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CAG red flags lapses in Ayushman Bharat scheme

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August 9: There are multiple instances of one Aadhaar number being linked across multiple beneficiaries of the Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana; while three phone numbers are repeated in case of 10,00,000-odd beneficiaries, the Comptroller and Auditor General of India (CAG) has said in its audit findings.

The audit covered the period from September 2018 to March 2021 and was tabled in Parliament on Tuesday. The Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana aims to provide health cover of ₹5 lakh per family per year for secondary and tertiary care hospitalisation to the poor and vulnerable population.

The report mentions that in Tamil Nadu there are seven Aadhaar numbers — such as ‘000000000000’, ‘784545xxxxxx’, ‘21547xxxxxxxx’, ‘2222xxxxxxxx’, ‘3265987xxxxx’, ‘2154785xxxxx’ — which are mentioned multiple times against beneficiary names.

“Successful generation of multiple e-cards (PMJAY ID) against same/erroneous Aadhaar number indicates lack of essential validation controls resulting in the presence of duplicate beneficiaries in the system,” the CAG noted.

Regarding the errors in linking Aadhaar in Tamil Nadu, the National Health Authority (NHA) said that the State is using its own IT platform (and database) for beneficiary identification. And the State government has been asked to migrate to the Aadhaar-based BIS platform of NHA to strengthen beneficiary verification protocols.

Same Mobile Number Being Used

The CAG findings shows that there are 7,50,000 beneficiaries under the scheme who are linked to the same mobile number ‘9999999999’; another 1,40,000-odd linked to the mobile number ‘8888888888’ and 96,000-odd to the number ‘9000000000’.

It was noted that this repetition of mobile numbers occurs multiple times and across the national database. For instance, 20 mobile numbers are linked across 10,000 – 50,000 beneficiaries, over 1,85,000 cell phone numbers are repeated across 11 – 1,000 names, and so on.

“Data analysis of BIS database revealed that there were large number of beneficiaries registered against the same or invalid mobile number. Overall 1,119 to 7,49,820 beneficiaries were linked with a single mobile number,” the report noted adding that: “ In case of loss of e-card, identification of the beneficiary may also become difficult. This may result in denial of scheme benefits to eligible beneficiaries…”

In its response, the NHA mentioned about the deployment of a new system — the BIS 2.0. This has been configured to arrest the prevalence of entering “random numbers” which are major cause of this inconsistency.

Audit reports also found that ineligible households that registered as PMJAY beneficiaries had availed benefits ranging from ₹ 12,000-₹22.44 crore under the scheme.

The report observed that excess payment of ₹57.53 crore was made to the empanelled health care providers; Payments were also made in cases of death without obtaining death summary from the State health authorities (SHA) and without receiving the mortality audit reports.

The NHA has released grants of ₹185.60 crore to eight States without ensuring release of upfront shares by the respective States during 2018-19. Also seven SHA diverted ₹50.61 crore from one head to another. Over ₹458 crore was recoverable from the insurance companies in six States/UTs. Interestingly, West Bengal withdrew from PMJAY in January 2019 but did not refund ₹31.28 crore to NHA.

As per NHA records, 7.87 crore beneficiary households are registered, constituting 73 per cent of the targeted households of 10.74 crore (till November 2022).





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