Health officials inquiring into the alleged irregularities in insurance claims found that some doctors at a private hospital in Kanpur had issued fake bills to get insurance money from the NHIS. The bills were for surgeries performed on a man with a problematic uterus and and on a woman who had hydrocele testis, a condition in which fluids accumulate around testicles.
Over 67,000 ‘smart cards’ were distributed in Kanpur district under the NHIS and 13 hospitals were empanelled by the authorities for providing free treatment to card holders, mostly underprivileged. However, there were severe irregularities reported in this.
“The influx of the patients to private hospitals suddenly registered a sharp rise after the empanelment,” said the officials. Also, a private insurance company allegedly empanelled as many as 52 private hospitals without bringing it to the notice of the health department.
Following receipt of large scale irregularities in the scheme, the health officials were forced to launch an inquiry.
The probe found that a private hospital claimed to have operated upon a man as he had problems with his ‘uterus’ and a woman who suffered from ‘hydrocele testis’. “The hospitals claim that the surgeries were performed, though reality is exactly the opposite...everything is done on paper only,” an official claimed.
According to the officials, this was just part of the many irregularities reported from private hospitals. Surprisingly, all the cover-ups were done just to claim Rs 30,000 provided under the scheme.
Health officials said the erring hospitals would be blacklisted and stern action would be taken against them.