Fake Ayushman Bharat claims cleared

Lucknow: In a suspected digital fraud in public health insurance system, irregular payments worth Rs 9.94 crore were detected under the Ayushman Bharat Scheme, leading to an FIR at the cyber cell police station on Wednesday.The State Agency for Comprehensive Health and Integrated Services (SACHIS), which implements Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) and the Chief Minister Jan Arogya Abhiyan in the state, lodged a complaint with the cyber cell after uncovering largescale anomalies in claim payments of 39 hospitals processed through the National Health Authority (NHA) portal.
According to officials, as many as 6,239 claims linked to 39 empaneled hospitals were irregularly processed, leading to suspected fraudulent disbursal of Rs 9.94 crore from May 1-22, 2025. The irregularities came to light during routine financial scrutiny when unusually high and disproportionate payments were flagged.Under the scheme's protocol, hospitals upload treatment claims on NHA portal, which are first verified by an Implementation Support Agency (ISA), then examined by SACHIS medical auditors, followed by financial vetting and final approval through the CEO's login before direct bank transfer.However, officials said the disputed claims were neither processed nor recommended by ISA and authorised by the accounts officer or CEO through legitimate logins.Technical analysis revealed that multiple official user IDs were allegedly misused. Many suspicious transactions were processed during late night hours, raising serious concerns about credential hacking or internal compromise.On average, 4,000-5,000 claims are cleared daily under the scheme in Uttar Pradesh, making the alleged breach alarming.SACHIS termed the matter a "serious case of digital fraud and embezzlement of govt funds" and sought stringent legal action under relevant penal and cyber laws."The cyber cell will conduct a forensic audit of server logs, IP addresses, and banking trails to identify those responsible," said DCP, crime, Kamlesh Dixit.‘Aadhaar-linked phones tampered, Ayushman portals breachedLucknow: Officials implementing Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) in Uttar Pradesh have filed an FIR after detecting unauthorised changes in Aadhaar-linked mobile numbers of key personnel and alleged misuse of official portals.The complaint, submitted by SACHIS, said that over the past month, mobile numbers linked to the Aadhaar credentials of several officers and employees were altered without their knowledge or consent. The changed numbers were allegedly used to receive OTPs and gain unauthorised access to portals operated by the National Health Authority (NHA).Officials suspected that the manipulation was carried out either through unauthorised access to the Aadhaar authentication system or by using forged documents and fake identities.The issue surfaced prominently after Shivam Pathak of a Lucknow-based NGO wrote to the state CEO, flagging alleged irregular Ayushman card generation.SACHIS informed the UIDAI regional office in Gomtinagar and escalated the matter to UIDAI headquarters and NHA. Suspicious IDs were moved to a "suspicious bucket" to block further misuse, and IP address mapping was initiated to trace unauthorised logins.