The Maharashtra government has identified 15,407 suspicious health insurance claims under Ayushman Bharat–Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) and Mahatma Jyotirao Phule Jan Arogya Yojana (MJPJAY) during a preliminary review, leading to the formation of a Special Investigation Team (SIT) to probe the matter. According to a Government Resolution issued on August 6, the flagged claims pertain to the period between 2024 and 2026. Initial instructions had been issued to district civil surgeons and district health officers to carry out physical verification of beneficiaries across all cases.
However, after a subsequent review, authorities determined that the irregularities could be widespread and involve multiple districts, necessitating a dedicated investigation. The SIT will examine hospital-level irregularities, including fake or medically unnecessary claims, inflated procedures,…
