Acting on the reports and complaints of discrepancies regarding the implementation of AB-Sarbat Sehat Bima Yojna (SSBY), Punjab’s State Anti-Fraud Unit has issued 77 show-cause notices to 63 erring hospitals.
“SAFU was directed to actively monitor, pursue any instance of fraud or irregularity observed under the AB-SSBY and take stringent action on every erring entity,” said the state Health and Family Welfare Minister Balbir Singh Sidhu on Thursday.
The Minister said that Punjab’s State Health Agency’s (SHA) Chief Executive Officer Amit Kumar, who is also SAFU Committee chairman, informed that 77 show cause notices have been issued so far to the hospitals and penalty amount of Rs 27,67,358 has been recovered from various hospitals, while 14 hospitals have been de-empanelled and nine have been temporarily suspended.
Besides, 24 hospitals have been issued warning letters, while seven hospitals have also been issued advisories, added the Minister.
Giving details about major discrepancies made by hospitals, Sidhu said that State SAFU team have cracked wrong referral cases, money taken cases from beneficiaries for medicines and treatment by the empanelled hospitals, claiming money for ICU wards whereas the patient was
admitted in the general ward, claiming money for the bilateral surgical procedures whereas the unilateral procedure was performed, denial of cashless treatment by the empanelled hospital to the beneficiaries and more than one surgical package claimed during a single hospitalization.
To avail the easy access of secondary and tertiary treatment services under the SSBY, the Minister said that the Punjab Government has also established the District Anti-Fraud Units (DAFU) in all districts to check these types of deceits.
“DAFU has been directed to take immediate action, if any health establishment under ABSSBY is found to indulge in fraudulent means.
After a thorough investigation, concerned DAFU puts up the case to the State Anti Fraud Unit for further action,” he said.
“To reduce the financial burden of people, Punjab Government is vigorously working to cover all patients and around 828 hospitals have been empanelled across the State,” he said, adding that the Government has also established District Grievances Redressal Committees for redressal of grievances of beneficiaries.