CAG flags error in health scheme where 7.5 lakh accounts were linked to 1 number
By MYBRANDBOOK
The Comptroller and Auditor General of India in its report has flagged data gaps and errors in the Ayushman Bharat - Pradhan Mantri Jan Aarogya Yojana (PMJAY). The report tabled in the Lok Sabha on Monday highlighted that nearly 7.5 lakh beneficiaries were linked to a single phone number under the health scheme.
The PMJAY scheme focuses on providing a Rs 5 lakh health cover per family per year for secondary and tertiary care hospitalisation to over 12 crore poor and vulnerable families.
As per the audit report of CAG, a total of 7,49,820 beneficiaries were linked with this particular mobile number - 9999999999 - in the Beneficiary Identification System (BIS) of the scheme.
The findings of CAG were based on PMJAY’s performance from September 2018 to March 2021. The report reveals that a large number of beneficiaries were registered against the same or invalid mobile number.
Around 1,39,300 beneficiaries are linked to the phone number 8888888888, and 96,046 others are linked to the number 9000000000.
“Mobile numbers are significant for searching records related to any beneficiary in the database, who may approach the registration desk without the ID. In case of loss of e-card, identification of the beneficiary may also become difficult,” reads the report.
The National Health Authority (NHA) agreed to the observation and said that the issue will be resolved with the deployment of the BIS 2.0. It also said that the BIS 2.0 system has been configured to ensure that more than a certain number of families cannot use the same mobile number.
Apart from this, another issue that has been highlighted is the presence of unrealistic household sizes for registered beneficiaries. After analysing the data it is revealed that 43,197 households had unrealistic family sizes ranging from 11 to 201 members.
This shows a lack of essential validation controls in the beneficiary registration process. This also indicates the possibility of beneficiaries taking advantage of the lack of clear guidelines, the report said.
The report also highlights that from states like Chandigarh, Haryana, Himachal Pradesh, Karnataka, Maharashtra, and Tamil Nadu, pensioners are included in the scheme. It highlighted delays in identifying and removing ineligible beneficiaries from the scheme, leading to the misuse of resources and excess payments to insurance companies.
“NHA, while accepting the audit observation, replied (August 2022) that it is developing an SOP for adherence by the States to ensure that any SECC 2011 beneficiary family found ineligible as per AB-PMJAY criteria can be removed from the list of eligible individuals/families,” the report suggested.
The CAG report also revealed shortcomings in infrastructure, equipment, and the presence of empanelled hospitals that did not meet the minimum criteria or quality standards prescribed under PMJAY. In some cases, duplicate registrations were made against Aadhaar numbers.
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