National Auditor Identifies Discrepancy: 7.5 Lakh Accounts Linked to a Single Number in Health Scheme

National Auditor Identifies Discrepancy: 7.5 Lakh Accounts Linked to a Single Number in Health Scheme

The findings of the Comptroller and Auditor General of India (CAG) report reveal concerns regarding data integrity and management within the Ayushman Bharat – Pradhan Mantri Jan Aarogya Yojana (PMJAY). Identifying and linking beneficiaries to a single phone number suggest potential errors or irregularities in data collection and management.

The PMJAY scheme is a significant initiative to provide essential healthcare coverage to economically disadvantaged families. The identified issue of nearly 7.5 lakh beneficiaries being linked to a single phone number raises questions about the accuracy of beneficiary records and whether proper verification and validation procedures were followed during enrollment.

Accurate data is crucial for effectively implementing such a healthcare scheme, as it directly impacts the delivery of benefits to the intended recipients. Any errors or gaps in the data can lead to improper allocation of resources, coverage, and services.

The report’s findings emphasize the need for robust data management systems, thorough verification processes, and regular audits to ensure the integrity of beneficiary information under the PMJAY scheme. Addressing these concerns is important to maintain the credibility and effectiveness of the program in delivering healthcare support to vulnerable families across the country.

The fact that a significant number of beneficiaries, specifically 7,49,820 individuals, were linked to a single mobile number (9999999999) in the Beneficiary Identification System (BIS) of the Ayushman Bharat – Pradhan Mantri Jan Aarogya Yojana (PMJAY) raises serious concerns about the accuracy and integrity of the beneficiary data.

Such a situation of multiple beneficiaries being linked to a single mobile number suggests potential errors, data duplication, or manipulation in the system. Accurate and distinct identification of beneficiaries is essential to ensure that the intended beneficiaries receive the healthcare benefits they are entitled to under the PMJAY scheme.

This discovery underscores the need for a comprehensive review of the data management and enrollment processes within the PMJAY scheme. It is crucial to rectify any inaccuracies, errors, or vulnerabilities in the data collection and verification methods to maintain the credibility and effectiveness of the program in providing healthcare support to vulnerable families. It also highlights the importance of strong data governance practices and regular audits to prevent and address such issues in the future.

The revelation that a significant number of beneficiaries were registered under the same or invalid mobile numbers during the period from September 2018 to March 2021, as highlighted by the Comptroller and Auditor General of India (CAG), points to serious flaws in the data collection and registration process of the Ayushman Bharat – Pradhan Mantri Jan Aarogya Yojana (PMJAY).

Each beneficiary’s unique and valid mobile number is crucial for proper identification and record-keeping. It allows for efficient tracking and access to beneficiary information, especially in cases where individuals may have lost their e-cards or IDs. The fact that many beneficiaries were linked to identical or invalid mobile numbers raises concerns about data accuracy, data integrity, and potentially fraudulent activities.

The CAG’s report underscores the necessity for rigorous quality checks and validation mechanisms during beneficiary registration. Addressing the issues highlighted in the report is essential to ensure that the benefits of the PMJAY scheme reach the intended beneficiaries promptly and effectively while also maintaining the transparency and accountability of the program. It highlights the need for ongoing monitoring, data cleansing efforts, and technological improvements to strengthen the scheme’s implementation and prevent future data-related discrepancies.

The National Health Authority’s response indicating the deployment of the Beneficiary Identification System (BIS) 2.0 to address the identified issues in the Ayushman Bharat – Pradhan Mantri Jan Aarogya Yojana (PMJAY) is a positive step toward rectifying the data gaps and errors highlighted by the Comptroller and Auditor General of India (CAG). The implementation of BIS 2.0, which is configured to prevent the excessive use of the same mobile number for multiple families, is expected to enhance the accuracy and reliability of beneficiary records.

Addressing the issue of unrealistic household sizes is also crucial to maintain the scheme’s credibility. Large family size variations could lead to inaccuracies in determining eligibility and allocating benefits. Ensuring that household sizes are realistic and within reasonable ranges is essential to provide equitable and fair access to healthcare benefits for eligible beneficiaries.

The corrective measures introduced by the National Health Authority demonstrate their commitment to improving the functioning and effectiveness of the PMJAY scheme. As the BIS 2.0 system is rolled out and the identified issues are rectified, it is anticipated that the data accuracy and integrity of the scheme will be significantly enhanced, leading to better implementation and outcomes for the beneficiaries.

The identification of unrealistic household sizes and the inclusion of ineligible beneficiaries in the Ayushman Bharat – Pradhan Mantri Jan Aarogya Yojana (PMJAY) scheme, as pointed out in the report, raises concerns about the effectiveness and efficiency of the beneficiary registration and validation process. The lack of essential validation controls and clear guidelines for beneficiary registration might have contributed to such issues, allowing ineligible beneficiaries to take advantage of the system.

Including pensioners and ineligible beneficiaries from multiple states further highlights the need for robust monitoring and verification mechanisms. Delays in identifying and removing such beneficiaries can result in the misuse of valuable resources and excess payments to insurance companies, potentially undermining the intended purpose of the PMJAY scheme.

To ensure the success and impact of PMJAY, the registration process must be thoroughly reviewed and improved to prevent the inclusion of ineligible individuals. Clear guidelines, stringent validation checks, and timely verification procedures should be implemented to minimize the risk of such discrepancies. Additionally, efficient and regular monitoring mechanisms are essential to promptly identify and rectify any instances of misuse or inaccuracies in the beneficiary data.

The report’s findings emphasize the need for continuous improvement and vigilance in implementing social welfare programs like PMJAY to ensure that the benefits reach the intended beneficiaries and are not misused or wasted due to administrative gaps.

The response from the National Health Authority (NHA) to develop a Standard Operating Procedure (SOP) for states to remove ineligible beneficiaries based on AB-PMJAY criteria is a positive step toward addressing the issues highlighted in the CAG report. A well-defined SOP can provide a standardized and systematic approach to identifying and removing ineligible beneficiaries, ensuring that only deserving individuals and families benefit from the scheme.

The shortcomings in infrastructure, equipment, and quality standards of empanelled hospitals raise concerns about the overall effectiveness and delivery of healthcare services under PMJAY. It is crucial for the scheme’s success that the participating hospitals meet the prescribed minimum criteria and quality standards to provide adequate healthcare to beneficiaries. Identifying duplicate registrations against Aadhaar numbers points to the need for stronger data validation and verification processes to prevent such discrepancies.

The CAG report underscores the importance of continuous monitoring, oversight, and improvement in implementing PMJAY. Addressing beneficiary eligibility, infrastructure, hospital empanelment, and data accuracy is essential to ensure the scheme provides affordable healthcare to vulnerable and underprivileged families. Regular audits, stringent quality checks, and effective coordination between central and state authorities are necessary to rectify shortcomings and enhance the overall efficiency of the scheme.