A doctor couple in Madhya Pradesh has been charged with cheating and forgery over allegations that they were running a racket to claim huge sums under the Ayushman Bharat health insurance scheme.
Dr Ashwini Pathak and Dr Duhita Pathak own the Central India Kidney Hospital in Jabalpur. It is alleged that they lodged about 70 Ayushman Bharat health card holders to a hotel next to the hospital. There was no link between their symptoms and their diagnosis in the hospital’s records, a preliminary probe has found.
The couple has been charged under sections relating to forgery and cheating, senior police officer Gopal Khandel has said. Dr Ashwini Pathak has been taken into custody.
Around 70 Ayushman Bharat scheme beneficiaries being treated not in a hospital but in a non-operational hotel without proper facilities in Jabalpur. In many rooms, two patients were being treated on one bed. The hotel cum hospital was sealed on Sunday @email@example.com/uvJ1pP4eQ8
— Anurag Dwary (@Anurag_Dwary) August 29, 2022
Mr Khandel said there are allegations that the couple would get Ayushman health card holders admitted, pay them a small sum and claim huge amounts from the government under the health insurance scheme.
Under the scheme, an annual health cover of Rs 5,00,000 is provided to each family for secondary and tertiary-care hospitalisation.
Jabalpur police chief Siddharth Bahuguna said they had received information that some Ayushman card holders had been admitted to Vega Hotel, although they were not seriously ill.
Police and health department officials then conducted a raid and found 70-odd people lodged at the hotel, which has been shut since the Covid pandemic struck. The hotel is run by the doctor couple’s son.
Most of those lodged at the hotel were from neighbouring districts such as Damoh and their medical records showed they were being treated at the hospital next door. On many beds, two patients had been accommodated.
The hotel has now been sealed on the orders of the district administration.
Denying the allegations, Dr Ashwini Pathak said: “It’s not a hotel anymore, we are running a 100-bed medical facility there after taking permission from the district hospital. We are not charging a single rupee from the Ayushman Bharat card holders.”
The doctor’s claim was refuted by Additional District Magistrate Namah Shivay Arjaria. “Central India Kidney Hospital admitted fake patients in Vega Hotel. Though the hotel has been sealed, certain medical facilities being run at the hotel, such as the CT scan centre, have not been shut for the benefit of the patients.”
Dr Sanjay Mishra, the district’s Chief Medical Officer, said: “Not only was the medical facility being run without permission from the Health Department, there was also an illegal CT scan centre in the hotel’s basement.”
According to a report submitted by Dheeraj Dabde, nodal officer for Ayushman Bharat in Jabalpur, ten ‘patients’ were found in the hotel rooms and were kept under observation at 5 pm last Friday. However, at 9.30pm, not a single patient was found on that floor and all rooms were locked.
According to an initial report filed by the Health Department, there was no link between the diagnosis mentioned in the hospital’s records and the symptoms reported by the patients.