Rajasthan suspends 7 doctors over RGHS audit irregularities; FIRs ordered against hospital, diagnostic centre

Jaipur: The Rajasthan govt Friday suspended seven doctors for alleged irregularities under the Rajasthan Government Health Scheme (RGHS) and initiated steps to register FIRs against a private hospital and a diagnostic centre for misusing the scheme.Principal secretary (Health) Gayatri Rathore said the state is taking continuous measures to ensure smooth operation of RGHS. She said that an audit in Sikar district found irregularities, following which seven doctors were suspended.
The suspended doctors include Dr Kamal Kumar Agarwal and Dr Sunil Kumar Dhaka, associate professors in the orthopedics dept, and Dr Mukesh Verma, associate professor in the general medicine department at Medical College, Sikar. Also suspended are Dr Rakesh Kumar of CHC Kirwa, and Dr Gajraj Singh, Dr S.S. Rathore, and Dr Sunil Sharma of SK Hospital.Rathore said FIRs are being registered against Bharatpur Nursing Home in Bharatpur and Bothra Diagnostic and Imaging Center in Bikaner. Letters have been sent to the chief medical and health officers of the concerned districts regarding the action.RGHS chief executive officer Harjilal Atal said an investigation report found that Kashish Pharmacy and Bharatpur Nursing Home in Bharatpur allegedly caused significant loss to the state exchequer through collusion and fraud. According to the investigation, Dr Sangeeta Agarwal, despite the hospital not being previously approved under RGHS, allegedly displayed an RGHS board and attracted beneficiaries. The report states that RGHS cardholders were treated at the hospital, their SSO ID passwords were taken to generate TIDs, and after treatment, tests and medicines were allegedly adjusted on the RGHS portal through Kashish Pharmacy to obtain payments. The probe also alleged that fake bills were prepared in beneficiaries' names to get claims approved. The hospital has already been de-empanelled from the RGHS scheme, and FIR action is now being pursued.Atal said scrutiny of claims submitted by Dr Bothra Diagnostic and Imaging Center, Bikaner, found cases where patients were allegedly prescribed more tests than necessary and irregularities were detected in test reports. Some patients' records displayed tests like HbA1c, RA Factor, and Procalcitonin without clear medical justification. In some cases, HbA1c reports for T2DM were not available, and related consultations were not mentioned on OPD slips.Given the seriousness, documents were verified by senior doctors at PBM Government Hospital, Bikaner. Statements indicated that several prescriptions bearing doctors' names and seals had signatures and handwriting they did not acknowledge. Some doctors said they were on leave or not in OPD on the relevant dates, yet prescriptions and tests were shown in their names. The investigation also found instances where doctors named on prescriptions were not posted at PBM Hospital at the time, or their registrations were from a later date.