Health Ministry Defends PMJAY As CAG Audit Exposes Multiple Frauds

Relevance: GS 2 - Powers, functions and responsibilities of various Constitutional Bodies; Government policies and interventions for development in various sectors and issues arising out of their design and implementation.

(Source: The Hindu, 08/10/23)

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Why in the news?

• Recently, the CAG’s performance audit report was tabled in the Lok Sabha noted multiple irregularities in Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana (PMJAY)
• The report noted irregularities such as providing treatment for patients who had already been declared dead, as well as for thousands of people using the same Aadhaar number or invalid mobile phone number.

What are the multiple irregularities exposed by the CAG Audit?

• Fake phone numbers: The CAG report highlighted instances within the PMJAY beneficiary database like the usage of fake phone numbers.
• For instance phone numbers like 9999999999 and 8888888888 were used in registration.
• Multiple beneficiaries linked to same Aadhaar: There were instances of multiple beneficiaries being linked to a single Aadhaar number, for instance, in For example, Tamil Nadu where 4,761 registrations were made against just seven Aadhaar numbers.
• Fraudulent database errors: The CAG report revealed that patients previously declared deceased continued to receive treatment under PMJAY.
• Data analysis in the Transaction Management System showed 88,760 patients died during specified treatment, yet 2,14,923 claims were paid for fresh treatment related to these patients.

Other irregularities

• Pending Penalties and Unauthorized Procedures
• Spending on ineligible beneficiaries
• Delays in Processing of Rejection Cases
• Systemic issues such as shortages of infrastructure, equipment, and doctors at empanelled hospitals, as well as cases of medical malpractice.

What are the steps taken by the government to address irregularities?

• Changes in IT portal: Necessary changes have been made in the current IT portal used by the National Health Authority (NHA) to capture only valid mobile numbers, in case the same is possessed by the beneficiary
• Introduction of Enhanced Verification Methods: The National Health Authority (NHA) introduced three additional beneficiary verification methods: fingerprint, iris scan, and face-authentication, in addition to OTP. Fingerprint-based authentication is the widely adopted choice.

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FAQs

MCQ

A question can be asked on the scheme, similar to the one given below

Question: With reference to ‘Pradhan Mantri Fasal Bima Yojana’, consider the following statements:

1. Under this scheme, farmers will have to pay a uniform premium of two percent for any crop they cultivate in any season of the year.
2. This scheme covers post-harvest losses arising out of cyclones and unseasonal rains.

Which of the statements given above is/are correct?

(a) 1 only

(b) 2 only

(c) Both 1 and 2

(d) Neither 1 nor 2