Synopsis
Prataprao Jadhav highlights how Aadhaar authentication and AI technology are combating misuse in the AB-PMJAY scheme. With a zero-tolerance policy, the NHA takes significant steps to ensure integrity, including de-empaneling hospitals, imposing penalties, and establishing a robust grievance redressal system for beneficiaries.Key Takeaways
- Aadhaar authentication and AI are crucial in preventing AB-PMJAY misuse.
- Over 1,100 hospitals have been de-empanelled due to irregularities.
- NHA employs advanced technology for fraud detection.
- A three-tier grievance redressal system is in place for beneficiaries.
- Physical verification of hospitals is mandatory for empanelment.
New Delhi, Feb 4 (NationPress) Aadhaar authentication and Artificial Intelligence-based technology are effectively curbing the misuse of the Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana (AB-PMJAY), stated Prataprao Jadhav, Union Minister of State for Health and Family Welfare, on Tuesday.
“The National Health Authority (NHA) has implemented a zero-tolerance policy towards misuse and is actively engaged in prevention, detection, and deterrence of various irregularities that may arise during the implementation of AB-PMJAY,” Jadhav detailed in a written reply in the Rajya Sabha.
“To date, 1,114 hospitals have been de-empanelled, while 549 have faced suspension under AB-PMJAY, with penalties totaling Rs 122 crore imposed on over 1,504 hospitals,” he noted.
Jadhav emphasized that in order to eliminate ineligible beneficiaries from the scheme, AB-PMJAY beneficiaries undergo Aadhaar e-KYC verification during the card creation process. Furthermore, beneficiaries are required to perform Aadhaar authentication when accessing services, which confirms the identity of eligible beneficiaries.
“The NHA employs artificial intelligence technologies to identify potential misuse within AB-PMJAY. The technologies utilized include rule-based triggers, machine learning algorithms, fuzzy logic, image classification, and de-duplication,” Jadhav explained.
Upon establishing misuse through desk audits and field investigations, appropriate actions are implemented. This may involve disabling Ayushman Cards, imposing penalties, recovering funds, or initiating legal proceedings against the violating entity.
This approach effectively prevents any leakage or wastage of public funds. Additionally, Jadhav pointed out that AB-PMJAY requires a physical verification of hospitals during the empanelment process. According to empanelment guidelines, public hospitals that provide inpatient services are automatically deemed empanelled.
The NHA has also introduced an enhanced version of the Hospital Engagement Module (HEM 2.0), which mandates physical verification for private hospitals. This includes the submission of original photographs and latitude-longitude details of the hospital, along with the physical verifier to confirm that the visit occurred,” the Minister stated, adding that HEM 2.0 has incorporated features for periodic reviews to maintain the accuracy of hospital information.
In cases where services under the scheme are not delivered by the empanelled hospital, beneficiaries are encouraged to file grievances. Under AB-PMJAY, a three-tier grievance redressal system has been established at the District, State, and National levels to address the issues encountered by beneficiaries in accessing healthcare services.
Each level includes a dedicated nodal officer and Grievance Redressal Committees to resolve grievances.
Beneficiaries can also submit their grievances through various channels, including the web-based portal Centralised Grievance Redressal Management System (CGRMS), Central and State call centers, email, and letters to State Health Authorities (SHAs).
