The Rajasthan Government Health Scheme (RGHS) is undergoing significant reforms. Chief Minister Bhajan Lal Sharma and Medical Minister Gajendra Singh Khimsar initiated a stringent crackdown on RGHS fraud. Consequently, the state government is taking decisive action against hospitals, pharmacy stores, and personnel engaged in irregularities within the scheme.
Actions Taken Against RGHS Fraud
Authorities have filed FIRs against one hospital and three pharmacy stores. They have also sent letters recommending action for 473 personnel across five departments. Disciplinary proceedings are recommended against eight allopathic and two ayurvedic doctors. Furthermore, authorities suspended twelve employees, including two doctors, for various scheme irregularities.
Investigation and Findings in RGHS Irregularities
Gayatri Rathore, Principal Secretary of the Medical and Health Department, revealed persistent complaints about widespread RGHS irregularities. These complaints triggered thorough investigations and an audit by the Finance Department. Based on these audit findings, FIRs were registered against operators of Shivam Drug Store (Churu), Guru Kripa Hospital and New India Medical Store (Sikar), and Shop No. 3 of Nagaur Cooperative Marketing Society Limited (Merta, Nagaur).
Harji Lal Atal, CEO of the Rajasthan State Health Assurance Agency, confirmed they sent letters to several departments. These include Education (Primary and Secondary), Medical & Health, Home, Jaipur Discom, and Ayurved. These letters detail allegations that 473 employees misused Ayurvedic treatments like Panchakarma/Shirodhara unnecessarily. They allegedly colluded with medical stores to create fake prescriptions. Furthermore, employees from various departments were suspended for misusing the scheme. They obtained treatment for tenants under the guise of family members or friends. Two Ayurvedic doctors reportedly prescribed medicines without examination. Eight allopathic doctors were also found writing unnecessary and fake prescriptions.
New Anti-Fraud Measures for RGHS
The RGHS scheme’s operation recently transferred to the Medical and Health Department. Subsequently, Minister Gajendra Singh Khimsar mandated strict action against all stakeholders involved in irregularities and fraud. He underscored the vital need for transparency, financial strength, and institutional restructuring within the scheme. He also directed technical strengthening for better oversight.
To strengthen the scheme and combat RGHS fraud, new comprehensive guidelines and a Standard Operating Procedure (SOP) are being prepared. A foolproof system is under development, which includes forming an Anti-Fraud Unit. This unit will comprise experts in IT, claim audit, medical audit, and surveillance. Additionally, a Grievance Redressal Cell will be established for rapid complaint resolution. A centralized complaint resolution centre will operate at the state level. It will be supported by an online complaint tracking system. At the district level, similar complaint redressal units will also be created.
Suspicious doctors, pharmacies, and hospitals are now under close monitoring. If fake prescriptions or bills are discovered, the beneficiary’s membership may be suspended or cancelled. Technological measures, such as e-prescription, e-billing, and real-time monitoring, have been introduced. Regular audits and surprise inspections are also being conducted. Guilty hospitals and pharmacy stores will be removed from the scheme. Legal action will also be pursued in the future.
Frequently Asked Questions
Q1: What actions is the Rajasthan government taking against RGHS fraud?
The Rajasthan government is filing FIRs against fraudulent entities, suspending employees, and recommending disciplinary action against doctors. They are also implementing new anti-fraud measures like an Anti-Fraud Unit and e-prescriptions.
Q2: Who is leading the crackdown on RGHS irregularities?
Chief Minister Bhajan Lal Sharma and Medical Minister Gajendra Singh Khimsar initiated the crackdown. Principal Secretary Gayatri Rathore and Rajasthan State Health Assurance Agency CEO Harji Lal Atal are also overseeing the actions.
Q3: What new measures are being implemented to prevent future RGHS fraud?
New measures include developing comprehensive guidelines and SOPs, forming an Anti-Fraud Unit, establishing a Grievance Redressal Cell, introducing e-prescription and e-billing, and conducting regular audits and surprise inspections.
References
- Rajasthan cracks down on RGHS fraud; FIRs, suspensions, and new anti-fraudmeasures launched – ETHealthworld
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