Hyderabad: Vigilance and enforcement has unearthed health fraud by private referral hospitals across the state where the hospitals are charging more than the CGHS rates for government employees, pensioners, MLAs and ex-MLAs, causing huge loss to the exchequer.
The investigation by the vigilance department also found that most hospitals are avoiding free treatment for BPL families.
Free services have to be provided to five per cent of total inpatients and 10 per cent of outpatients, and to students of social welfare hostels.
In a major irregularity and manipulation some of the hospitals have created records to show that they provided free treatment to white card holders. However, they have claimed the same bills under Arogyasri scheme and other insurance.
Out of 827 hospitals in the state, 69 were checked at random, and all of them were found to be erring.
In Hyderabad, all top hospitals are on the violators list and the vigilance department has asked the state medical and family welfare department to recover excess charges and levy penalty
When contacted, vigilance and enforcement director R.P. Thakur confirmed the report on irregularities by the private referral hospitals and said it has been submitted to the state government. Checks were conducted in Hyderabad, Visakhapatnam, Vijayawada and all other cities and towns of the state.
Out of 39 patients checked at random in all city hospitals, the loss suffered by the government is Rs 81.53 lakh.
The report said, “Very drastic and adverse excess bill amounts have been charged by the referral hospital as against the package rate or CGHS rate. The very purpose of MOU entered between government and hospitals to streamline the performance of referral hospitals has failed... Spirit of government to extend welfare measures to BPL families and students failed.”
The president of AP Super specialty Hospitals Association Dr B. Bhaskar Rao, said, “There are discrepancies as pointed out by the vigilance department. Government needs to look into this to save the health industry. Government has been putting all kinds of taxes, including luxury tax, service tax, power charges under commercial category, branding hospitals as commercial establishments. There are no incentives like land or power given to hospitals. We have taken huge bank loans and to sustain we need to run the hospitals very carefully.”
The report observed that the hospitals are not conducting free health camps in the villages adopted by them. It also rapped director of medical education for not conducting audits and checks and for non-implementation of GO 162, which makes free treatment up to certain per cent of patients mandatory.
