“27 claims were made by hospitals where the beneficiaries were already declared dead in their earlier claims," report said.
NEW DELHI: Alleging large-scale fraud in the veteran’s healthcare scheme, which caters to the families of over 24 lakh military pensioners, a top defence ministry official has submitted a report stating that the system has been abused to make fraudulent claims. There have also been attempts to process bills for beneficiaries declared dead.
A detailed 14-page report, accessed by ET, alleged that hospitals were overcharging patients, inflated bills were being passed and overpayment of Rs 94.42 crore were detected in January during a postaudit study. The report has recommended dismissal of the bill processing authority — another government-owned financial body — and has also sought an investigation into the issue.
“There is no need for further wait for higher corruption activities to take place since both the internal and external audit has pointed to severe corruption practice,” the letter by Additional Controller General Savitur Prasad addressed to several officials in the defence ministry, sent last month, read.
Shockingly, the report says that the audit has revealed that in several cases claims were made against the dead. “27 claims were made by hospitals where the beneficiaries were already declared dead in their earlier claims,” it read.
“The submission of claim for the already declared dead beneficiaries shows the gravity and intensity of the attempt to defraud the government,” the report states. The report also points to a CAG study that found inflated bills.
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“Hospitals have raised inflated bills in 37% of the cases…two different hospitals have raised bills for the same patient during similar or overlapping periods,” the report says, listing out several discrepancies.
The audit has also found at least 123 cases in which duplicate bills have been submitted, claimed and paid by the ex-servicemen contributory health scheme (ECHS) without being detected by the bill processing authority.
Among other charges made in the report are a suo motu increase in permissible service charges by ECHS, costs of items like stents, injections and medicines charged over the approved rates and claims of extended stay by hospitals that were against the rules.
Recommending an immediate dismissal of the bill processing authority for the discrepancies, Prasad has recommended that retired officials of the defence accounts department be deployed to process the ECHS work with immediate effect, as external consultants hired by the government.
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The ECHS is one of the government’s largest beneficiary schemes for veterans, with an annual budget of over Rs 2,400 crore. Over 24 lakh veterans and their families are entitled to healthcare in a number of private hospitals across the country under the scheme.
