MP medical news: Two private hospitals in Madhya Pradesh’s Jabalpur and Gwalior were suspended from the Ayushman Bharat’s Nirmayam scheme on Friday, after investigations revealed financial and procedural violations from there. The Madhya Pradesh state health agency carried out the action, on the basis of complaints and a probe report submitted by a third-party audit agency. 

Officials aware of the development said that the agency regularly reviews claims submitted by hospitals empanelled under the scheme to ensure compliance with regulations and transparency. 

Financial irregularities surface

During scrutiny of claims submitted by Jabalpur’s Life Medicity Hospital, the agency detected several serious procedural and financial irregularities. The investigation revealed that patients were admitted under incorrect categories and wrong treatment packages were applied to claim higher payments under the scene. 

Moreover, officials also found evidence of hospitals allegedly securing financial benefits by means of fraudulent practices. Notably, the hospital had earlier too faced financial penalties of Rs 46,99,990 for similar violations. Despite repeated warnings, when the irregularities continued, the hospital was suspended from the scheme. 

Gwalior’s Brahmani Hospital also meets the same fate

A similar probe was carried out into the claims submitted by Gwalior’s Brahmani hospital. As per the audit findings, the patients were portrayed as critically ill to secure higher payments under the scheme. Additionally, the claims were filed incorrectly, raising concerns of fraud. This hospital too had been levied a fine of Rs 21,08,300 for irregularities, and later the agency suspended it from the scheme, when it failed to comply with the norms. 

Health agency warns of strict action

The State Health Agency clarified that providing transparent and quality healthcare services to the beneficiaries is the top priority of the government. It underscored that any form of fraud or irregularity under the scheme shall not be tolerated. 

It is noteworthy that neither of the aforementioned hospitals received accreditation from the National Accreditation Board for Hospitals and Healthcare Providers (NABH), which is a serious lapse. Officials maintained that all empanelled hospitals under the scheme will strictly be monitored and action shall be taken if they are found to be flouting the rules.