The PM-JAY (Prime Minister Jan Arogya Yojana) under Ayushman Bharat is the largest health assurance scheme in India, providing Rs. 5 lakhs health cover to 12 crore poor and vulnerable families without any premium.
Some private hospitals are making efforts to attract these patients, as the payment is already guaranteed. At times, they even provide unnecessary treatments in order to secure the payment.
A recent scam involving private hospitals has come to light, where agents from private hospitals are targeting patients admitted in government hospitals with PM-JAY cards. These agents lure patients to leave government hospitals and admit them into private hospitals by hard-selling the benefits of private treatment.
The patients, who are often from poor, vulnerable families and rural areas, are easy targets for these agents, especially as many of them are illiterate.
They are convinced to shift to private hospitals with attractive offers, such as an air-conditioned room. It has also been reported that some of these private hospitals are carrying out unnecessary treatments, as the payments are already assured.
To combat this, Mehsana Civil Hospital in Gujarat’s Mehsana district has appointed two special bouncers. Their job is to identify these marketing agents from private hospitals and remove them from the hospital premises.
They are also tasked with informing the authorities so that appropriate action can be taken against the agents marketing within government hospitals.
Hospital authorities have stated that this is a test appointment, and if it proves successful, they will appoint ten such bouncers.
It should be noted that just two weeks ago, a massive scam by a private hospital was uncovered in Ahmedabad.
Khyati Hospital was found to be illegally organising camps in villages, performing angiographies and angioplasties on patients with PM-JAY cards, even when the procedures were unnecessary.
The hospital is believed to have collected over Rs. 27 crore from PM-JAY for 700 operations performed over several months. Some doctors and staff members have been arrested, while the owners remain absconding. Over ten patients have died as a result of surgeries they did not need.
PM-JAY is a fantastic scheme that benefits 40% of the country’s population, amounting to 55 crore beneficiaries. However, some private hospitals have found loopholes in the scheme and are exploiting them by taking advantage of innocent poor people.
Some government officials are also suspected of being involved in the scam, as they are believed to be passing the claims quickly without questioning them. The police are currently investigating this aspect of the case.
It is expected that more government hospitals will adopt the practice of deploying bouncers as they become aware of the issues happening within their premises.
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