Parliament Question: Fake Claims under Ayushman Bharat Scheme

GOVERNMENTOFINDIA MINISTRYOFHEALTH AND FAMILYWELFARE DEPARTMENTOFHEALTH ANDFAMILYWELFARE LOK SABHA UNSTARREDQUESTION NO. 1011 TOBE ANSWERED ON05TH DECEMBER, 2025 FAKECLAIMS UNDER AYUSHMAN BHARATSCHEME

1011. SMT.MALAROY:

Will the Minister of HEALTHAND FAMILYWELFAREbe pleased tostate:

(a) whether the Government has any data with regard tocases of fake claim under Ayushman Bharat Mission inthe country;

(b) if so, the details of totalamount of such fraud cases during the last three years, State-wise andyear-wise;and

(c)the steps takenbythe Government topreventsuch kindof fraudsinfuture? ANSWER THE MINISTER OFSTATEIN THE MINISTRYOFHEALTHAND FAMILYWELFARE

(SHRIPRATAPRAOJADHAV)

(a) to (c): Ayushman Bharat - Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) is governed on a zero-tolerance approach towards fraud. Advanced AI/ML-based analytics are used to proactively monitor fraud transactions. Various steps are taken for prevention, detection and deterrence of different kind of frauds that could occur in the scheme at different stages of its implementation. National Anti-Fraud Unit has been established at National Health Authority which works in close coordination with State Anti-Fraud Units to investigate and take action onissues relatedtofraud.

Appropriate action like suspension, show cause notice, warning letter, de-empanelment of hospitals, de-activation of e-cards, levying penalty on errant hospitals and lodging of FIRs, are takenagainst fraudulent entities.

*****