AB-PMJAY guideline violations: Over 2,000 hospitals de-empanelled, 1,200 suspended, says Nadda
Over two thousand hospitals faced de-empanelment for scheme guideline violations. Automated triggers detect suspicious claims within twenty-four hours of submission. Confirmed fraudulent claims are not paid, saving significant funds for the scheme. Ayushman Bharat Health Accounts have seen widespread creation across the nation. Millions of Ayushman cards were created for eligible beneficiaries…
Union Health Minister J P Nadda informed the Lok Sabha on Friday that over 2,000 hospitals have been removed from the Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) and 1,200 others suspended due to guideline violations until May 31 this year. Nadda revealed that 2,359 hospitals were de-empanelled for breaches, 29 First Information Reports (FIRs) were filed, and penalties totaling Rs 328.49 crore were imposed for scheme guideline violations.
The scheme employs a zero-tolerance approach towards fraud, with the National Anti-Fraud Unit under the National Health Authority (NHA) utilizing AI and Machine Learning to detect suspicious claims within 24 hours of submission. These flagged claims undergo examination before payment, and confirmed fraudulent claims are not paid, resulting in savings of Rs 676.14 crore as of July 31, 2026.
Additionally, other punitive actions such as penalties and FIRs are taken against hospitals violating guidelines.
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