AI to probe irregularities, misuse in RGHS: Fin secy

Jaipur: Finance secretary (expenditure) Naveen Jain said Friday that AI technology and experts would be used to investigate irregularities and misuse in the Rajasthan Govt Health Scheme (RGHS) and conduct an in-depth analysis of the claims under the scheme. Due to serious irregularities in RGHS, action was taken against some hospitals, diagnostic centres, and pharma stores in the state.
The guilty hospitals were de-empanelled. Penalties and interest were recovered on false claims, and in the case of govt employees, card suspension and penalty recovery were implemented.
Jain said due to shortcomings and complaints in the implementation of the RGHS, several hospitals, diagnostic centres, and pharma stores are under investigation. "Hospitals, pharmacy stores, employees, and pensioners not under investigation will continue to receive all benefits of RGHS as before. If there are any issues, complaints can be registered on the department's helpline 181 or portal," he said.
Jain added that requiring photos in IPD and OPD has brought transparency. "Soon, after receiving permission from the central govt, a biometric system like the Ayushman scheme will be implemented in the RGHS scheme," he said.
Jain emphasised that since the scheme is cashless, beneficiaries must remain vigilant to prevent misuse in their names. Advising beneficiaries to be cautious, he said that when RGHS OTP is requested by private hospitals or pharmacy stores, they should ensure it is given to an authorised person. "If false claims are made using the OTP received for treatment or medicine, it should be reported immediately. Beneficiaries should also ensure they are not unnecessarily admitted to IPD, prescribed unnecessary medicines or tests, and that surgeries are not started without proper test results," said Jain.
He said there were incidents of claims being submitted for amounts much higher than the original amount. "Therefore, it is the responsibility of all beneficiaries not to misuse or allow misuse of their RGHS card, OTP, and OPD wallet facilities," said Jain. TNN