Officials crack down on 203 network hospitals for various irregularities

Over 200 hospitals in Andhra Pradesh, participating in the Dr. NTR Vaidya Seva scheme, have faced scrutiny by health authorities for irregularities in patient care over the past two years. The NTR Vaidya Seva Trust has imposed fines amounting to ₹34.39 crore on 203 hospitals and initiated disciplinary actions against 44 hospitals.

These penalties include 25 suspensions, 13 payment stoppages, the removal of five hospitals from the network, and the cancellation of recognition for one hospital. Some hospitals were found charging for treatments that should be free for beneficiaries under the scheme, while others denied cashless treatment to eligible patients and delayed necessary medical procedures. Failures to adhere to prescribed protocols and neglect patient care were also among the grievances.

The Trust conducted investigations into these complaints and took appropriate disciplinary actions against the hospitals found to be in violation. Dr. Padmavathi, CEO of the NTR Vaidya Seva Trust, presented a report on these measures to Minister for Health, Medical and Family Welfare Satya Kumar Yadav. To uncover irregularities, officials scrutinize hospital bills and pre-authorisation requests, identifying unusual patterns, excessive treatment package usage, and suspicious transactions.

The process also detects duplicate billing, alterations to medical records, and misuse of the scheme. To expedite the verification process, the Trust is employing AI-based systems for bill checks, ensuring consistent audits, and swiftly resolving pending bills. However, suspicious AI-flagged bills do not automatically lead to disciplinary action.

Instead, final decisions on disciplinary measures are made after thorough investigations by district and state officers, who examine medical records and gather sufficient evidence.