Gujarat Cracks Down on Irregularities in PM-JAY Scheme: 5 Hospitals Suspended

Ahmedabad : In a decisive move against malpractice, the Gujarat health department has suspended five hospitals and two doctors from the Pradhan Mantri Jan Arogya Yojana (PM-JAY) and Maa Yojana for large-scale irregularities. The action underscores the state government’s zero-tolerance policy toward unethical practices under schemes designed to provide free healthcare to the underprivileged.

The State Anti-Fraud Unit (SAFU), in collaboration with a team of expert doctors, conducted thorough inspections of hospitals suspected of irregularities between December 2 and December 8. The investigations uncovered fraudulent activities, including tampered lab reports, lack of infrastructure, and violations of scheme guidelines, prompting immediate action.

Hospitals and Doctors Facing Suspension

The five hospitals suspended include:

Hir Children’s Hospital, Patan:

SAFU discovered tampering in 91 lab reports during pre-authorization, with inflated packages billed for neonatal care. Both the hospital and its on-duty doctor, Dr. Hiren Patel, were suspended. Additionally, Health Spring 24 Pathology Laboratory, associated with the hospital, faced suspension. The hospital was penalized Rs. 50.27 lakh and ordered to refund the amount.

Nishka Children’s Hospital, Patan:

A total of 60 lab reports were either unavailable or tampered with. As a result, the hospital and its on-duty doctor, Dr. Divyesh Shah, were suspended. Shiva Diagnostic Laboratory, linked to the hospital, was also suspended. The hospital faced a penalty and recovery of Rs. 15.16 lakh.

Sonal Hospital, Dahod:

The hospital was found lacking manpower, infrastructure, and infection control measures as per scheme guidelines. This led to its suspension from the PM-JAY scheme.

Centara Orthopedic Hospital, Ahmedabad:

The hospital’s 4th and 5th floors operated without proper permissions and lacked essential facilities, including a modular operation theater and adequate staffing. It was suspended until compliance with guidelines is ensured.

Shri Jalaram Children’s Hospital, Aravalli:

The hospital’s fire safety certificate had expired, and its neonatal intensive care unit (NICU) failed to meet prescribed guidelines. It remains suspended until these deficiencies are addressed.

Ongoing Audits and Future Guidelines

The SAFU team is intensifying its scrutiny of hospitals across the state, verifying records and ensuring compliance with scheme guidelines. Any additional violations discovered will result in similar action.

The Gujarat government is also drafting new Standard Operating Procedures (SOPs) for treatment protocols under the PM-JAY scheme, covering critical areas such as cardiology, radiology, chemotherapy, and neonatal care. These guidelines, expected to be announced soon, aim to prevent further malpractice and enhance the scheme’s effectiveness.

Commitment to Patient Welfare

Since January 2024, the Gujarat health department has suspended 12 hospitals for violating PM-JAY guidelines. The state government remains steadfast in its commitment to providing free and quality healthcare to the poor and middle-class citizens of Gujarat.

State Health Department officials emphasized the importance of safeguarding the integrity of the PM-JAY scheme. “We will not tolerate inhumane activities by hospitals and doctors exploiting this scheme for financial gain. Strict actions will continue against those found guilty,” an official stated.

Strengthening Oversight

To curb fraud and ensure accountability, the Gujarat health department is bolstering its oversight mechanisms. This includes closer collaboration between the railway administration and forest trackers, regular audits, and stricter penalties for violators.