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Ayushman Bharat: Show-cause Notices To Five Hospitals Over Irregularities, Health News, ET HealthWorld

SHA
) has issued show-cause notices to five hospitals including two private medical colleges for violations of the memorandum of understanding with it and the National Health Agency under PMJAY-Ayushman Bharat.
The notices were issued after an audit of these hospitals was carried out by SHA teams between March 4 and 6. In their notices, accessed by, SHA has provided hospital-wise listing of violations found by audit teams.
The hospitals have overcharged patients and even extracted cash from them. This cannot be done. I have inspected one hospital, which is on radar, today and would do rest in coming days, CMHO Dr BS Saitya , Index Hospital said.
The SHA audit team found that hospital was carrying out ghost billingit had shown 345 patients undergoing treatment but headcount showed just 76. It was also transferring patients to ICU not requiring such treatment for financial gains. OPD patients were being converted to in-patient department ones; no mandatory clinical records were maintained and same photos and documents were used in multiple claims.
We have submitted reply to the notice. It is not a big deal. The scheme implementation is going on as usual: Dr Suresh Bhadoria, Chairman, Sri Aurobindo Institute of Medical Sciences.
The audit team found that hospital had converted eligible Ayushman beneficiaries from cashless to cash payment-ones by not enrolling them under the scheme and without taking their informed consent. They charged money from Ayushman patients for consumables and materials already covered under the scheme.
The notice has been issued without knowing proper facts. I have submitted the reply to SHA, health commissioner in this regard. The SHA needs to pay Rs 42 crore pending with them: Dr Vinod Bhandari, owner, Anand Hospital.
The hospital was found admitting patients when not required and treating them in ICU, when they could have been treated in a routine ward. They even charged unauthorised money for consumables covered under Ayushman. The hospital was also found not having a fire exit and fire NOC, Ayushman kiosk and Ayushman mitra.
We have submitted reply to SHA notice on mail. The hospital has been NABH accredited for four years. There are no irregularities in implementation of Ayushman scheme: Dr Arun Chopra, Medical Director, Retina Speciality Hospital.
As per the audit team, the hospital had raised 184 pre-authorisations on the day of audit but only four patients were present there while it has bed strength of just 13. The hospital does not have a bill register, refund register and it does not serve food to patients.
There is nothing like irregularities in providing treatment to patients under the scheme. SHA helps in interpreting guidelines and we have been doing the work under the scheme for years: Dr Gautam Patidar, Centre Head, Gokuldas Hospital.
The hospital was found charging money for pre-authorisation periods from patients. The guidelines mandate that hospitals bear all expenses including diagnostic and consultive till seven days prior to pre-authorisation of the patients. The hospital also did not enrol patients under Ayushman scheme and charged money from them for treatment under the scheme.
We have submitted reply to SHA. These are not major irregularities. The SHA hasnt paid dues for the last six months. So, they come up with this audit: Dr Sanjay Gokuldas, owner, MP SHA is the nodal agency for implementation of PMJAY-Ayushman Bharat Scheme.
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Wednesday, March 22, 2023 at 5:45 am

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