CBI books two Kanpur hospitals for CGHS bill irregularities

New Delhi, Oct 8 (PTI) The Central Bureau of Investigation (CBI) has booked two hospitals in Kanpur for alleged irregularities in the CGHS billing and payments with bills raised for patients who were never admitted there, officials said on Wednesday.

The agency has booked Rajni Hospital and Taurus Hospital in Kanpur after an enquiry report by the CGHS Directorate showed gross irregularities, lack of proper infrastructure and violation of empanelment criteria.

The Central Government Health Scheme (CGHS) provides for subsidised treatment for serving and retired employees of Central government and some autonomous organisations for which hospitals, including empanelled private ones, are compensated by the government.

The CGHS directorate had constituted enquiry committee which cited grossly inadequate infrastructure, lack of basic medical facilities and critical equipment in Rajni Hospital which was running without meeting basic health care standards, violating empanelment criteria yet continued to submit high-value claims, which were processed and paid without sufficient scrutiny.

"The investigating committee examined the National Health Authority records which reveals that Rajni Hospital, Kanpur has raised a claim of total of Rs 39.34 crore, of which Rs 27 crore has already been paid since June, 2021 from CGHS, Kanpur," the report, which became the basis for the FIR, alleged.

The sample bill review by a hospital monitoring committee detected fake claims submitted on behalf of 25 CGHS beneficiaries who denied ever getting treated in Rajni Hospital whereas they were shown admitted 66 times with fake treatment bills of over Rs 79.42 lakh were paid to the hospital by CGHS, Kanpur, it alleged.

With regards to Taurus Hospital, the report red-flagged "questionable billing practices with a sudden and dramatic increase in medical claims" after change in its ownership.

"As per the enquiry report, Tarus Hospital has been paid over Rs 1.24 crore during 2024-25 in respect of the medical claims of different CGHS Beneficiaries," the FIR said. PTI ABS ABS NB NB