Media claims about dead people taking treatment under PM-JAY not true: Union Health Ministry
New Delhi, Aug 17: Media reports claiming that Ayushman Bharat PM-JAY beneficiaries who are already dead are still on the system getting treatment are misleading, the health ministry said on Thursday.
The ministry also said that mobile numbers have no role in deciding beneficiary eligibility.
The ministry's remarks came in response to media reports that claimed that the Comptroller and Auditor General of India (CAG) has flagged that treatments have been booked for AB PM-JAY beneficiaries who have been declared dead on the system.
The reports also claim that the same beneficiary had been found to avail treatment at two hospitals at the same time. "These media reports are completely misleading and ill-informed," the ministry said.
The CAG report which contains results of the Performance Audit on Ayushman Bharat Pradhan Mantri - Jan Arogya Yojana (AB PM-JAY) covering the period September 2018-March 2021 was placed in parliament in the Monsoon Session of 2023, the ministry said in a statement.
"It is clarified that under AB PM-JAY, hospitals are allowed to initiate requests for pre-authorization up to three days post the date of admission in the hospital. This feature is enabled to avoid denial of treatment in case of limited connectivity, emergency situations, etc," the statement said.
In some cases, the patients were admitted and before their pre-authorisation was raised, they died.
"In such cases, the date of death is the same as the admission date or earlier. Moreover, death has also been reported by the same hospital which raised the pre-authorization request. Thus, had the hospital intended to defraud the system, it would not have shown any interest in declaring the patient dead on the IT system," the statement said.
It is pertinent to note that more than 50 per cent of cases highlighted in the report have been booked by public hospitals, which have no incentive in committing fraud, as the money is reimbursed in the hospital account, it said.
Further, in case of death during treatment, the hospital has to mandatorily submit a mortality report, it said.
There are also many instances where the patients were admitted in the hospital as private patients (self-paid) but when they discovered the scheme, they requested the hospital to register them under the scheme for free treatment, the statement said.
The feature that allows back-dated pre-authorisation helps save people out-of-pocket expenditure.
On the patient getting treatment in two hospitals at the same time, the statement said that under AB PM-JAY, children up to 5 years of age avail treatment on the Ayushman Card of their parents.
Accordingly, Ayushman Cards can simultaneously be used for children and either of parents at two different hospitals, it said.
Usually, mother and child avail treatment using one Ayushman Card only, and if the child dies during treatment, the hospital declares the child dead which erroneously gets registered against the card of the mother, the statement said.
Subsequently, when the mother comes for next treatment, she is denied services on the grounds of her Ayushman Card being marked as 'dead.' In such cases, grievances are raised, and the 'dead flag' against the card of mother is removed, it said.
The government said it has deployed a four-step robust claim processing system under AB PM-JAY with the veracity of the hospital's claims examined at each step, the statement said.
It said defined triggers are run on claims to identify cases which need further examination. Such cases undergo desk and field audits and in case a hospital is found to be committing any fraud or abuse, penal actions including de-empanelment are initiated against the erring hospital.
The CAG finding one mobile number associated with multiple beneficiaries has no operational and financial implications as beneficiary identification process under Ayushman Bharat PM-JAY is not linked with the mobile number, the ministry said.
"The mobile number is captured only for the sake of reaching out to the beneficiaries in case of any need and for collecting feedback regarding the treatment provided," the statement said.
Ayushman Bharat PM-JAY identifies beneficiaries through Aadhaar identification.
"The details fetched from the Aadhaar database are matched with the source database and accordingly, the request for Ayushman card is approved or rejected based on the beneficiary details. Thus, there is no role of mobile numbers in the verification process," the statement said.
The AB PM-JAY caters to a beneficiary base (bottom 40 per cent) where many of them may not possess a mobile number or keep changing it frequently, it said.
Accordingly, the NHA has provided three additional options, i.e. fingerprint, iris scan, and face-authorisation for beneficiary verification along with OTP, of which fingerprint-based authentication is most used.
In view of the above, treatment to the beneficiaries can't be withheld just on the grounds that the beneficiary doesn't carry a valid mobile number, or the mobile number given by them has changed, the statement said.
"Accordingly, beneficiary mobile numbers have a very limited role in the AB PM-JAY treatment workflow. Also, the fact that PM-JAY is an entitlement-based scheme and not an enrolment-based scheme and therefore, the beneficiary database is fixed and cannot be edited to add new beneficiaries.
"Thus, mobile numbers have no role in deciding beneficiary eligibility. Therefore, it is an erroneous presumption that beneficiaries can avail treatment using mobile number," the statement stated.
The ministry also argued that since there was a field that asked for mobile numbers, it is possible that some random ten-digit number was entered by the field level workers in some cases in the earlier stages of the scheme implementation.
The OTP-based validation was not on initially as many beneficiaries either didn't carry the mobile with them or they shared the number of their relative or neighbour.
The ministry in the statement said that the National Health Authority and Ministry of Health and Family Welfare are examining in detail the recommendations of CAG performance audit report and necessary action is being taken to make the system more "robust, efficient and prudent."
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Rupee hits record low of 96.14/USD, settles at fresh closing low of 95.86/USD
Mumbai (PTI): The Indian rupee crashed below the 96/USD mark on Friday before closing at an all-time low of 95.86 (provisional) against the US dollar as elevated crude oil prices and inflation concerns added to the downside pressure on the rupee.
Rupee has registered over 6 per cent losses so far this year, and in the past six trading sessions, it has depreciated nearly 2 per cent as Iran war risk escalation pushed crude oil prices higher. The dollar index moved northwards after strong US retail sales and stable labour market data reduced expectations of aggressive Federal Reserve rate cuts.
Forex traders said global uncertainties, relatively high valuations, and the lack of AI-led investment opportunities have weighed on capital flows.
Moreover, weak net FDI inflows are likely to exert pressure on the balance of payments, while rising crude oil prices stoke inflation worries.
At the interbank foreign exchange, the rupee opened at 95.86, then slumped to a record low of 96.14 in intraday trade, registering a fall of 50 paise from its previous close.
The USD/INR pair finally settled at 95.86 (provisional) against the US dollar, registering a fall of 22 paise from its previous close, helped by likely RBI intervention.
On Thursday, the rupee weakened to a fresh record low of 95.96 before closing with a marginal gain of 2 paise at 95.64 against the US dollar.
Meanwhile, the dollar index, which gauges the greenback's strength against a basket of six currencies, was trading at 99.15, higher by 0.34 per cent.
Brent crude, the global oil benchmark, was trading up 3.14 per cent at USD 109.04 per barrel in futures trade.
On the domestic equity market front, Sensex fell 160.73 points to settle at 75,237.99, while Nifty declined 46.10 points to 23,643.50.
Foreign Institutional Investors turned net buyers, purchasing equities worth Rs 187.46 crore on Thursday, according to exchange data.
Meanwhile, the country's exports in April rose by 13.78 per cent to USD 43.56 billion despite global challenges, Commerce Secretary Rajesh Agrawal said on Friday.
Imports grew 10 per cent year-on-year to USD 71.94 billion in April. The trade deficit during the month stood at USD 28.38 billion.
"We expect the rupee to trade with a negative bias on elevated crude oil prices and inflation concerns. Strong dollar and FII outflows may also weigh on the rupee. However, any intervention by the RBI and hiking of import duty on gold and silver may support the rupee at lower levels. USD-INR spot price is expected to trade in a range of 95.60 to 96.20," said Anuj Choudhary, Research analyst at Mirae Asset ShareKhan.
Chinese President Xi Jinping and his US counterpart Donald Trump on Friday hailed their talks as "historic" and "landmark", as the American leader wrapped up his three-day visit on a high note, but no deals on any contentious issues were announced.
Both Presidents, who held several rounds of talks covering a range of global issues, including the Iran war and bilateral trade frictions, concluded their discussions with a private meeting at Zhongnanhai, the well-guarded compound in Beijing where top leaders reside.
