital, claimed ₹27,70,96,003 for 605 cardiology treatments under the scheme. In addition, within just six months, the hospital made claims amounting to ₹3.66 crore.
Khyati Hospital Claims ₹89.87 Lakh for 45 Heart Surgeries under PMJAY Scheme
Khyati Hospital has claimed ₹89,87,540 for 45 heart surgeries under the PMJAY scheme, including 380 angiographies, 220 angioplasties, and 36 bypass surgeries. Between June 1 and June 12, 2024, the hospital submitted claims for 650 cases to the Health Department.
It has been revealed that in 2021, the Health Department had de-empanelled Khyati Hospital due to irregularities. However, the hospital was later reapproved to provide treatment under the PMJAY scheme, raising questions about why it was allowed to continue receiving approvals despite previous issues.
