Mumbai: Maharashtra Chief Minister Devendra Fadnavis on Friday announced the formation of a Special Investigation Team (SIT) to probe alleged irregularities in Mahatma Jyotirao Phule Jan Arogya Yojana in Nashik district and asserted the guilty would face strict action and misappropriated funds would be recovered.
The announcement was made at a review meeting of the integrated Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana and Mahatma Jyotirao Phule Jan Arogya Yojana held in the state legislature, an official release said.
Fadnavis said the SIT would be headed by Nashik Divisional Commissioner Praveen Gedam and comprise experts from various departments to conduct a comprehensive probe into the alleged fraud.
Scrutiny carried out by the State Health Assurance Society for the 2024-26 period had identified around 16,000 suspicious insurance claims and surgeries across the state, of which nearly 9,500 were linked to Nashik district, the CM informed.
The empanelment of five hospitals in the district has already been cancelled in connection with the alleged irregularities, he added.
“The SIT will conduct a thorough investigation. After its report is submitted, strict action will be taken against those responsible and the misappropriated funds will be recovered,” the CM said.
Fadnavis said nearly 1.3 million potentially fraudulent cases would be screened using advanced analytics, with artificial intelligence and data analytics playing a key role in identifying suspicious claims.
Maharashtra Cyber Police would also be involved in tackling cyber-related fraud under the health schemes, he said.
He said the government would carry out special audits of high-value treatment claims, forensic audits of flagged cases and independent verification of suspicious transactions.
“A dedicated fraud prevention mechanism would also be established in every district and linked to a real-time monitoring dashboard to detect and act against irregularities promptly,” Fadnavis said.
Ensuring transparent and quality healthcare for poor and needy citizens was the government’s priority, he said while stressing that no malpractice in public health insurance schemes would be tolerated.
