State Agency for Comprehensive Health Insurance Scheme (SACHIS) has initiated action against 16 hospitals after instances of negligence were found.
Event Context
SACHIS, which monitors implementation of Ayushman Bharat Pradhan Mantri Jan Arogya Yojana, conducted surprise inspections at 20 hospitals in Bijnor.
Team Analysis
SACHIS CEO Archana Verma stated, “The objective of the inspection was to ensure that all hospitals empanelled under the scheme were fully complying with the guidelines prescribed. A three-member special team conducted surprise inspections at 20 different empanelled hospitals in Bijnor without prior notice. During the inspection, the team thoroughly examined the healthcare services being provided to patients, treatment procedures, documents, records, claim processes and other necessary arrangements.”
The investigation found that several hospitals were not fully complying with the prescribed standards of the scheme. Deficiencies in adherence to the Standard Treatment Guidelines as well as shortcomings related to quality standards were found at several locations.
“Non-compliance with the prescribed guidelines was detected in 16 hospitals. Of these, 6 hospitals have been issued suspension notices and orders have been passed to withhold their payments, while 10 hospitals have been served notices for irregularities,” said Verma.
Match Outlook
The penalties will now be calculated, and a penalty amounting to 10 times the applicable amount will be imposed. Irregularities found at these hospitals included repeatedly admitting patients from the same family, booking ICU beds without necessity, and similar practices. Notices have also been issued to the audit agency, while the District Programme Coordinator has been served a show cause notice.
Verma stated, “If any hospital ignores the prescribed standards or shows negligence in providing quality treatment to beneficiaries, strict action will be taken against it in accordance with the rules.”
She added, the department’s objective is to ensure that every eligible beneficiary under the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana receives transparent, standards-based and high-quality healthcare services in a timely manner so that chief minister Yogi Adityanath’s vision of a healthy and empowered Uttar Pradesh can be effectively realised.
