4 extra hospitals within the state have confronted motion as a part of the State Anti-Fraud Unit’s (SAFU) drive in opposition to alleged irregularities in hospitals empanelled beneath the Pradhan Mantri Jan Arogya Yojana —Mukhyamantri Amrutam (PMJAY-MA) scheme, a hybrid of the nationwide medical health insurance scheme beneath Ayushman Bharat and the Gujarat authorities.
With this, the variety of hospitals to have confronted motion as a part of the drive this monetary 12 months stands at 16.
The most recent hospitals to have confronted motion are Krishna Surgical Hospital and Swastik Multispeciality Hospital, each in Rajkot; Jayaben Modi Hospital in Bharuch; and Bankers Tremendous Speciality Hospital in Vadodara.
The Gujarat authorities started cracking down on alleged irregularities within the Ayushman Bharat scheme in gentle of the 2 main rackets coming to gentle this 12 months: the admissions of wholesome newborns at Nihit Babycare Youngsters Hospital in Rajkot and the dying of two males following alleged pointless angioplasty surgical procedures at Khyati Multispeciality Hospital in Ahmedabad.
Each the instances had stemmed from false claims made on the idea of tampered and solid medical data of sufferers, mentioned officers.
In the meantime, the well being division mentioned that the state authorities has ready new pointers (SOPs) for therapy beneath the scheme, together with for cardiology and cardiovascular surgical procedure, radiotherapy and neonatal care, that are slated to be declared shortly.
On Tuesday, an announcement from the well being division mentioned that SAFU, together with a group of skilled docs, visited hospitals suspected of committing irregularities beneath this scheme within the state.
Swastik Multispeciality Hospital, Rajkot
An audit was performed by the insurance coverage firm empanelled as a part of the scheme at Swastik Multispeciality Hospital in Rajkot. The insurer discovered tampering within the USG (Ultrasound Sonography) plates and HPE (Histopathological Examination) stories in a complete of 196 instances.
The hospital has been suspended from the scheme and motion may even be initiated in opposition to another hospitals related to this facility. Additional, a penalty of Rs 2.94 crore was imposed on the hospital as per the scheme pointers.
The hospital’s gynaecologist, Dr Rajesh Kandoriya, was blacklisted from the scheme.
Krishna Surgical Hospital, Rajkot
At this hospital in Upleta, rural Rajkot, the SAFU discovered a mess of issues, together with infrastructure, manpower and cleanliness. Not solely had the Constructing Use (BU) Certificates and Fireplace Security Certificates (FSC) of the hospital lapsed, it additionally didn’t have a certificates from the Atomic Vitality Regulatory Board (AERB) that’s required when X-ray tools is put in on the hospital.
Additional, the hospital was discovered missing in manpower as prescribed by the scheme, officers mentioned, including there have been points in An infection Prevention and Management (IPC) measures within the Intensive Care Unit (ICU).
Discrepancies have been additionally discovered within the info given by the physician within the OT word and anaesthesia word. The hospital has been thus suspended from the scheme until the time these defects are rectified, mentioned officers.
Jayaben Modi Hospital, Bharuch
The SAFU observed that officers at this hospital had uploaded the Tumour Board Certificates (TBC) within the software program by committing irregularities within the signature and stamps of authorities. Because of this, the hospital’s pre-authorisation claims price Rs 33.44 lakh will likely be recovered by the State Well being Company (SHA). A call relating to the penalty will likely be taken within the upcoming SGRC (State Grievance Redressal Committee).
Bankers Superspeciality Hospital, Vadodara
Officers investigating this hospital in Vadodara observed that the rules of the Ayushman Bharat scheme had been violated within the oncology surgical procedure packages. The hospital’s pre-authorisation claims price Rs 57.51 lakh will likely be recovered by the SHA whereas the penalty will likely be determined within the upcoming assembly of the SGRC.
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