NEW DELHI, Aug 9: A report by the Comptroller and Auditor General of India (CAG) has flagged data gaps and errors in the “Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana (PMJAY), the central government’s major health scheme.
The report, which was tabled in the Lok Sabha, highlighted that nearly 7.5 lakh beneficiaries were linked to a single phone number under the health scheme. The PMJAY scheme aims to provide a health cover of Rs 5 lakh per family per year for secondary and tertiary care hospitalisation to over 12 crore poor and vulnerable families.
The CAG’s audit report revealed that 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 CAG findings were based on PMJAY’s performance from September 2018 to March 2021. According to the report, there were large numbers of beneficiaries 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, the report pointed out.
“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.
While agreeing with the audit observation, the National Health Authority (NHA) stated that with the deployment of the BIS 2.0, the issue shall be resolved. The health authority further noted 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.
Another issue highlighted in the report is the presence of unrealistic household sizes for registered beneficiaries. The data analysis revealed that 43,197 households had unrealistic family sizes ranging from 11 to 201 members.
As per the report, the presence of such unrealistic members indicated 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 mentioned the inclusion of pensioners in the scheme from states like Chandigarh, Haryana, Himachal Pradesh, Karnataka, Maharashtra, and Tamil Nadu. 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.
(Manas Dasgupta)
