Rajasthan is taking strong action against fraud under the Rajasthan Government Health Scheme (RGHS) with a series of FIRs, suspensions, and new anti-fraud initiatives. The state has filed FIRs against multiple hospitals and pharmacies for irregularities, including fake prescriptions, and launched a comprehensive review of stakeholders involved in the scheme. Chief Minister Bhajan Lal Sharma and Health Minister Gajendra Singh Khimsar are overseeing the crackdown, ensuring transparency and improved regulatory compliance.

Key highlights

FIRs and suspensions for fraud under RGHS

• FIRs filed against three pharmacy stores and one hospital in Churu, Sikar, and Nagaur.

• 473 personnel across various departments are under investigation, with disciplinary action recommended against 10 doctors.

• 12 employees, including 2 doctors, have been suspended for misuse of the scheme.

Specific fraud activities uncovered

• Misuse of Ayurvedic treatments like Panchakarma/Shirodhara for non-medical reasons.

• Collusion between medical stores and personnel to create fake prescriptions.

• Misuse of the scheme for non-entitled individuals, including fake treatment claims for family members and tenants.

Technology-driven measures for transparency

• A new Anti-Fraud Unit will oversee medical audits, IT surveillance, and claims review.

• A comprehensive SOP and guidelines are being developed to streamline processes.

• E-prescription, e-billing, and real-time monitoring systems have been introduced for accountability.

Grievance redressal and complaint resolution systems

• A centralized complaint resolution system will be set up at the state level.

• District-level units for grievance redressal will also be established for faster complaint processing.

• Hospitals and pharmacies found guilty of fraud will be removed from the RGHS and face legal action.

The crackdown on fraudulent activities within the RGHS marks a significant step in reforming Rajasthan’s public healthcare system. The introduction of technology-driven monitoring, alongside rigorous audits and surprise inspections, ensures a more transparent, accountable, and efficient scheme. This comprehensive action aims to safeguard public trust and strengthen the integrity of government health schemes in the state.