Pvt hosp inflates bill, tampers with reports

Rajkot: A paediatric hospital in Rajkot has been fined Rs 6.54 crore for committing irregularities under the Pradhan Mantri Jan Arogya Yojana (PMJAY) scheme in case of 116 patients. The hospital, Nihit Babycare, had tampered with medical reports and submitted inflated bills to the health department for approval.
An investigation conducted by the health department over 45 days uncovered the irregularities conducted by Dr Hiren Mashru, who runs the hospital on Laxmi Nagar Main Road.According to the district health authority, the modified reports for 116 patients had been sent for approval with a total claim amount of Rs 65.47 lakh.
The penalty notice was issued Friday, with a fine of Rs 6.54 crore, which is ten times the claim amount of Rs 65.47 lakh. The hospital has been debarred from the PMJAY scheme and now faces de-registration. The doctor may also lose his licence to practise.
“The hospital tampered with the lab reports and x-ray reports. A committee in Gandhinagar approves the package based on these reports. The hospital had admitted 524 children since July last year. We found evidence of irregularities in the case of 116 children during our investigation,” said Dr P K Singh, in-charge chief district health officer.
The district health team began their investigation after detecting anomalies. According to standard procedure, doctors are required to send lab reports and x-rays to justify the patient’s diagnosis. Under the PMJAY scheme, a patient is eligible for free treatment up to Rs 10 lakh, with specific packages designed for various diseases.
But Dr Mashru, said officials, admitted children to the NICU for extended periods by tampering with the lab reports to garner more funds. The health department team verified the records of all 524 children by visiting laboratories, gathering test reports, and matching those with the ones that the hospital had submitted for claims. It was alleged that the reports were manipulated on the computers at the hospital.