The Comptroller and Auditor General of India (CAG) published a report in the Lok Sabha on Monday, identifying the issues related to the Ayushman Bharat – Pradhan Mantri Jan Aarogya Yojana (PMJAY). It revealed data gaps and errors, where 7.5 lakh beneficiaries were connected with just one phone number within the health scheme. The main objective of the PMJAY is to offer a health coverage worth Rs.5 lakh annually per family, relating to secondary and tertiary hospital care expenses. This program targeted more than 12 crore economically disadvantaged and unprivileged households.
As per the CAG audit report, it was discovered that a grand total of 7,49,820 beneficiaries were associated with the one specific mobile number – 9999999999 – in the Beneficiary Identification System (BIS) of the PMJAY scheme. The findings from the CAG were derived from PMJAY’s performance assessment during the period from September 2018 to March 2021. The report highlights the existence of considerable instances where beneficiaries were registered with identical or incorrect mobile numbers.
Nearly 1,39,300 beneficiaries are connected with the phone number 8888888888, while an additional 96,046 beneficiaries are connected to the number 9000000000. “The report spotlights the importance of mobile numbers for locating records concerning beneficiaries within the database and becomes relevant when people approach the registration desk without their identification. Additionally, in situations where the e-card is lost, identifying the beneficiary becomes challenging”, said the report.
The National Health Authority (NHA) , while accepting the findings of the report, indicated that with the implementation of the BIS 2.0, the issue shall be sorted out. The health authority additionally pointed out that the BIS 2.0 system has been designed with an intention to prevent a certain number of families from using the same mobile number.
The report highlighted another issue highlighting the presence of impractical household sizes for the registered beneficiaries. The analysis revealed that around 43,197 families had doubtful family sizes covering 11 to 201 members and this unrealistic data indicates that there is absence of few necessary verification controls in the registration process.The report also suggested that the beneficiaries have exploited the absence of well-defined guidelines.
After refining the socio-economic caste census (SECC) data, there were instances of two registrations which were made against 18 Aadhaar numbers in 36 cases. In Tamil Nadu, there were 4,761 registrations against seven Aadhaar numbers. In the span from 2018 to 2021, the state health authorities (SHAs) of Jammu & Kashmir (J&K) and Ladakh identified 16,865 and 335 ineligible beneficiaries, respectively.
The report included the details of pensioners in the scheme from states like Himachal Pradesh, Karnataka, Maharashtra, Chandigarh, Haryana, and Tamil Nadu. It highlights the delay in identifying and eliminating people who are not eligible under this program, resulting in misuse of resources and excessive payments to insurance companies. The CAG report also unveiled the deficiencies in infrastructure, equipment and the existence of authorized hospitals that didn’t meet the minimum criteria or quality standards prescribed under PMJAY. In some situations, it was observed that registrations were replicated using the Aadhaar numbers.
