• UGI USER
  • Aug 03, 2024
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ED SEIZES DOCUMENTS IN FAKE AYUSHMAN CARDS CASE

Why in the news?

  • The Enforcement Directorate (ED) seized documents related to suspicious transactions worth ₹21 crore for 23,000 patients.
  • Searches conducted on July 31 at 20 locations in Delhi, Chandigarh, Punjab, and Himachal Pradesh (Kangra, Una, Shimla, Mandi, and Kullu).
source:scribd

Background and FIR:

  • The investigation is based on an FIR by the State Vigilance & Anti-Corruption Bureau in Himachal Pradesh’s Una.
  • The case involves the alleged generation of fake Ayushman Bharat Pradhan Mantri Jan Arogya Yojana cards.

Findings and Fake Claims:

  • 373 fake Ayushman cards identified, with claims of about ₹40.68 lakh for non-existent treatments.
  • Hospitals made false claims for treatments, surgeries, and admissions that were never provided.
About Enforcement Directorate (ED):

  • Specialised financial law enforcement and economic intelligence agency in India.
  • Functions under the Department of Revenue, Ministry of Finance.
  • Enforces economic laws and combats money laundering and foreign exchange violations.

Organisational Structure:

  • Headquarters: New Delhi, headed by the Director.
  • Regional Offices: Mumbai, Chennai, Chandigarh, Kolkata, Delhi (headed by Special Directors).
  • Zonal Offices: 27 in cities like Mumbai, Hyderabad, Gurugram (headed by Joint Directors).
  • Sub Zonal Offices: 12-13 in cities like Mangalore, Allahabad, Indore (headed by Deputy Directors).
  • Composition:
  • Director, Special Directors, Joint Directors, Deputy Directors, and other investigative officers.

About Ayushman Bharat-PMJAY:

  • World’s largest government-funded health insurance scheme.
  • Launched:in 2018, provides ₹5 lakh per family for secondary and tertiary care.
  • Covers surgery, medical treatments, medicines, diagnostics.
  • Targets beneficiaries identified by SECC data.
  • Funded 60:40 (states), 90:10 (Northeast, J&K, Himachal, Uttarakhand), 100% (UTs without legislature).
  • National Health Authority (NHA) and State Health Agency  (SHA) implement the scheme.

Associated Article:

https://universalinstitutions.com/does-pmjay-need-a-design-change/#:~:text=Ayushman%20Bharat%2DPMJAY-,Overview%3A,for%20secondary%20and%20tertiary%20care