Cracking Down on Healthcare Fraud: Ayushman Bharat's Zero Tolerance Approach

The Ayushman Bharat Health Insurance scheme has de-empaneled over a thousand hospitals and imposed heavy penalties to combat fraud. A robust mechanism is in place to detect irregularities, ensuring compliance. A grievance redressal system supports beneficiaries, while efficient claim settlements are prioritized.

In a significant move against healthcare fraud, the Ayushman Bharat Health Insurance scheme has delisted 1,114 hospitals and imposed penalties totaling Rs 122 crore on 1,504 errant facilities. This action was disclosed in a report to the Lok Sabha on Friday, reflecting the scheme's zero-tolerance policy on misuse.

Minister of State for Health and Family Welfare Prataprao Jadhav highlighted that Ayushman Bharat is governed on principles focused on preventing misuse. A National Anti-Fraud Unit has been set up to oversee this effort, with specific actions including hospital de-empanelment and financial penalties.

A multi-tier grievance redressal system is in place to assist beneficiaries. Each level, from district to national, is equipped with a dedicated nodal officer and committees to address issues swiftly. Claim settlements are continually improving, with guidelines ensuring payments are processed within a specified timeframe.

(With inputs from agencies.)