The incidences of forgery and false claims are contributing to bleed the Atal Ayushman Uttarakhand Yojana (AAUY), the flagship health insurance scheme of Trivendra Singh Rawat Government. On Monday, the state health authority, spearheading the AAUY, removed Jaspur Metro hospital, Udham Singh Nagar from its panel. It also slapped a penalty of Rs 4.17 Lakh on the hospital which it had to deposit in seven days. The authority is also planning to lodge FIR against the hospital for forgery, betrayal and criminal conspiracy. AAUY officials were shocked when they found that the hospital sought claim for surgery and treatment of 26 patients without necessary pre authorization.
In some cases, the pre -authorisation was done after the patients were discharged from the hospital. Apart from these irregularities, this hospital charged money from 15 patients whom it would have provided free treatment. The hospital also claimed the cost of treatment of these patients under AAUY.
On investigation the authorities found that a total 67 patients were treated in the hospital till April 16,2019 and out of them 18 patients were treated on referral slip of Community Health Centre (CHC) of Jaspur. In many cases it was found that to refer the patients from government hospitals, the patients suffering from non serious ailments were referred under emergency.
The director administration, AAUY, Dr Abhishek Tripathi said that the seven charges were against the hospital on which notice was sent to the hospital. He said that the hospital didn’t replied to the notice despite the fact that sufficient time was granted to it. Dr Tripathi said that all charges against hospitals have been found to be true.
AAUY was launched amid much fanfare, on December 25, 2018 by the chief minister Trivendra Singh Rawat. In the scheme, the Uttarakhand CM provided a health insurance cover of Rs 5 lakh per annum to all 23 lakh families of Uttarakhand in the empanelled hospitals. Incidentally Uttarakhand is the only state where all families are under the health insurance umbrella of the state government. In AAUY the patients can avail benefit of the scheme for 1350 types of diseases in the empanelled hospitals.
