On the initiative of Chief Minister Shri Bhajanlal Sharma, major corrective steps are being taken to strengthen the Rajasthan Government Health Scheme (RGHS) so beneficiaries receive easy access to quality healthcare. In the last three months alone, the Medical Department has suspended 34 hospitals and 431 pharma stores for irregularities and misuse of the scheme. Furthermore, 28 government employees were also suspended for involvement in fraudulent activities, and 17 FIRs have been registered.
Health Minister Shri Gajendra Singh Khimsar stated that several complaints were received regarding irregularities by hospitals, pharma stores, and some government staff, which affected the scheme’s smooth functioning. A special audit and detailed investigation were conducted, and strict action has been taken against those found guilty. An Anti-Fraud Cell has also been established to prevent future violations, and a new SOP will be issued soon.
Double Claims for Single Surgery, Unnecessary Tests Highlighted
Principal Secretary (Medical & Health) Smt. Gayatri Rathore informed that in the past three months, strict monitoring was done to ensure smooth operations and protect the state exchequer. During this period, several cases of irregular, unauthorized, and unethical claims were detected involving approved pharma stores, private hospitals, and some beneficiaries under RGHS.
Violations included:
Raising double claims for the same surgery
Advising unnecessary diagnostic tests
Claiming high-value packages for tests available at lower rates
As a result, 34 hospitals were suspended, and penalties amounting to ₹36 crore have been recovered from them.
False Billing & Collusion Among Doctors, Pharmacists, and Beneficiaries
Similarly, in the last three months, 431 pharma stores were suspended for:
Not providing medicines
Not issuing bills
Submitting irregular or inflated bills
Collusion between pharmacists, beneficiaries, and doctors to misuse the scheme
Penalties worth ₹4.64 crore have been recovered from these pharma stores.
Additionally:
Over 1,000 RGHS cards used for fraudulent claims have been blocked
28 government employees have been suspended
Policy Reforms for Stronger Implementation
CEO, Rajasthan State Health Assurance Agency, Shri Harji Lal Attal, stated that comprehensive policy reforms and wide-scale systemic improvements are underway to make the scheme more robust. Technological upgrades are also being implemented to eliminate the scope of fraud.
He added that the primary objective is to ensure that all stakeholders receive rightful benefits under the scheme while maintaining strict vigilance against misuse.
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